Cannabis Strategy for Pharmacy
A Cannabis Strategy for Pharmacy: Enhancing Knowledge, Protecting Patients
The Ontario College of Pharmacists, the provincial agency that regulates pharmacy to protect the interests, health and wellbeing of the public, has published A Cannabis Strategy for Pharmacy: Enhancing Knowledge, Protecting Patients following the endorsement of the strategy by the College’s governing Council.
Bill C-45, the Cannabis Act, is now law after receiving royal assent on June 21, 2018. The Act is expected to come into force on October 17, 2018. On commencement, the Act will regulate the production, distribution and sale of cannabis for non-medical (recreational) purposes. Health Canada has proposed to maintain the current program for access to cannabis for medical purposes. Once recreational cannabis becomes legally available for purchase, the prevalence of use may increase, and patients may be more open to share the fact of their use with healthcare professionals.
In September 2017, Council agreed to establish a Cannabis Task Force to develop a cannabis strategy given the changing landscape of cannabis in Ontario. The Cannabis Strategy for Pharmacy simultaneously addresses relevant areas of practice and prepares the College and pharmacy professionals to address evolving cannabis-related issues, while considering how to best serve and protect patients and Ontarians in line with the College’s mandate.
On June 11, 2018, College Council endorsed A Cannabis Strategy for Pharmacy: Enhancing Knowledge, Protecting Patients. The Strategy consists of four priorities that together, through effective communication and collaboration will support the College’s mandate to serve and protect the public’s interest:
- Developing and maintaining competency
Goal statement - Pharmacists are educated on the use of cannabis for medical or recreational purposes, the benefits and risks of cannabis, and the potential interactions of cannabis with medications and health conditions.
- Providing patient care, health information and advice
Goal statement - Pharmacists use their knowledge and skills to provide information and advice to patients that considers the efficacy, benefits and risks of cannabis, and its interaction with medications, other treatments and health conditions.
- Documenting, developing and tracking data
Goal statement - Pharmacists document patients’ cannabis use and other data, such as healthcare or clinical data, to create a comprehensive patient profile; and the College supports the profession’s participation in research efforts with various stakeholders to strengthen the evidence base on cannabis use.
- Preventing harm
Goal statement - Pharmacists are engaged in supporting patients in accessing appropriate health services and applying harm prevention strategies in collaboration with regulated healthcare professionals and public health stakeholders.
The Strategy’s purpose is to facilitate the ability of pharmacy professionals to respond to changes in the pharmacy practice environment related to the use of cannabis for both medical and recreational purposes. It was created with the objects of the College in mind, namely to “develop, establish and maintain standards and programs to promote the ability of members [pharmacy professionals] to respond to changes in practice environments, advances in technology and other emerging issues.”
With the Strategy now developed, over the next several months the College will be working with pharmacy stakeholders and professionals on initiatives and activities aimed at bringing this Strategy to life and to supporting pharmacy professionals in providing optimal patient care for those who may be using cannabis. The College will communicate progress on the Strategy on a regular basis and will update members as this work unfolds.
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The College’s Cannabis Position:
Throughout the creation of the Strategy, the Task Force expressed support for the development of a College position statement building on the existing NAPRA position and further defining an appropriate regulatory opinion within the provincial context. At its June 11th meeting, College Council approved an expanded position on the distribution of cannabis that builds on its previous endorsement of the position of the NAPRA concerning the distribution of recreational cannabis in pharmacies.
With the recognition that the dispensing of cannabis within pharmacy is currently not permitted within the existing legal framework, the Ontario College of Pharmacists would not oppose any federal or provincial legislation that would permit the dispensing of non-smoked forms of cannabis for medical use within pharmacies, would not oppose legal dispensing for medical use within pharmacies regardless of whether cannabis is approved as a drug by Health Canada or whether it receives an assigned Drug Identification Number provided that sufficient quality control measures are put in place by Health Canada, and opposes the distribution by pharmacies of any forms of cannabis for the exclusive use or purpose of smoking, and in accordance with any provincial legislation.
Education requirement for Part A pharmacists
In recognition of the important role education would be playing within the Strategy, in March 2018 the Task Force recommended that Council require all pharmacists to complete cannabis education in preparation for the anticipated practice changes due to the legalization of cannabis for recreational use. The Strategy provides the appropriate context for this expectation to now move forward.
This recommendation was approved, allowing for work on the development of competencies and learning objectives for cannabis education to move forward. Work is now underway with an advisory group on identifying appropriate educational resources and sources. The College will communicate further details around this new requirement over the coming months.
The evolution of cannabis for medical purposes
The College recognizes that cannabis is an evolving matter and may update its position and Strategy as the legislative and regulatory framework in Canada and Ontario related to access and distribution of cannabis evolves and becomes more defined over time. The College’s position and Strategy strike a responsible balance to make sure that the public is protected as society adapts to increased legal access to recreational cannabis and the emerging matter of cannabis for medical use while supporting the profession of pharmacy to play an active and appropriate role as medication and clinical experts to promote positive patient outcomes.
In the meantime, as always the College expects all pharmacy professionals and pharmacies, including pharmacy owners, operators and designated managers, to act in accordance with established laws and regulations, standards of practice and code of ethics.