For many patients, cannabis is medicine. However, picking up cannabis at a dispensary is not like going to a real pharmacy.
At dispensaries, patients interact with budtenders, people with no specialized medical education. Some dispensaries employ nurse practitioners and physicians to advise patients, but most do not.
That leaves budtenders as patients’ go-to source for cannabis information and recommendations. This is true even in states that have only legalized medical cannabis. According to a 2019 study, the vast majority of cannabis users never consult a doctor. (1)
The lack of physician involvement could potentially be a problem for high-risk patients. Research shows that most budtenders give evidence-based recommendations and rarely mention adverse effects like cannabis use disorder. (2)
A 2021 study that examined state cannabis laws and dispensary practices found that “there is likely a gap between the way cannabis is perceived by dispensary staff and the way it is
perceived by clinicians… dispensary staff are comfortable giving advice from
an experiential standpoint. Conversely, clinicians may view cannabis through a traditional
Dispensaries in states with higher medicalization scores were more likely to consider physician or nurse input. Medicalization refers to how closely the state’s cannabis laws resemble pharmaceutical regulations.
Budtender recommendations are likely sufficient for most patients. However, those with serious or unusual conditions may benefit from additional medical advice.
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1- Boehnke, K. F., Scott, J. R., Litinas, E., Sisley, S., Clauw, D. J., Goesling, J., & Williams, D. A. (2019). Cannabis use preferences and decision-making among a cross-sectional cohort of medical cannabis patients with chronic pain. The Journal of Pain, 20(11), 1362–1372. https://doi.org/10.1016/j.jpain.2019.05.009
2- Merlin, J. S., Althouse, A., Feldman, R., Arnsten, J. H., Bulls, H. W., Liebschutz, J. M., Nugent, S. M., Orris, S. R., Rohac, R., Starrels, J. L., Morasco, B. J., & Kansagara, D. (2021). Analysis of State Cannabis Laws and dispensary staff recommendations to adults purchasing medical cannabis. JAMA Network Open, 4(9). https://doi.org/10.1001/jamanetworkopen.2021.24511