How a Lack of Dispensary Attendant Training Puts Patients at Risk

CannabizMD

March 12, 2019

Photo Credit: Sonya Yruel/Drug Policy Alliance

Currently in Maryland, to become a dispensary attendant or “budtender”, the only qualifications you need are being over 21, registering with the Maryland Medical Cannabis Commission (MMCC), having no felonies or drug convictions on your record, undergoing a criminal background check, and getting fingerprinted. In addition to meeting these requirements, people who want to work as attendants take part in a basic educational workshop about medical cannabis once every twelve months.

What’s missing? Detailed knowledge about medical cannabis. And that gap has the potential to have a significant impact on patients.

Explains Dr. Dustin Sulak, DO, an integrative medicine physician, founder and medical director of Healer.com, and creator of an in-depth attendant training curriculum, “In an ideal world, the responsibility of a dispensary agent would be to provide a patient with cannabis-based medications that are compatible with their medical provider’s recommendation. The problem is most patients are seeing doctors who don’t give any advice or direction on how to use the medicine. So the patient shows up at the dispensary, and the dispensary attendant is essentially asked to play doctor. That’s asking someone with no clinical experience who was hired for a customer service role to give advice on how to use the medication to treat conditions that can be really serious.”

“The current mandated training is completely inadequate to empower these attendants to actually help patients get a basic understanding of their medication and to identify people who may be coming in impaired or intoxicated, which could indicate misuse or that the patient is receiving the wrong strain or dosage of medication,” he cautions.

Maryland pharmacist Jason Weise, who has developed an in-depth, hands-on, Maryland-specific attendant training program agrees and notes that having well-trained and educated attendants also has a business benefit for dispensaries.

“When attendants receive training and professional development, there’s less turnover, which saves the costs associated with hiring and training new staff. A well-educated attendant staff can also increase patient satisfaction,” he says. “Attendants who understand the conditions that medical cannabis is recommended for and what types and preparations of medical cannabis are most effective for each condition become a trusted resource for patients. They develop a relationship and the patients will continue to rely on that dispensary and may recommend it to other patients.”

Weise predicts that the education of dispensary attendants will follow the same path as the process did for pharmacy technicians 20 years ago. Chains will develop training programs that will be reviewed and approved by a national organization or association and continuing education will be required of all employees in this role. Eventually, attendants may be licensed by a state board.

The challenges patients face

For patients, the lack of well trained attendants can make the process of using medical cannabis more complex and, sometimes, frustrating. They need to:

  • Understand what strain and preparation they used previously if they’re seeking to reproduce a good result or avoid a poor one
  • Be able to access a product that’s of consistent quality and potency from batch to batch
  • Be assured that the product they choose is free from contamination

“Right now, most attendants are primarily sales people,” adds Dr. Sulak. “They may well have good intentions, but they’re not clinicians. They may see one successful patient experience and assume that what worked for one MS patient will work for all, and that’s definitely not the case.”

There’s another area of concern—patient safety. Attendants who don’t receive in-depth training to build the knowledge they need to answer patient questions may put patients’ health at risk. In addition, a negative reaction, like feeling intoxicated or not receiving any relief when using a medical cannabis product, may discourage patients from trying again.

“A lot of people who are new to cannabis now are very hesitant and wary,” says Dr. Sulak. “My average new patient now is 70 years or older, has never tried cannabis, or it’s been decades since they’ve tried it. The aging population is really warming to the idea of using cannabis as a medicine, but they have a lot of reservations and fear about getting high, being impaired, falling. So, if they go into a dispensary and don’t get advice that will help them use the medicine correctly without experiencing the side effects and risks they’re worried about, it can really interrupt someone’s potential for successful treatment.”