Thursday, August 31, 2017

The Green Lottery – Who Will Distribute Recreational Cannabis?

The Federal government declared July 1, 2018 as the deadline to legalize recreational cannabis. The real tantalizing question is: how will it be distributed? The Provincial governments have the responsibility to make this decision.  Many investors, business owners and corporations are agonizing over this decision because recreational cannabis offers a significant earning potential.  Even pharmacists are eagerly waiting for the decision, as it could help revitalize the profession that has been hit with budget cuts over the past few years. Shoppers Drug Mart has already taken their first step into cannabis distribution by submitting an application to become a licensed medical cannabis distributor.

Who are the potential candidates for cannabis distribution? There are 3 viable options:
  1. Pharmacies
  2. Government owned dispensaries
  3. Privately owned dispensaries
From a clinical stand point there is no competition, pharmacies clearly are the best choice.  It’s logical for the medication experts (pharmacists) to dispense cannabis, especially as so many patients may be taking other medications concurrently that might interact.

However, the provincial governments will want to maximize their earnings. The best way to do this is by distributing cannabis through government owned dispensaries.  The issue with this option is that provincial governments will be too slow to set up distribution locations by the July 1, 2018 deadline.  This is why the Ontario government is considering combining LCBOs (Liquor Control Board of Ontario) with dispensaries.  This idea is absurd from a health care perspective because it encourages combining alcohol with cannabis; however, perhaps from a politician’s point of view, nothing is out of the question (just look at Donald Trump).

The last option, gaining a lot of traction recently, is privately owned dispensaries.  There are a number of illegally operating dispensaries throughout the provinces, which are hoping to legitimize when the provincial legislation passes.   They are already set up to dispense cannabis, which makes them an easy option for the provinces to certify as licensed cannabis distributors.  However, it may be difficult to regulate these dispensaries as many of these locations may not be using ethical business practices.  For those owners currently operating outside of the law, continuing to do so after legislation passes may not be a stretch.

Regardless of the provinces’ decision, pharmacists will need to be prepared to counsel and advise patients on the use of cannabis.

The following continuing education programs are an excellent way to learn more about cannabis:

For Ontario healthcare professionals only, there is a $1,500 government fund to help subsidize continuing education costs.  Therefore if you are a registered Ontario pharmacist, you may be eligible to be reimbursed! Visit Allied Health Fund for more details.

- Ajay Chahal

Thursday, August 24, 2017

The Journey Begins

 Hello rxBriefCase,

I’m excited to start my 5-week rotation with rxBriefCase and experience something completely different from the standard clinical rotations in community and hospital pharmacy clinics.  This is my fourth block, with six more to go until I’m finally finished school!  My previous rotations (block 1 and 2) were at Center of Addictions and Mental Health (CAMH), where I was part of the acute schizophrenia ward and outpatient mood/depression unit.  

Mental health is a topic that I have a passion for, and antidepressants are one of the most commonly prescribed medications in Canada.  Escitalopram was the 5th most commonly dispensed medication in 20131. If you are interested in furthering your understanding of the field, I’d suggest reading: 
  1. "A case of partial treatment response: what next?"
  2. "When treatment for depression doesn't work"
Both of these articles are in the rxBriefCase eNewsletter archive, and discuss therapeutic options in treatment resistant depression.

Having learned a lot about the nuances of communication during my time in hospital and community pharmacy, I’m excited to flip the script and focus on my written communication during my stay with the rxBriefCase team.

Stay tuned for future blog posts!

- Ajay Chahal

1. Spolarich, A. E. (2015, April 18). Commonly Prescribed Medications and Managing the Oral Side Effects of Medication Use. Retrieved August 23, 2017, from