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Balneaves LG, Alraja AA, Thompson G, Penner JL, John PS, Scerbo D, van Dyck J. Cannabis use in a Canadian long-term care facility: a case study. BMC Geriatr 2024; 24:467. [PMID: 38811895 PMCID: PMC11134741 DOI: 10.1186/s12877-024-05074-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 05/13/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Following the legalization of cannabis in Canada in 2018, people aged 65 + years reported a significant increase in cannabis consumption. Despite limited research with older adults regarding the therapeutic benefits of cannabis, there is increasing interest and use among this population, particularly for those who have chronic illnesses or are at end of life. Long-term Care (LTC) facilities are required to reflect on their care and policies related to the use of cannabis, and how to address residents' cannabis use within what they consider to be their home. METHODS Using an exploratory case study design, this study aimed to understand how one LTC facility in western Canada addressed the major policy shift related to medical and non-medical cannabis. The case study, conducted November 2021 to August 2022, included an environmental scan of existing policies and procedures related to cannabis use at the LTC facility, a quantitative survey of Healthcare Providers' (HCP) knowledge, attitudes, and practices related to cannabis, and qualitative interviews with HCPs and administrators. Quantitative survey data were analyzed using descriptive statistics and content analysis was used to analyze the qualitative data. RESULTS A total of 71 HCPs completed the survey and 12 HCPs, including those who functioned as administrators, participated in the interview. The largest knowledge gaps were related to dosing and creating effective treatment plans for residents using cannabis. About half of HCPs reported providing care in the past month to a resident who was taking medical cannabis (54.9%) and a quarter (25.4%) to a resident that was taking non-medical cannabis. The majority of respondents (81.7%) reported that lack of knowledge, education or information about medical cannabis were barriers to medical cannabis use in LTC. From the qualitative data, we identified four key findings regarding HCPs' attitudes, cannabis access and use, barriers to cannabis use, and non-medical cannabis use. CONCLUSIONS With the legalization of medical and non-medical cannabis in jurisdictions around the world, LTC facilities will be obligated to develop policies, procedures and healthcare services that are able to accommodate residents' use of cannabis in a respectful and evidence-informed manner.
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Affiliation(s)
- Lynda G Balneaves
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada.
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada.
| | - Abeer A Alraja
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | | | - Jamie L Penner
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | - Philip St John
- Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Daniella Scerbo
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
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Stone BM. When Public Will Meets Legislative Resistance: Five Lessons from Ohio's Issue 2 Cannabis Legalization Controversy. Cannabis Cannabinoid Res 2024. [PMID: 38527180 DOI: 10.1089/can.2024.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
In this paper, I explore the challenges of legalizing cannabis in Ohio, focusing on the passing of the Issue 2 Bill, legislative resistance, and public response. I propose five strategies for effective policy change: persistent advocacy post policy change success, establishing strong coalitions, empowering grassroots movements, promoting rigorous data-driven research, and launching public education campaigns. I offer a detailed analysis of the interaction between public opinion and legislative action in cannabis legalization and its implications for substance-related policy change.
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Affiliation(s)
- Bryant M Stone
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Fehr F, Lo LA, Nelson C, Nanson K, Diehl L, Nielson K, Reddon H, Walsh Z. Stigma-related barriers to medical cannabis as harm reduction for substance use disorder: Obstacles and opportunities for improvement. Int J Ment Health Nurs 2024; 33:195-201. [PMID: 37767954 DOI: 10.1111/inm.13231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023]
Abstract
Emerging evidence on substituting cannabis for more harmful drugs has led to cannabis becoming a novel harm-reduction strategy for combating the current drug poisoning crisis. However, the authorization of medical cannabis as part of a harm-reduction approach and recovery strategy has significant implementation barriers rooted in longstanding stigma towards cannabis. Through a multi-discipline collaboration of Canadian clinicians and academic researchers, we highlighted stigma barriers and opportunities to address these barriers to elicit improved delivery of medical cannabis as a harm-reduction therapy within existing therapeutic frameworks. Evidence from existing literature and real-world experiences converged on three key themes related to stigma barriers: (1) Lack of medical cannabis education within the healthcare community, (2) lack of consensus and coordination among harm-reduction services and (3) access to medical cannabis. We highlight potential solutions to these issues, including improved healthcare education, better coordination between care teams and suggestions for improving access. Through this discussion, we hope to contribute to reducing the stigma around using medical cannabis as a harm-reduction strategy for individuals with a substance use disorder and consider new perspectives in policy development surrounding recovery services.
