How Do Cannabis Shop Workers Approach Product Recommendations?

How, exactly, do cannabis shop workers come up with product recommendations to customers? 

That question was the basis of a study published Wednesday in JAMA Network Open. University of Pittsburgh researchers led a team of mostly clinicians that conducted a national cross-sectional survey of people who worked at a cannabis shop that sold cannabis that contained THC, and who talked to customers about their purchases. The survey of 434 respondents from 351 “unique” cannabis shops was conducted between February and October 2020, and specifically asked those who participated about their approaches to “formulating customer recommendations and talking to customers about risks.” 

Most of the people who answered the survey were budtenders (40%), followed by “managers” (32%), and then “pharmacists,” which accounted for just 13% of respondents. 

And, more surveys came from New York, Oregon, California, and Florida than from other regions, and researchers noted that roughly one-third of responses “were from states in which is legal.” 

Results showed that 74% of respondents said they made their recommendations to customers based on the buyer’s “medical condition,” while 70% said they were based on other customers’ experiences, and 63% reported they were based on “the customer’s prior experience with cannabis.” Finally, researchers noted, only 40% of respondents said it came down to “clinician input.”

“Most respondents routinely advised customers about safe storage and common adverse effects, but few counseled customers about cannabis use disorder, withdrawal, motor vehicle collision risk, or psychotic reactions,” researchers highlighted.

This is what most surprised Jessica Merlin, lead researcher and associate professor of medicine at the University of Pittsburgh. 

“The thing that really struck me about this is that dispensaries really operate in a different paradigm than what we’re used to as a medical paradigm,” Merlin said. “In the medical paradigm, we always think about, with any therapy, both the benefits and the potential risks or harms. And so I think what really stood out to me is that I want my patients to know about the potential harms of cannabis so that they can be really informed consumers and use the product safely as possible. I cannot expect that to happen at a dispensary.”

What prompted this research? 

“We know that we actually don’t know what goes on in the dispensary. And, it occurs to us that the role that oftentimes we play as physicians when we, for example, prescribe medication, is now being filled by somebody with a training background and a role that we’re just unfamiliar with,” Merlin told Cannabis Wire

Recruitment for the study was far from straightforward, as researchers first wanted to reach employees at cannabis shops by phone, using a script that asked managers to distribute the survey to “frontline staff.” 

“We found that managers were often difficult to reach, and managers and higher-level administrators expressed concern about the potentially proprietary nature of the information we wished to gather (eg, dispensary practices) and our intentions regarding speaking directly to staff (eg, poaching staff for opening of new dispensaries),” researchers noted. “This recruitment method led to few completed surveys.” 

Researchers then “purchased” a list of nearly 5,000 U.S. dispensaries from a “marketing company,” and then filled in the gaps through listings on Weedmaps, for example. Merlin said researchers did not verify whether the shops were licensed through the state because “when people go out into the world,” to obtain cannabis, “they can go anywhere,” licensed or unlicensed storefronts. 

This study was funded through “internal funds” within the University of Pittsburgh. 

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