When I first received my medical marijuana card, my visits to the local dispensary were generally long, drawn out affairs. The bud tenders on staff would meticulously walk me through each strain on display, describing in detail their psychoactive and somatic effects. As someone prone to cannabis-induced anxiety I eventually learned that strains with low THC and high CBD counts were what I needed, but it took a lot of trial and error to find the right strain of medicine. Although the bud tenders spoke with authority about the effects of their medicine, I would often find that the effects of the bud recommended for me didn't at all match what the bud tender had told me.
According to a new study published last week in the journal Cannabis and Cannabinoid Research, my dispensary experience is likely a common one.
Led by clinical psychologists at Stanford University, the new study found that many dispensary staffers have had little to no training that would allow them to recommend types of weed to their patients in a responsible and informed manner. It is the first study to systematically look at the characteristics and practices of dispensary staff, otherwise known as 'bud tenders.'
"Although each state has created its own legislation to govern the cultivation and distribution of cannabis to individuals, there is currently little to no guidance or oversight of associated patient care," the authors of the study wrote. "This is troubling, as cannabis comprises more than 400 chemical compounds and is associated with widely variable effects among humans."
The study was based on a survey of 55 dispensary staffers from nine different states, although the majority of the participants were in Colorado, California and Arizona. The survey found that 94 percent of dispensary staffers would provide specific cannabis advice to patients, although only 55 percent reported having any sort of formal training. For 36 of the respondents, this training was limited to customer service and business practices. Only 11 respondents had any sort of medical training and 7 had some background in science.
The survey also asked the respondents to record the types of bud recommendations they would make for patients. It found that dispensary staff were more likely to recommend a 1:1 ratio of THC:CBD for anxiety, PTSD or trauma than high THC, and more likely to recommend high CBD for ailments like arthritis or Alzheimer's.
As the study's authors note, some of the recommendations provided by dispensary staffers were consistent with current medical understanding, such as recommending indica strains for chronic pain. The problem of course is that this medical information is often inconsistent itself.
For example, one recent study recommended indica for sleep disorders while another recommended sativa. Yet as the study notes, strains tend to make less of a difference in the effects experienced by a patient than the levels of cannabinoids such as THC and CBD.
Due to the relative lack of information about the medicinal uses of pot and practices at dispensaries, the study ultimately concludes that it is up to states to write cannabis legislation in such a way that continuous training is required for those providing advice to patients.
"While one might expect the most qualified individuals to provide specific recommendations of cannabis product to be trained physicians who are aware of a patient's medical history and other prescription medications that could interact with certain cannabinoids, it is dispensary staff who are the most likely to provide cannabis advice," the study's authors wrote. "As each state is currently responsible for drafting and monitoring its own cannabis legislation, it is imperative for states to mandate some form of educational certification for any individual providing cannabis advice to patients, not just physicians."