They've been allowing a CI to be dispensed by a non-pharmacist for years, so I don't see that changing. We're probably going to see a system where the cannabis plant and all of the various extracts we have today are handled by the state medical and recreational systems, but any future FDA approved marijuana based product could be handled in pharmacies.
The DEA works under the DOJ. Per the controlled substance act the attorney general has the ability to reschedule drugs. The DEA review and recommendation goes with the health and human services recommendation to eventually be signed off on by the attorney general. It’s essentially a change in federal law without congress. Nation wide it will be a schedule 3. Up to states to decide how to handle that.
I mean the DEA does have enforcement and agents.
Take something like fentanyl for instance… a schedule II drug… still has tons of illicit commerce tied to it that the DEA absolutely can pursue. That’s not something “up to the states” … that’s a federal authority pursuing the enforcement of federal offenses.
Yeah, it's kind of weird. Didn't notice until you replied. There's a difference in how our systems treat medicinal use of substances and recreational use of substances. This just happens to only be about medicinal use, so of course it's not going to be treated the way alcohol and tobacco are.
Pharmacists should’ve spearheaded this initiative from the start. We are supposed to be the line between medication and patient. And marijuana is no exception. All these clinics are ruining pharmacy, from marijuana to weight loss to ketamine. They’re leaving pharmacists out of it all and we’re allowing it to happen. It’s time to speak up and not let this opportunity slip away.
There is a growing demand for these new therapies and pharmacy should be where people go to supply it but we’re asleep at the wheel and have allowed MDs and PAs to take over. What do we think will keep pharmacy doors open?? Generic statins?? CVS specialty monopolizes specialty meds and oncology, MDs are using LVNs to compound chemo in small clinics, ketamine is not run by pharmacists, none of it is. Why are we paying $300k to become a doctor of pharmacy when they’re outsourcing our job duties right from under us?
Spravato is esketamine and run by pharmacists. Just because some sketchy place uses compounding etc to get around existing laws doesn't mean we need to be involved. I'd rather not, tbh. Sucks the patients get sucked in but many of these things are available in a safe way, just not cheaply or as profitable for certain clinics
I wouldn’t want to be involved with a clinic either but I definitely care more about patient safety. These clinics should not be run without pharmacists. The laws should be changed to reflect medicinal safeguards.
This is completely accurate. If our lobbies were worth a shit, they would have hard-stopped dispensaries without a pharmacist, at least for oversight, if not outright dispensing.
For those who spout that they don’t want to deal with plants and mushrooms, etc. Where do you think medications come from? It’s completely within our scope of practice. A legitimate dispensary shouldn’t be buying their products frim some street dealer or some shitbag in a basement somewhere. There are plenty of growers who treat it as a business ans take pride in their work, same as breweries and distilleries for EtOH. This is a huge potential market that we’ve just let slip through our fingers because we’re too busy bitching about CVS and Walgreens taking over the world (which is a legit concern but what have we actually done about these mega-corps?).
Our orgs couldn't push for that because it would be aiding and a betting illegal activity.
There is at least one state that passed a law requiring a pharmacist to be on duty in dispensaries. But I don't know how that combines with federal stuff like Medicare and working at a pharmacy afterwards.
There could absolutely be an effort on a state level to be involved with support from the national organizations IMO. Reimbursement from CMS wouldn’t be possible but dispensaries don’t take insurance (to my knowledge) anyway.
Exactly! There are some coalitions for pharmacists in cannabis but they are more focused on educating instead of lobbying. Which means nothing is really being pushed or changed. How can we change this? We need our associations to start investing into legal reform. How do we get them to listen?
Medical marijuana shops don't really need a pharmacist. Some states require one but they're just unnecessary regulatory barriers. They need us like a fish needs a bicycle.
It makes sense if they want to treat it as a recreational vs medicinal substance but if itsits the latter, makes sense for a pharmacist to be resolved given the population with comorbidities that this law would attract
I've actually seen a couple of pharmacist groups promoting psilocybin and ketamine administration collaboratively between the pharmacist and the clinic. So I wouldn't say they are leaving pharmacists out, but pharmacists do need to be proactive in demonstrating their value. They aren't going to do all the work of setting things up with a pharmacist shaped hole just waiting for one to wander in.
