My Pharmacy Leadership mini-project consisted of reviewing the drafts for the Interdisciplinary and Pharmacy Policies, as well as, the Clinical Practice Guidelines for Medical Marihuana (MM) in the acute care setting. The main question that my project aimed to answer was whether or not these resources would be (1) sufficient in guiding front-line workers to assess and handle medical marihuana and (2) easy for front-line workers to navigate and utilize.
In order to evaluate the policies and guidelines, I had to first get a better understanding of the regulations and background behind Medical Marihuana. Medical Marihuana, which falls under the Controlled Drugs and Substances Act, can be legally obtained by patients, under the Access to Cannabis for Medical Purposes Regulations (ACMPR). Legal formulations include: fresh or dried marihuana or cannabis oil, and access to legal supply is only through a licensed producer, registering with Health Canada to make own supply or to designate a surrogate marker to grow the supply (NOT through storefronts/dispensaries; legal licensed producers will always mail to patient). From Sept 2015 to 2016, the use of MM has tripled (1) – further emphasizing the need to ensure that front line workers are equipped to assess and handle MM as more patients coming into the ER will likely be using medical marihuana.
Questions that my preceptor had me consider while making my presentation were:
- Are the documents enough to guide front-line workers in a situation where:
- Patients are self-treating?
- Patients are using MM illegally?
- Absence of a doctor prescription?
- Patient does not have a family doctor?
- Patients are getting illegal supply?
- What are health care worker’s legal obligations in the handling of MM?
- How do we ensure the rights of those who don’t want to be exposed second hand to marihuana (e.g. when either smoked or vapourized), as well as, the rights of those who do want to consume medical marihuana?
Management principles required to complete the project include:
- Change Management
- Patient Safety
This project provided a great opportunity for me to further understand the complexicity of the use and handling of medical marihuana, and the challenges behind communicating policies and guidelines to front line staff (e.g. the difficulty behind consolidating all the required information into one document, accounting for all the potential situations that could occur in the front-line, providing a user-friendly decision process algorithm), and evaluate the current drafts of these documents and come up with possible solutions.
FYI: Something I learned in my distribution rotation – MariHuana refers to the legal medical marihuana, and MariJuana refers to ilicit marijuana (e.g. smoking)!
- Procedure to accessing MM: http://www.hc-sc.gc.ca/dhp-mps/marihuana/access-acceder-eng.php#s2
- Authorized Licensed Producers for MM: http://www.hc-sc.gc.ca/dhp-mps/marihuana/info/list-eng.php
- Regulations for Access: http://www.hc-sc.gc.ca/dhp-mps/marihuana/law-loi/index-eng.php
- Sample Medical Document: http://www.hc-sc.gc.ca/dhp-mps/marihuana/info/med-eng.php
- Loss or theft report: http://www.hc-sc.gc.ca/hc-ps/alt_formats/hecs-sesc/pdf/substancontrol/substan/compli-conform/loss-perte/form_4010-eng.pdf