1. Educating the naïve patient: From harm reduction to benefit maximization Amanda Reiman MSW PhD Director of Research Berkeley Patients Group

2. Today’s talk Demographic trends in the medical cannabis population: age and experience Meeting the needs of this patient group Harm reduction AND Benefit maximization: Education, implementation, evaluation Next steps…

3. Trends in the patient population N=304 anonymous surveys collected at BPG at intake (2010) 74% male, 57% White, Mean age is 32. 75% use cannabis for a pain related condition. 86 patients reported more than one condition. Almost 20% of new patients have used cannabis for the first time in the past 6 months. Significantly more likely to be Latino/a or African American (p<.01).

4. Deviations from previous data Almost 20% of new patients have used cannabis for the first time in the past 6 months. Mean age is 32. Previous data from BPG patients (N=350) revealed a mean age of 39 (2008). Explanations… Focusing on the naïve patient…

5. Cannabis naïve patients… Come to cannabis for various reasons Lack of success with traditional treatment; catastrophic illness; beliefs about pharmaceuticals Do not possess the language to express their needs knowledge of the various preparations or methods of ingestion, strains, etc. May not have a guide to lead them through the process of selection and ingestion Important in learning to reduce harm and maximize benefits Might be intimidated and have pre-conceived, propaganda based notions of cannabis

6. Harm reduction and Benefit maximization Two sides of the same coin Harm reduction: reducing the chance of a negative experience from using cannabis Benefit maximization: increasing the chance of a positive experience from using cannabis

7. Harm Reduction Negative experiences from cannabis use can occur anxiety, upset stomach, rapid heart rate (more common in naïve users) Legal sanctions The importance of set and setting Dispensaries play an important role Information about dependence and withdrawal should be presented honestly. Navigating patient status among friends, family, employers, etc. (especially younger patients)

8. Benefit Maximization Cost-effectiveness Make each dollar count! Symptom specific medicine Efficacy and efficiency! Method of ingestion Salves….who knew?

9. Next steps… Cannabis 101 (EDUCATION) Language Demystification Legal review How to handle negative experiences Dependence and withdrawal Industry professionals should also receive education on answering “basic” questions Guide to medicate with patient for the first time (IMPLEMENTATION) Patient liaison on site Workshops on assessing the effects of cannabis (EVALUATION) Effects Method class

10. Questions? Amanda@berkeleypatientsgroup.com