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opinion

Phil Emberley is the director of professional affairs for the Canadian Pharmacists Association (CPhA). He has been a practising pharmacist for almost 30 years.

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Suppose you take three medications for three different conditions. Now, add medical marijuana. Wouldn't you want to know possible risks and interactions?

That's why the Canadian Pharmacists Association (CPhA) recently recommended that pharmacists play a front-line role in patient management and dispensing of medical marijuana.

More patients are choosing medical marijuana as a treatment. As it stands today, many may be at risk by not receiving the same counsel and oversight provided for other drugs. For many patients, medical marijuana is a third or fourth line treatment, and these patients are often on a number of other medications. The potential for drug interactions increases and the need for pharmacist oversight becomes even more important.

As an association, our decision to update our policy position was not taken lightly. We remain concerned with the lack of robust clinical evidence needed to develop appropriate therapeutic guidelines for medical marijuana and to fully integrate it into existing drug schedules.

We represent thousands of pharmacists across Canada – all playing a critical role in the health and safety of Canadians. CPhA's decision is about safety and responding to the need for appropriate oversight by health care professionals. CPhA consulted its membership and Canadians, and commissioned independent third party research on how best to enhance patient safety with respect to medical marijuana.

We followed the evolving political and social landscape, and the pressures associated with the gap between legal access to medical marijuana and illegal, unregulated access. All roads pointed in the same direction, leading CPhA to take a stand on the issue and respond responsibly to the evolving needs of Canadians.

In a national survey by Abacus Data, 73 per cent of Canadians surveyed agreed that medical marijuana should be treated like other medicines and available only through a pharmacy; and 77 per cent agreed that patient safety and oversight would improve if medical marijuana was available through a pharmacy.

Furthermore, it has been reported that only 8 per cent of Canadians using marijuana for medical purposes obtain it through legal channels. This means the majority of those using medical marijuana are either growing it at home or, more likely, obtaining it from illicit market, where quality and safety measures are unclear. We are deeply concerned about the proliferation of these so-called medical marijuana dispensaries that are illegally providing health care advice to thousands of Canadians – this cannot be allowed to continue.

As experts in medication management, pharmacists have a vast network of existing infrastructure. We work with controlled substances daily and have a proven ability to secure the supply chain ensuring the safety and security of the products we dispense.

We're acutely aware of the unintended consequences of medication, potential harms inherent with this product and others that Canadians may be using as part of their drug therapy regime.

We provide an unbiased perspective and act in the best interest of patients. We serve as their most accessible point of contact with the health care system – before and after they've met with their doctors.

Equipped to ask and answer questions, we are natural partners in a patient-focused framework for dispensing and managing medical marijuana. The involvement of pharmacy enables the government and health care professional to better understand and gather evidence on the clinical effectiveness of medical marijuana which is vital to informing the development of clinical guidelines and refining Canada's longer-term medical marijuana policy.

It is essential that prescribed therapeutic products, presenting the possibility of drug interaction and other risks, are managed by regulated professionals. Patient safety should be the primary consideration and, as such, pharmacists must play a front-line role in ensuring the safe and effective use of medical marijuana.

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