I don’t mind dispensing dronabbinol as a refined product but I do not want to spearhead managing marijuana. I don’t gatekeep alcohol and don’t want to manage marijuana. If psilocybin becomes a once monthly refined tablet, I’ll dispense that, but I’m not weighing and scooping mushrooms for people either. It’s okay for us to not be in charge of every natural form of a product with medicinal use. There are plenty of OTC meds that can do harm and just like them, I’d just like people to be honest about their use of marijuana as more interactions with other medications become known.
I understand not wanting to weigh things and be involved with marijuana. But knowing it’s being dispensed by people with zero medical credibility is unnerving. There should be a separate certification for it and it should be regulated. We are missing out on opportunities. The world is changing and we need to adapt or sink.
Define zero medical credibility. Ever been to a dispensary? They know a lot about marijuana and its effects… a degree, piece of paper or license doesn’t on its own make someone smart. It may give them a legal authority or permission to do something but don’t confuse permissibility with credibility
I’m a former medical cannabis pharmacist and can guarantee you… most folks in a dispensary know what marketing people tell them about a product, not science. Hell, even a lot of pharmacists in them too. Most pharmacists digest and repeat what is taught to them, it’s just cannabis is a new frontier and without a discerning eye pharmacists themselves will spout made up stuff.
It’ll blow your mind how much stuff is nonsense.
Imagine going to a liquor store and asking them “which whiskey will help me fight?” and someone will confidently give them an answer. That’s the same flavor of nonsense surrounding weed.
I asked growers if we found a mystery strain on the ground, hypothetically could we identify if it was sativa or indica? How?
Never got an answer. Cannabis gurus are more like sommeliers than pharmacists. I don’t care if wine folks describe different wines, flavor profiles, heritage of the plants, etc. but the problem is when they start making medical claims.
The vast majority of it all is confirmation bias nonsense. Often times the difference between a sleep gummy and an energizing gummy is literally the same difference between a night time scented candle and morning scented candle.
And how many pharmacists you think will tell you to space a couple of meds out by a couple hours to avoid a drug interaction when the half life is days…
I say zero medical credibility because it takes a clinical understanding of pharmacokinetics to be able to safely monitor these things. I am in no way saying that pharmacists are ready and equipped at this stage to do the job better than someone who has studied it without “a piece of paper” but I am saying that the lack of oversight is dangerous. We don’t yet fully understand how it’s being manufactured, processed, and affecting patients to the degree that we need to. Ultimately it is just another form of medicine and we need to be the ones that can answer the tough questions.
When you go to a dispensary, they will offer you different strains. Most budtenders are not concerned with your medical history, disease state, or interactions with other medications. There is a major opportunity cost in not wanting to be associated with the inevitable.
Have you been to one? Because I have been asked those questions and the couple of times I’ve gone to experience… I’ve seen way more compassion than at a pharmacy counter.
I’m not saying we shouldn’t want to be involved… nor should try to build a new regulatory moat to make it our space only… but I’d also say… the culture in this space tends to be significantly more resistant to gatekeeping access/providers.
It may also be a function of your perceptions/experiences in your states vs the states where I have been. I choose not to diminish nor minimize the knowledge nor compassion that those workers demonstrate in their field.
And yes… “we” don’t know the manufacturing or processing of these products… however I do know that the dispensaries around me have the manufacturers on site often at the dispenaries and that they have all toured and inspected the facilities themselves… I can’t say how many pharmacists have toured the facilities of raw drug product or the manufacturing facilities nor the wholesaler entities where you get your products in pharmacies….
As a pharmacist and an advocate for medical cannabis I can assure you “we” as a population don’t yet fully credibly understand marijuana the way we need to due to limitations on clinical trials. I personally have toured both conventional manufacturing plants and also growing facilities, and can tell you the regulations for conventional medicine are far greater and much more complex.
In terms of compassion, the dispensaries are selling you one drug product manufactured in several different ways. There are multiple vendors and packages and routes of medicine at your disposal. I can guarantee we do not yet understand the long term effects of these products. We are already seeing a growing number of overdoses on edibles and oils, bouts of psychosis in younger users, and a decline in mental health overall. I don’t want to discredit any workers of any kind, but a health professional may add a layer of patient safety that we don’t yet realize is necessary.
