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How Budtenders Work with Cancer Patients. An April 2023 study entitled "Dispensary Personnel's Views and Experiences Regarding Oncologic Cannabis and the Counsel They Offer Adults with Cancer" that was published in the peer-reviewed Wiley journal Cancer Medicine explored "dispensary personnel's views and experiences regarding oncologic cannabis and the counsel they extend individuals with cancer."
How Budtenders Work with Cancer Patients Study
The study noted that medicinal cannabis is legal in 38 states and the District of Columbia and that a cancer diagnosis qualifies patients to participate in these state-level programs in nearly every state. "Twenty-three of these states (and the District of Columbia) have in place parallel non-medical 'adult use' cannabis laws which provide an additional avenue by which individuals with cancer may access cannabis," reported the study's authors.
"A minority of oncologists feel qualified to clinically counsel adults with cancer regarding cannabis."
The scientists reported that recent research indicates that only "a minority of oncologists feel qualified to clinically counsel adults with cancer regarding cannabis" and that those diagnosed with cancer often access information about cannabis for cancer "from non-medical sources, chiefly cannabis dispensaries."
Participant Profile
The study involved a survey of 26 patients. About half (54 percent) were female and the group featured a median age of 40. Forty-two percent of those surveyed worked in a medical cannabis dispensary, while 38 percent worked in adult-use cannabis retail environments. "Mean number of years in the cannabis industry was 5.3," reported the unique study.
Need for Cannabis Training
The research report noted that other research indicates that budtenders and dispensary technicians "tend to receive little [and] unstandardized on-the-job training in cannabis therapeutics." In other words, the retail level of the modern American cannabis industry is grossly undertrained and uneducated.
The researchers reported that their findings necessarily question the advice offered to cancer patients by budtenders and dispensary staff.
How Budtenders Work with Cancer Patients Study Results
How Budtenders Work with Cancer Patients. Interviews with the survey group of patients indicated that cancer patients shopping for medical cannabis at a retail dispensary do so for four primary reasons:
Physical symptoms
Mental health symptoms
Disease modifying therapy
General wellbeing (e.g., "holistic," "neuroprotectant potential," "quality of life")
The specific symptoms that cancer patients were seeking to treat with their visit to the dispensary were lack of appetite, nausea, and vomiting. Mental health symptoms included anxiety, depression, and sleep impairment.
Consumption Avenues
Those interviewed for the survey reported that they consumed edibles and tinctures. Reported one participant: "I think edibles are really great, and so are these really high-potency pastes, for lack of a better word—the THC and CBD pastes." However, when rapid relief was desired, most patients preferred either inhalation (smoking or vaping) or tinctures. The typical onset period for traditional (not nanoemulsified) oil-based edibles is 90 to 120 minutes. This long onset is one of the biggest disadvantages of edible cannabis products.
"When rapid relief was desired, most patients preferred either inhalation (smoking or vaping) or tinctures."
Many patients recommended high-potency delta-9 THC, while others preferred CBD products. "In general, it seemed that CBD was favored for those naïve to cannabinoids (to avoid THC-related somnolence and paranoia), and high THC, for analgesia," reported the study.
How Budtenders Work with Cancer Patients Study Conclusions
How Budtenders Work with Cancer Patients. The study reported the following conclusion:
"This paper represents one of the scientific community's first glimpses into dispensary staff views and advising practices around oncologic medical cannabis. Among participants, consensus seemed to have been reached about the botanical's efficacy for cancer-related symptoms, less so regarding its antineoplastic potential. General principles for serving those with cancer included provision of client-centered and symptom-based care, for instance by tailoring a regimen according to a client's personal priorities and evolving that regimen based on feedback over time.
"Some suggested that THC was not only more effective than CBD for symptoms such as pain, but also potentially more likely to cause euphoria and somnolence."
"This finding is of significance since on-line recommendations for high concentration cannabinoid pastes often target a fixed high daily cannabinoid dose in a one-size-fits-all fashion. Akin to traditional beliefs in medicine, non-inhalation modes of administration were generally recommended to and preferred by individuals with cancer.
"Some suggested that THC was not only more effective than CBD for symptoms such as pain, but also potentially more likely to cause euphoria and somnolence, and therefore to be consumed with caution in the cannabis-naïve individual. In these instances, CBD-predominant products would be preferable. Challenges in advising adults with cancer included being able to accurately identify them as such at the dispensary counter; arriving at a dosing regimen that was not cost-prohibitive; and operating in the absence of clear oncologic guidelines.
"While the informed assertions to come out of this study should be tested in a larger population-based survey, if replicated, they would suggest that the oncologic community must grapple with the extent to which its members feel comfortable with both the nature and degree of counsel adults with cancer receive at the dispensary counter.
"The impressions and recommendations of dispensary personnel in this study seemed to mirror those of United States oncologists. In population-based samples, oncologists largely agreed on the symptom management but not the antineoplastic potential of cannabis. Like dispensary personnel, they favored oral administration on net, but seemed not to have reached consensus on optimal ratios of cannabinoids.
"In population-based samples, oncologists largely agreed on the symptom management but not the antineoplastic potential of cannabis."
"Data from this study also begin to suggest manners in which the oncologic cannabis system could be strengthened. First, insurance coverage for cannabis therapy would facilitate dosing consistency which may currently be cost prohibitive for some individuals with cancer. Second, formal dispensary guidelines for identifying and serving adults with cancer could serve to standardize an oncologic approach. As corollary, expanded on-the-job oncologic cannabis therapeutics training may be in order.
"Research has demonstrated that oncology teams lean heavily on the brain trust of dispensary personnel to advise their patients. Understanding the advice given at the dispensary counter seems quite germane and stands to influence clinical care in this domain. Our exploratory study should be followed by a larger, in-depth, oncological-focused population-based dispensary personnel survey, one that could serve as a valuable springboard to hypothesis generation in social psychology and clinical research pertaining to this important topic."
View the original study.
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