Drug policy experts are calling for national education programs to tackle the lack of awareness and ‘stigmatising attitudes’ towards medical cannabis patients.
In a new paper, researchers from Liverpool John Moores University, have highlighted how current policies, and a lack of training for professionals, are contributing to a range of harms among patients prescribed medical cannabis.
The findings, which are published in the journal Critical Social Policy, come just weeks before the sixth anniversary of the legalisation of medical cannabis on 1 November, 2018. They highlight how ‘contradictory policies’, ‘a lack of training’ and the ‘prohibitionist constructions of cannabis’ have resulted in patients experiencing stigma and inequality.
Stigmatising social interactions
For the qualitative study, the research team conducted interviews with 24 patients and carers of those who are legally prescribed medical cannabis about their everyday experiences. The data was then evaluated and divided into themes to explore stigmatising social interactions in healthcare; police and security services; work and home life.
Some participants reported that their NHS healthcare providers ‘lack knowledge’ of the legality of cannabis medicines. While some were ‘curious and keen to learn’ others displayed ‘stigmatising attitudes’ towards prescribed patients.
Encounters with ‘untrained or ill-informed police’ also raised concerns for patients, with some experiencing ‘wrongful treatment’ by the police despite having a legal prescription. Others said they ‘live in a state of anxiety’ about potential encounters with ‘ill-informed officials’.
A separate study recently found that almost a third did not know that medical cannabis was legal under prescription, meanwhile more than 88% believed that they would benefit from more training on the substance and how to identify legal medical cannabis patients.
A fear of confrontation when administering their medication in public spaces was also identified, with many worrying about the reactions of landlords, employers, friends and family, fuelled by the confusion around the legality of cannabis.
According to the authors, Black patients, disabled patients, and parents, are among specific groups encountering ‘multidimensional stigma’ and ‘particular stereotyping’ around cannabis.
“Some patients had already experienced stigmatising attitudes towards their disability or chronic illness – cannabis stigma was an additional stress on top,” Lindsey Metcalf Mcgrath, co-author of the paper, told Cannabis Health.
“Patients with children fear that they will be judged as bad parents due to them taking cannabis medicine. And prohibitionist racist stereotyping around the ‘typical’ cannabis user lingers for Black patients legally prescribed the drug.”
Resisting the stigma
The paper goes on to explore the ways in which patients may try to ‘resist’ this stigma.
Some said they felt unable to be open about their medication, limiting their activities to avoid the need to medicate in public, resulting in ‘health impacts’ and ‘curtailment of liberty’. There were also reports of some attempting to distinguish themselves as ‘law-abiding’ by distancing themselves from those who still accessed cannabis without a prescription.
Other patients took on the responsibility of attempting to tackle this stigma by widely sharing their own experience in an attempt to improve education and change people’s minds about the medicinal benefits.
“Health gains from prescription cannabis were helping many patients in our study lead more active lives again, but fear of taking their medicine in public spaces or on public transport can hold them back,” Metcalf McGrath added.
“One patient told us that the stigma associated with cannabis is an added stress on top of coping with chronic illness. It is important that patients can take their prescribed cannabis when and wherever they need it.”
‘Professional and public education’
Like many of the patients they spoke to, the researchers are calling for ‘comprehensive professional and public education about the legality of medical cannabis’.
Their recommendations include the roll out of national programs to raise awareness of legal cannabis prescribing for all health professionals to avoid ‘stigmatising attitudes’, as well as training for police, airport and security staff to ‘protect the legal freedom of cannabis patients’ and ‘avoid reputational damage in instances of unwarranted attention’.
Public facing organisations, including venues and transport providers are also urged to ‘make provision’ for cannabis patients, both in terms of staff training and safe medicating spaces.
But alongside this there is also a need to tackle the ‘source of cannabis stigma’, with ‘critical reforms in drug policies’.
They add: “To dismantle these discourses and genuinely reduce harm requires renewed efforts to challenge state authority and persuade the government to give due regard to the growing global evidence base against prohibition and in favour of cannabis prescribing.”
Take part in new research
For a new study, the researchers are looking to speak to patients about their experiences of taking non-prescribed cannabis for a health issue or medical condition.
To take part in the study, you must be:
- currently taking cannabis for medical purposes without a doctor’s prescription
or a carer for someone taking cannabis for medical purposes without a prescription
Find out more here or email Dr Lindsey Metcalf McGrath at L.J.Metcalf@ljmu.ac.uk