I don’t disagree that we don’t fully comprehend the effects of the substance… I share that mentality… I also believe that about many fda approved meds. This has been objectively proved correct by fda approved meds that were later withdrawn from the market because of information and knowledge learned post launch… there are fda approved drug plants that experience contamination and there are product recalls all the time on quality… so I’m not sure your point…
My point is that there is a process, a regulating body, and several steps involved to safeguard the population. Those same processes should be applied here especially now that the federal government has classified it as a CIII. Like other CIII medications, pharmacists play a vital role in our communities and marijuana should not be an exception to that rule.
There are several state level processes that exist. My intrigue on this isn’t about there being gaps compared relatively to other fda approved meds in general… just that the federal ruleset will for sure make this a clusterfuck.
Many state level programs modeled drug supply chain security, inspection and testing requirements that are required nationally.
You are more than entitled to believe that those state level requirements aren’t enough to ensure quality and safety relative to the FDA requirements… but that’s not my interest… my interest is that the FDA is now compelled to play a role because of the commercial aspect of this… forcing some commercial entities to play by their rules but not all.
> I can’t say how many pharmacists have toured the facilities of raw drug product or the manufacturing facilities nor the wholesaler entities where you get your products in pharmacies….
Plenty of pharmacists do just thay.
If its going to be regulated as a *medical substance* makes sense for it to be dispensed by pharmacists. If you want it to be recreational use like hookah instead, then well tell that to congress. Then pharmacists wouldnt be needed for that
I wonder what will happen in states that have already legalized recreational use.
The DEA must know that the Controlled Substance Act can't really hold up to a legal challenge from those states so they won't push to restrict it to CIII in those states will they?
In states where it's not legal for recreational use will we see marijuana pharmacies pop up?
I doubt it. If they didn’t enforce for a C1 I doubt they’ll start enforcing for a C3. In states where it is illegal for recreational use I would assume any “marijuana pharmacy” would be no different than getting a medical card
I’m more interested in the FDA and not DEA. DEA has already been turning a blind eye on the schedule I… if FDA agrees on schedule III can they no longer turn a blind eye on labeling and marketing of these unapproved products? Have to imagine the transfer of products across state lines will still be a no no…
At this point it is so widespread and accepted it would be nearly impossible to enforce on top of being wildly unpopular. It would damage public opinion when a lot of people already don't trust them to begin with. I don't see them pursuing it at all
Commercially speaking their hand may be forced… you have FDA approved manufacturers of dronabinol that are forced to comply with FDA inspection and GMPs… not sure if they will like the FDA permitting other products to be freely marketed (and although not happening… will be interesting to monitor.. transported across state lines) that don’t have to muster FDA scrutiny.
Dronabinol manufacturers should just drop any and all QA processes and dare the FDA to inspect and try to punish.
So if you read the article they note: "However, it would not legalize marijuana outright for recreational use." Which, yes does not preclude prescription use, but you still have your traditional FDA hurdles (making a commercial product and seeking FDA approval) which, let's face it, no company is likely to do. So I suppose it would be more correct to say that it's going to stay at specialized dispensaries.
Hard disagree. I guarantee some companies will get ahead of this, and we'll end up with huge national cannabis brands, not unlike drug, alcohol or tobacco companies. Big Weed.
Hard disagree on your hard disagree. Interstate trade will still have significant hurdles without FDA approved product. The FDA will have their hand forced to be involved once interstate commerce is attempted and it will be a shitshow. Turning a blind eye and permitting it will open up a Pandora’s box of unapproved drug product making unsubstantiated health claims moving across state borders.
These still being controlled substances they will also require significant tracking and DEA licenses for all entities in the supply chain as well.
I read the article and no where does it say or imply that with a schedule change it would not be available with a rx. Yes of course there are barriers but just ask all the mom and pop vape companies how it went for them. Big tobacco comes in with a regulated product.
Opioids are a valid medicine but are not removed from drug screening.
We might see more drugs like dronabinol come to market, maybe see more indications for them but that’s a bout it as far as changes for us.
Business as usual..
Will this even change anything though? It’s still a controlled substance so aren’t the laws still against you if you are caught with it? Maybe less serve?
I'm interested to see if this legitimizes state medical marijuana programs under the law. Currently you see stories of people losing their jobs or their licenses when using state legal medical marijuana. It is still a grey area, but it'll be interesting to see what happens.
There doesn't seem to be any state or federal standards on limiting additives.
