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 came into force on October 17, 2018. The Act regulates the production, distribution and sale of cannabis for non-medical (recreational) purposes. Health Canada is maintaining the current program for access to cannabis for medical purposes. The prevalence of use may be increasing and patients may be more open to discussing 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, the College will work 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, the Task Force recommended in March 2018 that all pharmacists complete cannabis education in preparation for the anticipated practice changes due to the legalization of cannabis for recreational use. This recommendation was approved by Council, allowing the College to begin work on developing competencies and learning objectives for cannabis education in keeping with the Strategy’s priorities.
These core competencies – determined with the assistance of an advisory group consisting of community and hospital pharmacists, educators and a patient advocate – must be met in all accredited cannabis education courses to ensure consistency in educational training for all Part A pharmacists registered with the College.
During the 2020 pharmacist annual renewal process, pharmacists must declare that they have completed a College-approved cannabis course. The deadline to declare is March 10, 2020 (when annual renewal ends).
Additional information regarding the mandatory education requirements and a list of approved cannabis education courses can be found on the Cannabis Training Requirements and Courses webpage.
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.