Ask the Expert: If I recommend marijuana, what should I ask the dispensary?
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Due to US DEA classification of marijuana as a Schedule I drug, meaning there is no accepted medical use and a high potential for abuse, healthcare providers have not been adequately educated about its use. No clinical guidelines exist to guide dosing or indications for use, making it difficult to have a standardized treatment approach, especially with differing state regulations.
Instead of traditional pharmacies, patients seeking marijuana for medicinal use often go to dispensaries. Some dispensaries focus on stocking and selling only recreational products or medicinal products, while others offer both. Therefore, products and the role of staff may vary significantly—from online-certified “budtenders” to licensed pharmacists—making it difficult for providers to effectively communicate and collaborate with the dispensary team. In addition, not all dispensary teams are making evidence- based recommendations, so it is important to inquire about proper training before referring patients to a specific dispensary.1Ask the dispensary: Do they offer medicinal products, recreational products, or a combination?
Species and Strains
Marijuana, known as the genus Cannabis, is divided into three species: Cannabis sativa, Cannabis indica, and Cannabis ruderalis. The major cannabinoids present in Cannabis are delta9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Cannabis ruderalis is rarely grown alone due to low levels of THC. Hybridization occurs by breeding different species, to create new strains with select characteristics.2
Numerous strains of marijuana exist, so understanding composition is important, instead of relying on names alone. Strains may contain C. indica, C. sativa, or varying amounts of either. Strains are also designed to contain varying ratios of THC, CBD, and other cannabinoids and