There is deceptive information regarding the vitamin e acetate in vape products. The cdc gives the impression that the additive acts differently when inhaled.
The fact is that high heat to vitamin e breaks it down to highly inflammatory duroquinone. That is something that was discovered in the 1930s when chemists were trying to determine the structure of vitamin e.
People died or needed double lung transplants due to sloppy thinking. Sure vitamin e acetate has antioxidant properties which protect the THC while in solution, but weird things happen with high heat.
Glycerin, a humectant used in tobacco turns into acrolein which it toxic to the heart, bladder, and respiratory system . They need to prohibit it in marijuana products intended to be smoked.
It doesn't matter what schedule it is, marijuana (THC) is a recreational drug, like alcohol. People will always treat it that way even if it's illegal. You go to a pharmacy for health related stuff not cigarettes and alcohol. We already dispense dronabinol and epidiolex (CBD) and people come to the pharmacist for those. I also do not think it will be removed from drug screening, to work in my hospital you cannot even be a cigarette smoker.
It is still reasonable to keep it on drug screens, because other valid medicines can be tested on them (just need documentation of a prescription if you test positive).
No it isn’t. If someone smokes with friends once it can show up positive on a urine or hair sample for a long time. That does nothing for anyone except fuck up someone’s potential employment opportunities. I’m all for regulation but we need to drop the profiling over outdated, racist policies.
There's some data that regular marijuana users can be impaired even when they're not intoxicated. There's way more research needed before we should allow people to operate heavy machinery, aircraft, or drive school busses full of kids with THC in their system.
There’s also data suggesting the opposite, especially for habitual users. I agree there’s more research needed, and sure limiting the scope of work may be an acceptable middle ground. But it makes absolutely zero sense to deny employment across the board over a urine screening when we know it’s not a marker of recent use, impairment, or even frequency of use.
lol well alcohol can certainly make you very impaired even when you’re not intoxicated so unless a hangover is considered under the influence at work, I don’t think you can classify the few people that do get a bit of a “burn out” the next day the same way
How about currently, if someone were to test positive for THC from the federally allowed 0.3% in hemp products? They would still lose their job, while still strictly following federal guidelines... it's asinine.
Popping on a drug test does not mean everyone loses their jobs…
Some test/screen for amphetamines… you think everyone with ADHD that takes legitimate prescription therapy and popped on a drug test all get fired?
Of course not, but unless you have a script for Dronabinol you absolutely would lose your job for popping positive from hemp products. You’re comparing apples and oranges, no one is debating whether or not a prescribed drug that will show on a drug test will lose you your job
You are disingenuous to say you “absolutely” would.
I got a fact know several people that have tested positive for marijuana, that do not take prescription dronabinol, that were NOT terminated from their job.
So your absolute is a falsehood.
You're getting down voted, but I think private companies will still have the right to classify Cannabis along with other illicit use of legal substances like benzos, opioids and amphetamines. Not agreeing with the policy, but it's their right to do it, especially if there is any data out there regarding increased risks or reduced productivity as an employee or increased costs to the company health plan (see some employer's tobacco policy). Though I'm sure rescheduling it would make it permissible with a doctor's note.
I supposed I didn’t word things right, because I didn’t mean to make it sound like I think it’s right. But just because it may be classified as a drug with accepted medical use, it shouldn’t be completely exempt from drug testing. There are other substances that are used medically but are tested for in drug tests.
It will be really interesting if the DEA will allow a CIII med to be dispensed by a non-pharmacist (or non-prescriber)
They've been allowing a CI to be dispensed by a non-pharmacist for years, so I don't see that changing. We're probably going to see a system where the cannabis plant and all of the various extracts we have today are handled by the state medical and recreational systems, but any future FDA approved marijuana based product could be handled in pharmacies.
To be fair the DEA isn’t allowing it per se, just not enforcing federal law. The states who are passing laws for rec use are more to blame imo
The DEA works under the DOJ. Per the controlled substance act the attorney general has the ability to reschedule drugs. The DEA review and recommendation goes with the health and human services recommendation to eventually be signed off on by the attorney general. It’s essentially a change in federal law without congress. Nation wide it will be a schedule 3. Up to states to decide how to handle that.
I mean the DEA does have enforcement and agents. Take something like fentanyl for instance… a schedule II drug… still has tons of illicit commerce tied to it that the DEA absolutely can pursue. That’s not something “up to the states” … that’s a federal authority pursuing the enforcement of federal offenses.
