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Medical Marijuana 101: What Does A Dispensary Worker Need To Know?

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As the marijuana industry takes shape in Massachusetts, it will need a trained workforce. What skills will that person behind the dispensary counter have? How about employees who will process marijuana? Who's training these workers? Here's a glimpse as the Northeastern Institute of Cannabis (NIC) in Natick opens its doors.

The Northeastern Institute of Cannabis in Natick (Martha Bebinger/WBUR)
The Northeastern Institute of Cannabis in Natick (Martha Bebinger/WBUR)

On a sunny fall afternoon, men and women sat at tables in a stark white classroom. For that day, the class was called "patient services."

"Get a complete list of symptoms, right at the beginning," instructor Bill Downing said. "Ask your patients, 'How long have you suffered from this condition?' It gives you a feeling for what their situation is."

Downing, who is also a marijuana caregiver, clicks through charts that match the reasons patients use marijuana — relief from pain, depression, nausea and glaucoma, with compounds in the plant that are most likely to help.

CannLabs' breakdown of health benefits specific cannabinoids have for certain diseases. (Courtesy of CannLabs)
Click to enlarge: CannLabs' breakdown of health benefits specific cannabinoids have for certain diseases. (Courtesy of CannLabs)

He runs through the marijuana-infused products his students would be selling at a dispensary: tinctures, lip balm, bubble bath, salves and lotions.

"Topical applications are great for localized pain," he said. "And they don't get you high."

This is one of 12 classes students must complete and pass tests on to receive a certificate from NIC. It's a for-profit training center with two classrooms in an office park. The course costs $1,500 and covers growing marijuana, legal, business, science and regulatory issues.

"This industry’s coming, and we need to be ready to train the workers," said NIC events coordinator Chris Foye. "That’s what we’re going to do."

NIC opened this fall. So far, 14 students have graduated and 70 more are enrolled. There’s one other classroom program in Massachusetts. The New England Grass Roots Institute says its classes are for person enrichment, not professional training. Foye says NIC is filling a demand from dispensary owners who will be required to pay $500 to register each employee yearly with the state.

"They’ve already been spending millions of dollars on the application process to open this dispensary," he said. "They don’t have time to be messing around with people that, you know, just want to smoke weed. This is serious. And that’s what this school is establishing: that it’s serious."

Students at NIC must have a high school diploma or GED. Founder Mickey Martin said he's applied for a state occupational school license and expects to receive it soon. Martin wrote much of the curriculum NIC uses, with input from business owners and others in states with an established legal marijuana industry, and with material from his book, "Medical Marijuana 101."

NIC and other such training programs around the country are deciding, on their own, what it means to train and certify a marijuana dispensary employee. State regulations require eight hours of training a year that includes instruction on patient confidentiality rules. But the state does not say anything more about what the people who will advise patients should know, and there are no national standards.

"That is something that we’d like to see developing in the industry," said Taylor West, deputy director with the industry trade group National Cannabis Industry Association. "We’re just in the early days on that right now, but I think it’s a direction you’ll start to see people moving in."

While dispensary owners figure out what kind of training employees need, the industry is growing fast, and students at NIC are anxious to jump in.

"We have so many states that are legalizing it, so I see it taking a huge step forward and getting a lot of potential behind it. I see it becoming a really big thing," said Michael Wunderlich, a 21-year-old car mechanic from Methuen who wants to become a master grower.

Michael Wunderlich of Methuen listens to Bill Downing's class on patients services at Northeastern Institute of Cannabis in Natick. (Martha Bebinger/WBUR)
Michael Wunderlich listens to Bill Downing's class on patients services at the Northeastern Institute of Cannabis. (Martha Bebinger/WBUR)

When Wunderlich tells family and friends about his planned career change, he said he hears "mixed emotions about it."

"Older people, they don’t really understand it," he said. "They’re still in that Reefer Madness thing. But a lot of people my age, they think it’s really cool."

At NIC, the future dispensary workers cover a lot of material about marijuana and its potential benefits for patients in a short period of time. Downing ran through the basics of deciding how much marijuana to recommend for each patient.

"The standard for THC [one of the cannabinoids in marijuana] is 25 milligrams per dose," Downing said. "It won't get you high but will help to stimulate your appetite, will take the edge off your pain, calm your nerves, do the things we're concerned about with medical cannabis."

He told students that some patients will need more.

"The doses required for curative cancer are much higher than standard recreational doses," Downing said.

There is no established medical research that shows marijuana can cure cancer. Advice on setting doses differs.

Dispensary workers will have to adjust doses based on the way a patient ingests marijuana and the strain they use. Dispensaries are required to test the marijuana they sell, but this too is an evolving practice.

Dispensary workers will grow and sell dozens of different strains of marijuana. Downing runs through a brief history of some common types: OG Kush, Dairy Queen, Blue Dream, Cheese and Sour Diesel. He suggests a couple of websites where students can get more information about the characteristics and benefits of each.

Some dispensaries will have a physician employees can consult before advising patients about which strain and what dose of marijuana to try. But Dr. Richard Pieters, president of the Massachusetts Medical Society, says the training does not seem adequate.

"These people that are being trained need to understand the drugs that are being used for those conditions and the interaction of this agent with those drugs," Pieters said. "That will require substantially more than 48 hours of training in my opinion."

What is or isn't the right amount of training and what that training should include is a matter of opinion as medical marijuana dispensaries prepare to open in Massachusetts. Growing and using marijuana is nothing new, but operating in a legal market is, in Massachusetts.

"People have been doing this for years," NIC's Foye said. "People are professionals in a black market industry, and we're trying to get over that part of it."

In the end, the most important training may be among patients, who will navigate between the worlds of standard medicine and the new option of marijuana.

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Martha Bebinger Reporter
Martha Bebinger covers health care and other general assignments for WBUR.

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