Medical Cannabis: Are Pharmacy Students Prepared?

By: Jessica Dotson, PharmD/MBA Student

Once overwhelmingly opposed by the majority of Americans, cannabis has since gained major popularity over the last decade. A 2019 Pew Research Center survey found that 67 percent of Americans say the use of cannabis should be legal.¹ Though still illegal under federal law, medical cannabis (MC) is now legal in 36 U.S. states and the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands. Furthermore, an additional 11 states have approved the use of “low THC, high cannabidiol (CBD)” products in limited situations for medical purposes.² Other countries, such as Canada, have implemented legislation that makes the use of cannabis legal for both recreational and medicinal purposes.³ As pharmacists, we are the most knowledgeable and qualified health professionals to counsel patients on MC and its possible interactions with other medications. Right? 

Currently, this statement is debatable because education on MC in pharmacy school curriculum is significantly lacking. A recent survey of student pharmacists found that more than 86 percent were uncomfortable counseling patients on MC drug interactions.⁴ These results very much align with what we found in our preliminary survey research of the pharmacy students attending our school. 

Though these results may seem bleak, there are some pharmacy schools that have begun to incorporate it. According to a 2019 survey of all the U.S. pharmacy schools, 62 percent of the 68 schools who responded stated they have incorporated MC in their curricula.⁵ Though this is encouraging, our survey findings indicate student pharmacists still feel unprepared to enter and thrive in this ever evolving landscape. It is imperative that we realize the critical role pharmacy educators play in helping to close this knowledge gap. But how?

According to Smithberger et al., the most common way universities include MC in their curriculum do so through required courses with the information being presented in lecture format. Others include the topic in elective courses or actually have electives specifically dedicated to MC alone.⁵ Another study surveying pharmacy programs nationwide in Canada, found that 9 of the 10 programs included discussion of cannabis in some form, typically appearing in 1 course as a portion of a broader lecture. For example, some of the programs included it in discussion of chemotherapy-associated nausea as an alternative therapy.³ 

Study Objectives

1. Determine student pharmacists’ attitudes towards medical cannabis 
2. Determine student pharmacists’ perceptions of their knowledge on MC
3. Gain more insights about student pharmacists’ comfort levels with current laws and regulations, MC recommendations for medical conditions and counseling knowledge 

Description

A brief SurveyMonkey™ questionnaire was emailed to all the student pharmacists (P1-P4) of our school to measure attitudes, knowledge perception, and comfort level with MC counseling. A 5-point Likert-scale (1=strongly disagree to 5=strongly agree) was used for most of the questions. 

What We Found

A total of 124 student pharmacists responded to the survey. Our findings revealed that 72 percent of the student pharmacists surveyed had never received any education on MC. Even more notable, 92 percent of them agreed that it is imperative to have education on MC incorporated into pharmacy school curricula. This is especially revealing when we found that only 75 percent felt as though MC should be made legal in all U.S. states, yet the large majority still realized the need to be educated on it regardless of their personal opinions on legalization. The necessity was also glaringly obvious when we found that nearly 84 percent of the student pharmacists surveyed feel uncomfortable with their knowledge in order to counsel patients on MC.

Final Thoughts

This preliminary data further proves student pharmacists do not feel prepared to assist and counsel patients using MC. It emphasizes the necessity of finding innovative and engaging ways in our pharmacy curriculum to educate our student pharmacists on topics related to MC information and counseling, either during didactic or experiential instruction. There is a dire need for further discussions among pharmacy educators and administrators to determine the most constructive way to incorporate MC into their curriculum. Regardless of our personal feelings toward the matter, the reality is that patient use of MC is here to stay. Our current and future pharmacists need to be prepared to assist patients with MC just as any other medications in the market. Consider some of the following:

• incorporate MC instruction into required courses by including it as a portion of a broader lecture
• find experiential opportunities that partake in some form of MC education and offer it as an option to students
• survey your faculty to gain insight on their thoughts of if and where MC education should be taught in the curriculum and include students in the discussion as well

What barriers do pharmacy institutions and pharmacy educators face in implementing MC into their curriculum? 

References:

1. Pew Research Center. Two-thirds of Americans support marijuana legalization. Nov 2020.
2. Karmen Hanson AG. State Medical Marijuana Laws. Published November 10, 2020.
3. Tang, G, Schwarz, J, Lok, K, & Wilbur, K (2019). Cannabis content in Canadian undergraduate pharmacy programs: A national survey. Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC, 153(1), 27–31.
4. Moeller KE, McGuire JM, Melton BL. A nationwide survey of pharmacy students’ knowledge and perceptions regarding medical cannabis. J Am Pharm Assoc 2003;60:218-24.
5. Smithburger PL, Zemaitis MA, Meyer SM. Evaluation of medical marijuana topics in the PharmD curriculum: A national survey of schools and colleges of pharmacy. Curr Pharm Teach Learn. 2019;11(1):1-9.

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Author Bio

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Pulses is a scholarly blog supported by a team of pharmacy education scholars