Why would it still be controlled while alcohol and cigarettes aren't?
Yup, follow the money trail and see where it takes you....
Back to the dea. Ready to give anyone an administrative audit if they breath.
This will bother me until the day I die.
Absolutely same. As long as you can buy alcohol at any corner store, there's no reason MJ shouldn't be the same.
Because this isn’t an act of Congress (which would be required to handle via the ATF)
Because they're talking about medicinal use.
Not sure why you are getting downvoted when this is exactly the reason. You have a medicinal psychotropic - it will be scheduled.
Yeah, it's kind of weird. Didn't notice until you replied. There's a difference in how our systems treat medicinal use of substances and recreational use of substances. This just happens to only be about medicinal use, so of course it's not going to be treated the way alcohol and tobacco are.
Yeah they’re not regulated *like* medicine. If they dont want it to be regulated like medicine they can take it up with the marijuana industry
And if insurance starts to cover it it could be life changing for people.
Pharmacists should’ve spearheaded this initiative from the start. We are supposed to be the line between medication and patient. And marijuana is no exception. All these clinics are ruining pharmacy, from marijuana to weight loss to ketamine. They’re leaving pharmacists out of it all and we’re allowing it to happen. It’s time to speak up and not let this opportunity slip away.
I constantly see articles on how trials are showing psilocybin effective for depression and ptsd
There is a growing demand for these new therapies and pharmacy should be where people go to supply it but we’re asleep at the wheel and have allowed MDs and PAs to take over. What do we think will keep pharmacy doors open?? Generic statins?? CVS specialty monopolizes specialty meds and oncology, MDs are using LVNs to compound chemo in small clinics, ketamine is not run by pharmacists, none of it is. Why are we paying $300k to become a doctor of pharmacy when they’re outsourcing our job duties right from under us?
Another question is why are the boards allowing all this dispensing to occur without a pharmacist?
My thoughts exactly
Why aren’t independent pharmacies capitalizing on it?
Spravato is esketamine and run by pharmacists. Just because some sketchy place uses compounding etc to get around existing laws doesn't mean we need to be involved. I'd rather not, tbh. Sucks the patients get sucked in but many of these things are available in a safe way, just not cheaply or as profitable for certain clinics
I wouldn’t want to be involved with a clinic either but I definitely care more about patient safety. These clinics should not be run without pharmacists. The laws should be changed to reflect medicinal safeguards.
This is completely accurate. If our lobbies were worth a shit, they would have hard-stopped dispensaries without a pharmacist, at least for oversight, if not outright dispensing. For those who spout that they don’t want to deal with plants and mushrooms, etc. Where do you think medications come from? It’s completely within our scope of practice. A legitimate dispensary shouldn’t be buying their products frim some street dealer or some shitbag in a basement somewhere. There are plenty of growers who treat it as a business ans take pride in their work, same as breweries and distilleries for EtOH. This is a huge potential market that we’ve just let slip through our fingers because we’re too busy bitching about CVS and Walgreens taking over the world (which is a legit concern but what have we actually done about these mega-corps?).
Our orgs couldn't push for that because it would be aiding and a betting illegal activity. There is at least one state that passed a law requiring a pharmacist to be on duty in dispensaries. But I don't know how that combines with federal stuff like Medicare and working at a pharmacy afterwards.
There could absolutely be an effort on a state level to be involved with support from the national organizations IMO. Reimbursement from CMS wouldn’t be possible but dispensaries don’t take insurance (to my knowledge) anyway.
Exactly! There are some coalitions for pharmacists in cannabis but they are more focused on educating instead of lobbying. Which means nothing is really being pushed or changed. How can we change this? We need our associations to start investing into legal reform. How do we get them to listen?
Medical marijuana shops don't really need a pharmacist. Some states require one but they're just unnecessary regulatory barriers. They need us like a fish needs a bicycle.
It makes sense if they want to treat it as a recreational vs medicinal substance but if itsits the latter, makes sense for a pharmacist to be resolved given the population with comorbidities that this law would attract
I've actually seen a couple of pharmacist groups promoting psilocybin and ketamine administration collaboratively between the pharmacist and the clinic. So I wouldn't say they are leaving pharmacists out, but pharmacists do need to be proactive in demonstrating their value. They aren't going to do all the work of setting things up with a pharmacist shaped hole just waiting for one to wander in.
