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Working With Chronic Pain Patients: Tools for Dispensaries

September is Pain Awareness Month, a month dedicated to highlighting the experience of chronic pain and its effects on individuals, families, and the global community. 

Pain is just as common among those who use medical cannabis, as those who choose more conventional medications. Therefore, budtenders play a crucial role in a patient’s road to recovery. In a dispensary setting, staff must have the right tools to empathically understand, communicate with, and provide for the chronic pain patient. They are ultimately the key to a positive experience and positive therapeutic outcomes for the customer.

Typically, dispensary staff members have experience knowing which product is best for treating which condition, but staff are often missing the necessary pain-specific tools and communication techniques used commonly by physicians. 

Unless they have personal experience with chronic pain, they may not even know how prevalent, serious, and isolating the experience is. Giving staff the knowledge plus pain-specific communication tools will facilitate a better experience at the counter. In some cases, it may even improve the patient’s outcome at home.

The Prevalence of Chronic Pain 

The doctor’s office and the dispensary counter may not initially seem that much alike, but taken down to the patient level, there are many similarities. Patients seeking care through the traditional medical system, those opting for the plant-based approach, and those who prefer a little bit of both all have common questions, opinions, and conditions. At the top of their list of concerns is chronic pain. 

Pain is the number one reason for a doctor’s visit in the US. It affects 50 million Americans, with 20 million experiencing it chronically. Every year, pain costs the country approximately $635 billion in lost productivity, medical costs, and disability payments. It is the leading cause of long-term disability in the US. Statistics are similar when broadened to a global scale

Chronic pain is one of the most challenging medical conditions to diagnose and to treat. With poor outcomes and medications plagued with potential side effects, many patients are frustrated with the available treatment options. One only needs to look at the opioid crisis to see the failures of the current approach to treatment. 

Patient frustration with the status quo has convinced many to seek alternatives, which usually means moving towards medical cannabis. The statistics on medical cannabis for the treatment of pain is less concise but still convincing. In every patient survey or data analysis to date, pain is always a top-five condition treated with cannabis. 

In 2011, a review of medical cannabis patients in the state of California found that over 80 percent reported pain as a primary reason for use. A 2017 report, also from California, confirmed a majority of medical cannabis patients used the plant for pain. Pulling from our own RYAH Data platform, pain registers as the fourth most popular reason for medical cannabis use (for both men and women).

Furthermore, cannabis for the treatment of pain is earning a lot of scientific support. A prospective open-label study, published in the Journal of Clinical Pain, determined cannabis “resulted in improved pain and functional outcomes, and a significant reduction in opioid use.” A previously published literature review on the subject, published in the same journal, reported: “71% [of assessed studies] concluded that cannabinoids had empirically demonstrable and statistically significant pain-relieving effects.”

Finally, in one of the deepest investigations to date, the National Academy of Sciences concluded in their pivotal report, The Health Effects of Cannabis and Cannabinoids, that “there is conclusive or substantial evidence that cannabis or cannabinoids are effective: For the treatment for chronic pain in adults.”

Although there is always a need for more long-term clinical study, the evidence is so far extremely positive for the use of cannabis for the management of pain.

Gathering the Tools for Chronic Pain

Both budtenders and family doctors spend a significant portion of their day working with pain patients. Although there may be a world of difference between the professions, under the current system, patients are seeking medical advice and treatment suggestions from both. 

In this strange world where the role of doctor and budtender overlaps, budtenders can benefit from a deeper understanding of the condition. Which means teaching staff the language of pain. The experience of pain varies greatly from one patient to another, and this makes it challenging for dispensary staff to accurately gauge the severity and experience to suggest appropriate options.

Physicians and patients often rely on visual handouts, like the Ability Chart and the Migraine Conversation Guide, to assess the pain experience. There are several other useful rating systems as well, such as the numerically-based Global Pain Scale. These help better define the nature of the pain, how it limits daily activities, time of day, and so much more. 

Beyond the communication tools suggested here, the American Chronic Pain Association has a host of other options specific to certain conditions. They could come in handy for medical dispensaries looking to deepen their connection to the patients they serve, to provide better service and better suggestions.

By reviewing these simple yet highly effective charts, budtenders could easily improve their recommendations for strain, potency, and method of consumption. For example, if a patient reports chronic pain as a 5/10 that limits their ability to work during the day, their budtender may consider a medium potency, energetic strain to ease their moderate pain but still improve day-time productivity. 

A secondary but equally as important component to improving the dispensary experience for pain patients is to round out the education of the budtender. Teaching budtenders the full scope of chronic pain helps them ask the right questions when guiding medical cannabis patients. 

For example, acknowledging that chronic pain is not just a physical experience but an emotional one as well. Often, pain comes with a host of other comorbidities, such as “mood alterations (such as depression), anxiety, sleep disturbances, fatigue/lack of energy, neurocognitive changes, and other vague symptoms including generalized diffuse pain states.” Therefore, developing a basic understanding of how one condition can become tied up with another may help a budtender advise the patient on best practices and best product options.

Third: incorporating dose control and data analysis into the patient experience. Dose-metered dry herb vaporizers, which combine traceable proprietary dry-herb cartridges with valuable predictive analysis, help improve the patient experience. Not only does this help the patient experiment with dose and strain for a better outcome, but it can also help the budtender adjust for adverse effects. With detailed information on what worked (and what didn’t), budtenders and patients alike can both make better decisions.

Finally, a simple yet effective way to improve the in-dispensary experience for the pain patient is to enhance empathy during conversations. Chronic pain is isolating, stigmatizing, and often combined with mental health issues. For the patient, this can be a terrifying experience. Giving dispensary staff sensitivity training will improve their in-person interactions and improve customer satisfaction—independent of the plant-medicine they purchase.

Tools for the budtender include communication skills and the language of pain, knowledge about the prevalence and experience of chronic pain, better data analysis, and, finally, empathy. Considering that budtenders are increasingly taking on the role of doctor and pharmacist for medical cannabis patients, they need to arm themselves with the right tools to improve the patient experience and therapeutic outcomes. This is especially true when it comes to working with patients with chronic pain. 

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