Clearer guidance on cannabis counselling

As cannabis use becomes more mainstream, pharmacists are increasingly fielding patient questions about safety, dosing and therapeutic benefits. In a recent Pharmacy Forum webinar hosted by the Canadian Foundation for Pharmacy (CFP), panelists discussed tools and strategies to help pharmacists answer these questions with confidence.

Moderated by Maria Zhang, an Advanced Practice Clinical Leader (Pharmacy) at the Centre for Addiction and Mental Health (CAMH) and an Adjunct Lecturer at the Leslie Dan Faculty of Pharmacy, University of Toronto, the panel emphasized the importance of translating research into practical tools for real-world pharmacy practice.

One such tool is the Cannabis Care Guide for Pharmacists, made possible with funding from CFP’s Innovation Fund. Dr. Beth Sproule, a scientist at CAMH’s Institute for Mental Health Policy Research, and her team developed the Guide and tested its feasibility in community pharmacies in Ontario. The idea for the Guide came from pharmacist Laura Murphy, a graduate student of Sproule’s, who passed away in 2024.

After screening 146 patients, of whom about one-third reported current cannabis use, 60% of them agreed to a consultation. Of those 60%, they were able to schedule follow-up consultations with about 20%. “The objective was to describe how the Guide could be used in real-world practice and identify barriers and facilitators,” explained panelist Avery Loi, a pharmacist at the University Health Network who co-led the project with Sproule while he was a student at the University of Toronto. He added that pharmacists valued the Guide’s structured framework, particularly for gathering consistent patient information and determining when to refer clients for additional care.

Panelists highlighted the changing landscape of cannabis use and patient expectations. Karen Ng, a pharmacist within the Toronto Academic Pain Medicine Institute Hub at Women’s College Hospital, noted that “almost 50% of my consults are around questions about cannabis and safe use,” and observed a shift toward more cautious perceptions of its benefits. She said the Guide’s appendices on dosing and harm reduction are particularly helpful for addressing patient uncertainty.

“Most have come in using it recreationally, but are curious—does it help with my pain, mood, or sleep? I don’t know my doses or what’s in the product. The guide helps us structure those discussions and promote safer use,” she said.

New evidence suggests that pharmacists are eager to take on greater roles in cannabis care when they have the right tools. Sandra Gerges, Program Coordinator and Professor for the Pharmacy Technician Program at Humber Polytechnic, shared findings from a national survey completed recently exploring pharmacists’ readiness to counsel on cannabis. While 80% of respondents said cannabis education should be part of their role, 65% felt unprepared to provide it. “Pharmacists really did want something to help guide that conversation,” said Gerges. “They wanted detailed dosing information, drug interactions and harm-reduction strategies.”

Dr. Sproule noted that the Guide is part of a larger effort to translate research into real-world practice and to fill a gap in pharmacist education, particularly as many pharmacists report feeling unprepared to counsel patients on cannabis.

The panel discussed educational resources complementing the Guide, including an upcoming free continuing education professional development course through the University of Toronto, covering foundational cannabis knowledge, legal frameworks, clinical responsibilities and ethical considerations. Resources for youth were highlighted as well, such as CAMH’s The Blunt Truth series which provides tips on safer ways to use cannabis.

Panelists underscored that, despite the growing availability of cannabis, evidence on its safety and efficacy remains limited, and standardization is lacking. As Loi noted, “Even if you know exactly what’s in it, all these different products have not been studied for us to provide clear guidance on combinations or dosing.”