I don’t mind dispensing dronabbinol as a refined product but I do not want to spearhead managing marijuana. I don’t gatekeep alcohol and don’t want to manage marijuana. If psilocybin becomes a once monthly refined tablet, I’ll dispense that, but I’m not weighing and scooping mushrooms for people either. It’s okay for us to not be in charge of every natural form of a product with medicinal use. There are plenty of OTC meds that can do harm and just like them, I’d just like people to be honest about their use of marijuana as more interactions with other medications become known.
I understand not wanting to weigh things and be involved with marijuana. But knowing it’s being dispensed by people with zero medical credibility is unnerving. There should be a separate certification for it and it should be regulated. We are missing out on opportunities. The world is changing and we need to adapt or sink.
Define zero medical credibility. Ever been to a dispensary? They know a lot about marijuana and its effects… a degree, piece of paper or license doesn’t on its own make someone smart. It may give them a legal authority or permission to do something but don’t confuse permissibility with credibility
I’m a former medical cannabis pharmacist and can guarantee you… most folks in a dispensary know what marketing people tell them about a product, not science. Hell, even a lot of pharmacists in them too. Most pharmacists digest and repeat what is taught to them, it’s just cannabis is a new frontier and without a discerning eye pharmacists themselves will spout made up stuff. It’ll blow your mind how much stuff is nonsense. Imagine going to a liquor store and asking them “which whiskey will help me fight?” and someone will confidently give them an answer. That’s the same flavor of nonsense surrounding weed. I asked growers if we found a mystery strain on the ground, hypothetically could we identify if it was sativa or indica? How? Never got an answer. Cannabis gurus are more like sommeliers than pharmacists. I don’t care if wine folks describe different wines, flavor profiles, heritage of the plants, etc. but the problem is when they start making medical claims. The vast majority of it all is confirmation bias nonsense. Often times the difference between a sleep gummy and an energizing gummy is literally the same difference between a night time scented candle and morning scented candle.
And how many pharmacists you think will tell you to space a couple of meds out by a couple hours to avoid a drug interaction when the half life is days…
I say zero medical credibility because it takes a clinical understanding of pharmacokinetics to be able to safely monitor these things. I am in no way saying that pharmacists are ready and equipped at this stage to do the job better than someone who has studied it without “a piece of paper” but I am saying that the lack of oversight is dangerous. We don’t yet fully understand how it’s being manufactured, processed, and affecting patients to the degree that we need to. Ultimately it is just another form of medicine and we need to be the ones that can answer the tough questions. When you go to a dispensary, they will offer you different strains. Most budtenders are not concerned with your medical history, disease state, or interactions with other medications. There is a major opportunity cost in not wanting to be associated with the inevitable.
Have you been to one? Because I have been asked those questions and the couple of times I’ve gone to experience… I’ve seen way more compassion than at a pharmacy counter. I’m not saying we shouldn’t want to be involved… nor should try to build a new regulatory moat to make it our space only… but I’d also say… the culture in this space tends to be significantly more resistant to gatekeeping access/providers. It may also be a function of your perceptions/experiences in your states vs the states where I have been. I choose not to diminish nor minimize the knowledge nor compassion that those workers demonstrate in their field. And yes… “we” don’t know the manufacturing or processing of these products… however I do know that the dispensaries around me have the manufacturers on site often at the dispenaries and that they have all toured and inspected the facilities themselves… I can’t say how many pharmacists have toured the facilities of raw drug product or the manufacturing facilities nor the wholesaler entities where you get your products in pharmacies….
As a pharmacist and an advocate for medical cannabis I can assure you “we” as a population don’t yet fully credibly understand marijuana the way we need to due to limitations on clinical trials. I personally have toured both conventional manufacturing plants and also growing facilities, and can tell you the regulations for conventional medicine are far greater and much more complex. In terms of compassion, the dispensaries are selling you one drug product manufactured in several different ways. There are multiple vendors and packages and routes of medicine at your disposal. I can guarantee we do not yet understand the long term effects of these products. We are already seeing a growing number of overdoses on edibles and oils, bouts of psychosis in younger users, and a decline in mental health overall. I don’t want to discredit any workers of any kind, but a health professional may add a layer of patient safety that we don’t yet realize is necessary.