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Affiliation(s)
- Florriann Fehr
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Lindsay A Lo
- Department of Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Chris Nelson
- Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada
| | - Kate Nanson
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Lauren Diehl
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Karl Nielson
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Hudson Reddon
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada
| | - Zach Walsh
- Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada
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Muacevic A, Adler JR. How Demographic Factors Impact Attitudes Toward the Recreational Use of Cannabis. Cureus 2023; 15:e34304. [PMID: 36860218 PMCID: PMC9970729 DOI: 10.7759/cureus.34304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2023] [Indexed: 01/30/2023] Open
Abstract
While cannabis legalization in the United States has become more commonplace, differences in attitudes toward its use persist. Negative attitudes toward cannabis create barriers to care for those seeking its use for therapeutic purposes. Existing research regarding the attitudes surrounding cannabis is specific to medical cannabis (MC) use or cannabis use in general. To address this gap, the present research sought to explore the demographic factors that influence attitudes toward recreational cannabis, including gender, age, ethnicity, race, level of education, marital status, number of children, the legal status of cannabis in the state of residency, employment status, political party affiliation, political view, and religion. The Recreational Cannabis Attitudes Scale (RCAS) was used to measure participants' attitudes toward recreational cannabis. A one-way analysis of variance (ANOVA) or one-way Welch ANOVA was used to determine variations in RCAS scores between different demographic groups. Data from 645 participants indicated that gender (P = 0.039), employment status (P = 0.016), political party affiliation (P = 0.002), political view (P = 0.0005), the legal status of the state of residence (P = 0.003), religion (P = 0.0005), and experience with cannabis (P = 0.0005) had significant variations between groups regarding attitudes toward recreational cannabis. Understanding the factors that inform attitudes is critical to efforts to destigmatize cannabis use. Education about cannabis is an effective measure in reducing stigma, and paired with demographic information, advocacy efforts can be more accurately targeted.
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Clobes TA, Arellano M, Gagnon M, Klaiman C. Differences in Attitudes Toward Medical Cannabis With Humanized Patient Scenarios. Cureus 2022; 14:e28354. [PMID: 36168378 PMCID: PMC9507077 DOI: 10.7759/cureus.28354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Attitudes toward medical cannabis are shaped by a number of factors, such as religion, previous use, and political affiliation. Individuals with less supportive beliefs toward cannabis, in general, may be more open to its therapeutic applications in a humanized patient scenario (PS). Methods A modified medical cannabis attitude scale was used to measure participants' attitudes toward medical cannabis. Two humanized patient scenarios were presented to the participants, and their level of agreement with the patient having access to medical cannabis was measured. After the scales were standardized, a Wilcoxon signed-rank test (WSR) was utilized to determine whether a difference between medical cannabis attitudes and approval of medical cannabis use in the humanized PS exists. Results A total of 645 participants completed the full survey and were included in the data analysis. Most participants were supportive of the patients in the humanized scenarios having access to medical cannabis; 76.1% and 75.7% of respondents, in each of the scenarios, selected the highest level of approval. There was a significantly higher approval for medical cannabis with the PS than attitudes toward medical cannabis in general (Z=-17.415, p<0.0005). Conclusion Individuals were more supportive of patient access to medical cannabis when exposed to humanized PS than their general attitudes toward medical cannabis indicated. Applying the results of this current research, a viable plan to reduce the stigma surrounding cannabis is to use patient testimonials in public-facing advocacy efforts regarding medical cannabis.
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AminiLari M, Kithulegoda N, Strachan P, MacKillop J, Wang L, Pallapothu S, Neumark S, Sharma S, Sethi J, Zacharias R, Blain A, Patterson L, Busse JW. Benefits and Concerns Regarding Use of Cannabis for Therapeutic Purposes Among People Living with Chronic Pain: A Qualitative Research Study. PAIN MEDICINE 2022; 23:1828-1836. [PMID: 35652734 DOI: 10.1093/pm/pnac085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Although there is growing interest in medically authorized cannabis for chronic pain, little is known about patients' perspectives. We explored perceptions of people living with chronic pain regarding benefits and concerns surrounding their use of cannabis for therapeutic purposes. SETTING A hospital-based clinic in Hamilton and two community-based interdisciplinary pain clinics in Burlington, Ontario, Canada. METHODS In this qualitative descriptive study, we conducted semi-structured interviews with 13 people living with chronic pain who used cannabis therapeutically, living in Ontario, Canada. We used thematic analysis, with data collection, coding, and analysis occurring concurrently. RESULTS People living with chronic pain reported important benefits associated with use of cannabis for therapeutic purposes, including reduced pain, improved functionality, and less risk of harms compared to prescription opioids. Most patients also acknowledged harms, such as grogginess and coughing, and there was considerable variability in patient experiences. Financial costs and stigma were identified as important barriers to use of cannabis. CONCLUSION Evidence-based guidance that incorporates patients' values and preferences may be helpful to inform the role of cannabis in the management of chronic pain.
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Affiliation(s)
- Mahmood AminiLari
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | | | | | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton.,The Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Ontario, Canada
| | - Li Wang
- The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Sushmitha Pallapothu
- The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | | | - Sangita Sharma
- Emergency Medicine, Department of Medicine, Faculty of Health Sciences, McMaster University
| | - Jagmeet Sethi
- McMaster University, Department of Medicine, Hamilton, Ontario, Canada
| | - Ramesh Zacharias
- McMaster University, Michael G. DeGroote Pain Clinic, Hamilton, ON, Canada
| | - Allison Blain
- McMaster University, Michael G. DeGroote Pain Clinic, Hamilton, ON, Canada
| | - Lisa Patterson
- McMaster University, Michael G. DeGroote Pain Clinic, Hamilton, ON, Canada
| | - Jason W Busse
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada.,The Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Ontario, Canada.,Department of Anesthesia, McMaster University, Hamilton, ON, Canada.,Chronic Pain Centre of Excellence for Canadian Veterans, Hamilton, Ontario, Canada
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