Inside the Mind of a Medical Cannabis Pharmacist in Utah

Utah is unique when it comes to cannabis, and the state’s program includes many unique exceptions not often seen across the rest of the country in states where medical cannabis is legal.
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In Utah, dispensaries are referred to as pharmacies, and the method of which patients must apply for and obtain cannabis medicine differs. While the state of Utah is home to over three million people, only 15 pharmacies and eight cultivators are allowed to legally operate there.

Pharmacists are essential to the structure of Utah’s medical cannabis program, as they are legally the only way that medical cannabis patients can obtain cannabis products. Beehive Farmacy’s Pharmacist in Charge, Mindy Madeo, has been a pharmacist for over 20 years, but found a new calling to enter the cannabis industry after the state of Utah legalized medical cannabis. Madeo attended the University of Maryland School of Pharmacy’s cannabis program, which she will soon be graduating with a Masters of Science in Medical Cannabis Science and Therapeutics. It’s currently the only pharmacy school in the U.S. to offer such a degree, and furthermore, Madeo is one of the only people in Utah to have earned such a distinction.

Madeo took time to chat with High Times about what sets Utah apart from other states’ medical cannabis programs, the influence of the Church of Jesus Christ of Latter-day Saints (LDS), and what the future holds for patients.

Courtesy of Mindy Madeo

The Essential Pharmacist

When Madeo began her entrance into the cannabis industry, she helped one of the pharmacies, called Wholesome, open up shop. While that pharmacy was a bit more business-focused, Madeo then moved on to Beehive Farmacy where she currently works as Pharmacist in Charge. Beehive Farmacy has two locations out of the total 15 that are allowed statewide, one in Salt Lake City and another in Brigham City. “It’s been really amazing,” Madeo said of her role. “The work I do every day is really like my dream. I’ve been doing it for two years and I still say I would do it even if I wasn’t getting paid.”

Madeo explained how Utah’s medical cannabis program works for patients. Similarly to other states, patients must go to a doctor and obtain a recommendation for a cannabis card—but new patients can’t just go to a pharmacy to pick up their medicine right away. “It is required by law that every single patient that’s new to the cannabis program, has to sit down and have a consultation with the pharmacist. And that’s the unique thing. That’s the thing that no other state does,” Madeo explained. “And it’s expensive to run as a business to do that, but the results are just phenomenal.”

These consultations only take an average of 30 minutes, during which pharmacists like Madeo will ask their patient which medications they currently take. “I’ve noticed as I was doing this that it’s not just the pain pills,” she shared. “It’s stimulants, like the Adderall and Ritalin in the morning that people can come off of. It’s the sleeping pills at night. It’s the antidepressants. It’s the stomach meds. I’ve even had I’ve even had quite a few patients come off of blood pressure medications.” After identifying their patient’s needs, pharmacists recommend various cannabinoid combination products, or different cultivars or terpene profiles, to use as a treatment.

Madeo also notes the importance of teaching new patients how to control their dosage, what to do if they consumed a bit too much, and for regular consumers, how to reset tolerance or reassess their current medication. “So I think giving patients control of their pain, control of their health, where they’re able to increase or decrease or try different products is very empowering for people. And I wish more medicine would be like that.”

The LDS Church

Aside from regular curious customers, Madeo has also witnessed the shift in perspective by the Church of Jesus Christ of Latter-day Saints (LDS) and its members. “In Utah, it’s amazing because the LDS church, at first was not on board. There was a lot of controversy,” she said of the church’s initial stance on cannabis. “And then they changed some policy saying like ‘You can’t have cannabis.’ And then they changed it again and saying ‘It’s fine if it’s with a doctor.’ So currently, it’s 100% fine as long as the doctor recommends it. And I am seeing so many old people, so many people that come in [and] you can tell [that] they’re Mormon, they’re wearing CTR rings. Their minds are changing. And to me, that in itself is just an amazing thing to watch.”

Expanding Legislation in Utah

Utah initially passed its medical cannabis legislation when former Gov. Gary Hubert signed House Bill 195 into law in March 2018, which allows patients the “right to try” cannabis as a treatment if they are terminally ill. Later in November 2018, Utah voters approved Proposition 2, which created the foundation for the state’s current medical cannabis program. The state’s program launched in March 2020, and now there are an estimated 41,000 medical cannabis patients in the state, as of January 2022.

Cannabis isn’t the only medical treatment that legislators are contemplating when it comes to access. In the 2022 legislative session, Utah legislators passed House Bill 167, also called the Mental Illness Psychotherapy Drug Task Force, which will review studies about psychedelic substances being used as a treatment for medical patients. Substances such as psilocybin therapy, or even the use of MDMA, are being used to treat certain medical conditions.

Ultimately, Madeo sees a bright future for the medical patients of Utah, and those who aren’t currently patients but are becoming curious about how cannabis can help. However, there are still many hurdles to overcome. “In Utah, and probably in the whole country is, right now we sit and we differentiate between medical use and recreation[al] use, right? That word ‘recreation’ is a terrible word. We should be calling it ‘adult-use.’ But we still use “rec.” To me, that’s such a judgment call, and I don’t think there’s much of a difference between the two.”

Madeo commented on the judgmental attitude of laws in Utah, from limitations on advertisements or restriction on anything that is Rastafarian inspired, such as colors or designs. “To me, they’re trying to whitewash the plant that we’ve been using forever,” she said.

But this judgement also extends to consumers as well. “We’re somehow like targeting this culture that we think we’re judging them and we’re saying, ‘You have dreadlocks, you are using concentrate … you’re using too high of a dose, so you’re a rec patient.’ That person could have anxiety, they could have cancer. Give me five minutes with someone who you say is rec and I’ll find a medical reason why they’re using it.”

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