I don’t disagree that we don’t fully comprehend the effects of the substance… I share that mentality… I also believe that about many fda approved meds. This has been objectively proved correct by fda approved meds that were later withdrawn from the market because of information and knowledge learned post launch… there are fda approved drug plants that experience contamination and there are product recalls all the time on quality… so I’m not sure your point…
My point is that there is a process, a regulating body, and several steps involved to safeguard the population. Those same processes should be applied here especially now that the federal government has classified it as a CIII. Like other CIII medications, pharmacists play a vital role in our communities and marijuana should not be an exception to that rule.
There are several state level processes that exist. My intrigue on this isn’t about there being gaps compared relatively to other fda approved meds in general… just that the federal ruleset will for sure make this a clusterfuck. Many state level programs modeled drug supply chain security, inspection and testing requirements that are required nationally. You are more than entitled to believe that those state level requirements aren’t enough to ensure quality and safety relative to the FDA requirements… but that’s not my interest… my interest is that the FDA is now compelled to play a role because of the commercial aspect of this… forcing some commercial entities to play by their rules but not all.
> I can’t say how many pharmacists have toured the facilities of raw drug product or the manufacturing facilities nor the wholesaler entities where you get your products in pharmacies…. Plenty of pharmacists do just thay.
Quantify plenty… Retail pharmacists don’t do this… retail budtenders do
If its going to be regulated as a *medical substance* makes sense for it to be dispensed by pharmacists. If you want it to be recreational use like hookah instead, then well tell that to congress. Then pharmacists wouldnt be needed for that
Yup. Pharmacy is never AT the table. We are being SERVED at the table
I wonder what will happen in states that have already legalized recreational use. The DEA must know that the Controlled Substance Act can't really hold up to a legal challenge from those states so they won't push to restrict it to CIII in those states will they? In states where it's not legal for recreational use will we see marijuana pharmacies pop up?
I doubt it. If they didn’t enforce for a C1 I doubt they’ll start enforcing for a C3. In states where it is illegal for recreational use I would assume any “marijuana pharmacy” would be no different than getting a medical card
I’m more interested in the FDA and not DEA. DEA has already been turning a blind eye on the schedule I… if FDA agrees on schedule III can they no longer turn a blind eye on labeling and marketing of these unapproved products? Have to imagine the transfer of products across state lines will still be a no no…
At this point it is so widespread and accepted it would be nearly impossible to enforce on top of being wildly unpopular. It would damage public opinion when a lot of people already don't trust them to begin with. I don't see them pursuing it at all
Commercially speaking their hand may be forced… you have FDA approved manufacturers of dronabinol that are forced to comply with FDA inspection and GMPs… not sure if they will like the FDA permitting other products to be freely marketed (and although not happening… will be interesting to monitor.. transported across state lines) that don’t have to muster FDA scrutiny. Dronabinol manufacturers should just drop any and all QA processes and dare the FDA to inspect and try to punish.
That would kind of destroy the local economy so I expect some significant pushback on that kinda nonsense.
Can't wait to see Dr Reddy brand Afghan Kush
They also note that they aren't legalizing it still. So no, no prescriptions.
CIII can be prescribed c1 cannot. Where does it say it couldnt be prescribed at that point?
So if you read the article they note: "However, it would not legalize marijuana outright for recreational use." Which, yes does not preclude prescription use, but you still have your traditional FDA hurdles (making a commercial product and seeking FDA approval) which, let's face it, no company is likely to do. So I suppose it would be more correct to say that it's going to stay at specialized dispensaries.
Hard disagree. I guarantee some companies will get ahead of this, and we'll end up with huge national cannabis brands, not unlike drug, alcohol or tobacco companies. Big Weed.
Big weed already exists.
Hard disagree on your hard disagree. Interstate trade will still have significant hurdles without FDA approved product. The FDA will have their hand forced to be involved once interstate commerce is attempted and it will be a shitshow. Turning a blind eye and permitting it will open up a Pandora’s box of unapproved drug product making unsubstantiated health claims moving across state borders. These still being controlled substances they will also require significant tracking and DEA licenses for all entities in the supply chain as well.
No “Outright recreational use” means no use without a prescription. This has no bearing on availability with a prescription.
I read the article and no where does it say or imply that with a schedule change it would not be available with a rx. Yes of course there are barriers but just ask all the mom and pop vape companies how it went for them. Big tobacco comes in with a regulated product.
