As cannabis reform continues to make its way throughout the U.S., we are collectively witnessing brand new trends on the part of consumers. One of those trends is pregnant people using cannabis, which is prompting budtenders and healthcare providers alike to recognize that they need more education on the issue to properly guide potential consumers.
National guidelines state that cannabis should not be consumed during pregnancy, though the use of cannabis during pregnancy has increased over time.
One recent study found that cannabis use among pregnant people is up sharply, with past-month rates nearly doubling to seven percent and daily or near-daily use tripling to 3.4 percent from 2002 to 2017.
Pregnant people often get information on cannabis use from the budtenders who sell the cannabis, though even for the people who seek information from healthcare providers, education for both groups hasn’t kept pace with the uptick in use.
A new study published in The American Journal of Drug and Alcohol Abuse explored this further, with the objective of determining healthcare professionals’ and budtenders’ perception of risks and benefits to cannabis use. Both groups in the study indicated that they wanted more information on interacting with pregnant and nursing people about their cannabis use.
Celestina Barbosa-Leiker, vice-chancellor for research at Washington State University Health Sciences and the leader of the study, said that it is in the best interest of the patient to provide such training to budtenders and healthcare professionals alike.
“We need to use all approaches and all people in the patient’s life to help them,” she said. “There is such limited research with budtenders, but they need to be part of this conversation because they are seen as trusted sources by their customers and our patients. We need to engage with them because that’s where the information is being disseminated.”
The study recruited 10 healthcare professionals, who self-reported providing healthcare services to people who used cannabis while pregnant or postpartum, and 10 budtenders, who were eligible to participate based on self-report of employment at a cannabis retail store within the last year.
Interviews were conducted over the phone or on the university campus in a clinical lab, depending on patient preference, with questions centering around perinatal cannabis use and perceptions of reasons for the use.
Both healthcare providers and budtenders agreed that pregnant and breastfeeding consumers mostly used cannabis to relieve nausea, anxiety, pain and stress, rather than for recreational use.
Healthcare providers deviated from budtenders, saying they had a negative opinion on the effects of cannabis use among these patients. They indicated they tried to be nonjudgmental when having these conversations, but they followed the national guidance, which advises patients to refrain from using cannabis during pregnancy and while breastfeeding, similar to the advice surrounding alcohol and cigarette use.
Budtenders more often perceived cannabis as a natural substance, safer than alcohol or cigarette use and had a more positive view of pregnant and nursing people using the drugs. Budtenders also tended to recommend lower-THC products for pregnant and breastfeeding customers, while healthcare providers were much more black and white—either a choice between no use or heavy use, with little perception of cannabis use on a spectrum.
Barbosa-Leiker noted that patients who feel stigma from their healthcare provider, or who cannot access information or guidance from the provider, are more likely to turn to a budtender for advice. She sympathized with budtenders, who are often relied on as a go-to source for pregnant and nursing people, when they often don’t have the training themselves to properly relay valid information.
One of the budtender participants noted that they have to rely on “stoner science” of largely unverified claims, or Google searches, to help customers.
“Training is needed for healthcare professionals to assist with patient discussions about cannabis products and to manage changes in clinical practices due to increases in perinatal cannabis use,” the study notes. “Budtenders also need training on cannabis products and request training on how to best serve perinatal customers. We encourage researchers and healthcare professionals to work with patients and budtenders to better serve perinatal women that use cannabis.”
Ultimately, the goal would be for a pregnant or breastfeeding person to feel as comfortable talking about cannabis use with their healthcare provider as they do with a budtender. Barbosa-Leiker says that will take training and methods of asking questions in the right way.
“With that additional training, I think those conversations can happen in a more nonjudgmental way, in a harm-reduction way, and hopefully trust will be built,” Barbosa-Leiker said.
