LSU Shreveport's Medical Cannabis Training for Counselors

As you drive east on I-20 after crossing the Louisiana state line heading towards Shreveport, you pass a large billboard advertising that any doctor can recommend medical cannabis for whatever they deem a debilitating condition. Without fail, every time I drive by it, I am reminded of how different the medical cannabis laws are in my new home state of Louisiana from my native state of Texas.

The number of medical cannabis patients increased by 4.5-fold during 2016 and 2020, but educational opportunities for counselors and other mental health professionals are still very few. LSU Shreveport has demonstrated a successful track record of sold-out workshops on careers in cannabis over the last three years that provides a good foundation to build on.?

Medical Cannabis in the South Central

?The media narrative forecasts the South as the new cannabis frontier. Shreveport is the unofficial capital of the Arklatex region. The tri-state economic area of 1.5 million people makes up southwest Arkansas, northwest Louisiana, northeast Texas, and the furthest southeastern county of Oklahoma that sits along the Red River. This southern region almost joined the exclusive club of 21 states and the District of Columbia. Arkansas passed medical cannabis legislation in 2016 and amended it in 2017, but 56% voted against legalizing recreational use in 2022. The state currently has 89,160 patients, with 38 dispensaries generating close to $81 million in sales tax revenue since mid-2019.

?In Texas, medical cannabis is a divisive issue where 67% support cannabis legalization, but where politicians have also prevented public sentiment from influencing public policy. Gov. Abbott signed into law the Texas Compassionate Use Act in 2015 that legalized medical cannabis for certain conditions such as epilepsy, autism, cancer, and post-traumatic stress disorder but refuses to pardon low-level marijuana offenders. Texas is currently experiencing a 10% growth in medical cannabis patients month-over-month, with 100,000 expected to be enrolled in the program over the next 18 to 24 months.

?Like Louisiana, in that there are no qualifying medical conditions, the medical cannabis market in Oklahoma has more than 365,000 patients enrolled in the program. The state is an outlier compared to the other three states that make up the South Central by the number of dispensaries open. According to the Oklahoma Tax Commission, there are more than 2200 licensed dispensaries across the state, with retail sales surpassing $800 million and $71.6 million in state and local tax revenue in 2020. Gov. Stitt called for a special election on March 7, 2023 for Oklahomans to decide on State Question 820 voter initiative that will legalize recreational sales.

?Unlike Arkansas and Texas, Louisiana experienced a big year for cannabis in 2022, where nearly six in ten support legalization. The smokable flower was added to the list of medical cannabis products available this past January 1st. Even though two bills responsible for setting up a regulatory framework for adult consumption did not make it out of committee, ten bills passed, including reciprocity for out-of-state patients and their ability to participate in the Louisiana market and receive the same legal protection as residents. There are currently nine dispensaries across the state filling more than 200,000 recommendations (prescriptions) this past year with expected sales to reach $100 million. Gov. Edwards signed HB 819 medical cannabis into law in 2020 and the HB 652 decriminalization law in 2021.

Lack of Medical Cannabis Education

A bigger medical cannabis market base in Louisiana (and the rest of the Ark-La-Tex and the South Central) means counselors will eventually work with clients who choose to medicate with medical cannabis. The clients may ask about it to seek relief from symptoms related to anxiety, chronic pain, depression, or ADHD if they have not already. It goes beyond the scope of practice for counselors to recommend cannabis treatment to clients, but that should not prevent us from conversing with our clients or acting as an educational resource for evidence-based research on therapeutic uses. ?

A bigger problem exists now of patients not getting the necessary information from healthcare providers to help decide whether the treatment is best for them. There is a large gap in medical cannabis knowledge for all healthcare providers, preventing them from meeting the public demand for medical cannabis education. A past study found that allied health trainees lacked sufficient knowledge and were not prepared to counsel patients on medical cannabis.

Stigma can also play a big factor in training that can cause disinterest. The lack of professional interest reminds me of what Dr. Sanjay Gupta said about a colleague who told him, do you really want to be that guy that pushes marijuana ? He goes on to say that this is the biggest challenge when researching cannabis because of an assumption that cannabis is only smoking pot and ignoring all the other parts of the plant.

Anecdotally, it reminds me of a phone interview experience I had during the pandemic with a university in a northeast state that had recently passed cannabis legalization for medical and recreational use. During the interview, a faculty committee member asked me if I supported the legislation, to which I responded yes and provided reasons why. One of the other committee members scoffed, and the tone quickly changed as they spoke and shared their views on how it was going to cause more drug use and impaired driving. The interview ended, and I never heard back. The lesson I took from that experience was that lack of professional interest in cannabis can look the same everywhere in the country, regardless of geographical location or political ideology. ?

?Medical Cannabis and Counseling Workshop

?As a counselor, I work with clients with chronic medical conditions and disabilities who choose to treat with medical cannabis. I assess their use and potential risks. I also belong to a professional cannabis association for clinicians and subscribe to industry newsletters to access current research, educational resources, and legislation.

?Most faculty, counseling students, and community providers are unaware of passed legislation or legal rights that come with medical cannabis use in the state. Training counselors by becoming educated resources for medical cannabis information can help promote client benefits and knowledge needed to attain health and wellness goals. The goal for offering an on-campus certificate in Medical Cannabis Science and Therapeutic Use is to train future mental health professionals who can help educate and support their clients in the Ark-La-Tex region.

This workshop is a sample of that proposed 12-hour post-baccalaureate certificate program. It will be interactive and include recorded interviews with local industry leaders and cannabis specialists who share their experiences and expertise. There will also be time for networking opportunities for counselors, students, and other mental health professionals interested in medical cannabis. The workshop and certificate cover the following four sections. These class descriptions and topics are evolving and a starting point for creating future research on curriculum and training standards.

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History of Cannabis & War on Drugs

This section covers the historical timeline of cannabis and the War on Drugs, as well as the impact on people of color and stigma from drug war propaganda. Effects of discrimination from institutions, government, power and oppression on clients’ life as well as cultural factors relevant to rehabilitation and mental health counseling will be discussed.

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Medical Cannabis Science & Therapeutic Use

This section covers basic cannabis science and evidence-based research on therapeutic uses. Effects of cannabis use, impairment, and dependence will be covered as well. Strategies will be discussed for interfacing with other medical and allied health professionals, including interdisciplinary treatment teams.

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Cannabis law, Business, & the Workplace

This section covers Louisiana cannabis law, cannabis entrepreneurship, discrimination, and workplace concerns, as well as strategies for training employers, educators, and families on medical cannabis and the state law.

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Case Studies & Practical Applications

This section covers medical cannabis case studies to provide attendees an opportunity to apply ethical principles. Section includes exploring intake interviews for cannabis use, brief mental status evaluation, biopsychosocial and mental health histories, and assessment for potential for substance use disorders.

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The medical cannabis workshop is on Thursday, February 2nd, 2023, from 8:00 am to 4:30 pm at LSU Shreveport. Click here for more information.

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Unable to make it? Sign up here to join a Louisiana counselor medical cannabis interest group.