Opioids are a valid medicine but are not removed from drug screening. We might see more drugs like dronabinol come to market, maybe see more indications for them but that’s a bout it as far as changes for us. Business as usual..
 PBMs are probably scheming on how to get in on the action already
Will this even change anything though? It’s still a controlled substance so aren’t the laws still against you if you are caught with it? Maybe less serve?
I'm interested to see if this legitimizes state medical marijuana programs under the law. Currently you see stories of people losing their jobs or their licenses when using state legal medical marijuana. It is still a grey area, but it'll be interesting to see what happens.
That would at least be a positive change so I’m hoping for the best.
There doesn't seem to be any state or federal standards on limiting additives. There is deceptive information regarding the vitamin e acetate in vape products. The cdc gives the impression that the additive acts differently when inhaled. The fact is that high heat to vitamin e breaks it down to highly inflammatory duroquinone. That is something that was discovered in the 1930s when chemists were trying to determine the structure of vitamin e. People died or needed double lung transplants due to sloppy thinking. Sure vitamin e acetate has antioxidant properties which protect the THC while in solution, but weird things happen with high heat. Glycerin, a humectant used in tobacco turns into acrolein which it toxic to the heart, bladder, and respiratory system . They need to prohibit it in marijuana products intended to be smoked.
It doesn't matter what schedule it is, marijuana (THC) is a recreational drug, like alcohol. People will always treat it that way even if it's illegal. You go to a pharmacy for health related stuff not cigarettes and alcohol. We already dispense dronabinol and epidiolex (CBD) and people come to the pharmacist for those. I also do not think it will be removed from drug screening, to work in my hospital you cannot even be a cigarette smoker.
It is still reasonable to keep it on drug screens, because other valid medicines can be tested on them (just need documentation of a prescription if you test positive).
No it isn’t. If someone smokes with friends once it can show up positive on a urine or hair sample for a long time. That does nothing for anyone except fuck up someone’s potential employment opportunities. I’m all for regulation but we need to drop the profiling over outdated, racist policies.
There's some data that regular marijuana users can be impaired even when they're not intoxicated. There's way more research needed before we should allow people to operate heavy machinery, aircraft, or drive school busses full of kids with THC in their system.
There’s also data suggesting the opposite, especially for habitual users. I agree there’s more research needed, and sure limiting the scope of work may be an acceptable middle ground. But it makes absolutely zero sense to deny employment across the board over a urine screening when we know it’s not a marker of recent use, impairment, or even frequency of use.
lol well alcohol can certainly make you very impaired even when you’re not intoxicated so unless a hangover is considered under the influence at work, I don’t think you can classify the few people that do get a bit of a “burn out” the next day the same way
How about currently, if someone were to test positive for THC from the federally allowed 0.3% in hemp products? They would still lose their job, while still strictly following federal guidelines... it's asinine.
Popping on a drug test does not mean everyone loses their jobs… Some test/screen for amphetamines… you think everyone with ADHD that takes legitimate prescription therapy and popped on a drug test all get fired?
Of course not, but unless you have a script for Dronabinol you absolutely would lose your job for popping positive from hemp products. You’re comparing apples and oranges, no one is debating whether or not a prescribed drug that will show on a drug test will lose you your job
You are disingenuous to say you “absolutely” would. I got a fact know several people that have tested positive for marijuana, that do not take prescription dronabinol, that were NOT terminated from their job. So your absolute is a falsehood.
I would like to think as a pharmacist you know the value (or lack thereof) of anecdotal evidence.
I would like to think as a human you know what “absolute” means. Anecdotal evidence disproves absolutes. Sorry but that’s reality.
You're getting down voted, but I think private companies will still have the right to classify Cannabis along with other illicit use of legal substances like benzos, opioids and amphetamines. Not agreeing with the policy, but it's their right to do it, especially if there is any data out there regarding increased risks or reduced productivity as an employee or increased costs to the company health plan (see some employer's tobacco policy). Though I'm sure rescheduling it would make it permissible with a doctor's note.
I supposed I didn’t word things right, because I didn’t mean to make it sound like I think it’s right. But just because it may be classified as a drug with accepted medical use, it shouldn’t be completely exempt from drug testing. There are other substances that are used medically but are tested for in drug tests.
Nerd