President Donald Trump’s executive order issued on December 18 signaled a shift in US medical cannabis policy, opening new paths for research and fueling a wave of mergers and acquisitions across the sector. However, one essential issue remains unresolved: how will patients receive medical marijuana in a way that resembles standard healthcare?
Canada confronted this same problem years ago, and its experience offers a cautionary tale.
In 2016, Canadian authorities broadened access to medical marijuana nationwide. While many viewed the decision as progressive, the chosen framework at the time left significant gaps. Healthcare professionals, particularly pharmacists, were largely excluded from the system. Cannabis could be authorized by physicians, but it was not prescribed in the traditional sense, nor dispensed through pharmacies.
That structure became even more problematic after Canada legalized recreational marijuana in 2018. Many observers expected that adult-use legalization would finally bring medical marijuana into mainstream healthcare settings. Instead, the divide deepened. Doctors continued to issue general authorization documents rather than prescriptions, often without specifying dosage, formulation, or method of use. Pharmacists remained on the sidelines, unable to guide patients directly at the point of care.
Meanwhile, recreational marijuana became widely available through retail stores and online platforms that were often more accessible than medical channels. For many patients, especially those dealing with neurological conditions, chronic pain, or nausea, the recreational market offered speed, convenience, and lower costs. Clinical oversight became a secondary concern.
That shift carried risks. Cannabis can interact with other medications and requires careful guidance on dosing and timing—the kind of support that pharmacists offer. However, that support was largely missing.
Within regulatory limits, some organizations tried to fill the gap. Call centers staffed by licensed pharmacists offered education on proper use, side effects, and potential interactions. Efforts were made to steer patients toward safer formulations and to apply basic pharmaceutical standards to product review.
While patients valued that support, the model was not financially viable. Counseling could not be sustained when purchases flowed through nonmedical channels. Ultimately, the initiative ended not because demand was lacking, but because the system made true medical delivery unworkable.
As U.S. cannabis policy continues to evolve, the country faces a similar crossroads. The central question is no longer about access alone. It is about delivery. Canada’s experience highlights the risks of prioritizing access while sidelining healthcare professionals. If marijuana is to be treated as a medication in the U.S., pharmacists will need to play a central role in providing it.
For medical marijuana companies like Trulieve Cannabis Corp. (CSE: TRUL) (OTCQX: TCNNF), a model that improves service to patients would be of great help in ensuring patients can access professional help as they use medical marijuana to manage their symptoms.
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