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Smith A, Olson RE, da Costa NC, Cuerton M, Hardy J, Good P. Quality of life beyond measure: Advanced cancer patients, wellbeing and medicinal cannabis. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:1709-1729. [PMID: 37283094 PMCID: PMC10946949 DOI: 10.1111/1467-9566.13684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/09/2023] [Indexed: 06/08/2023]
Abstract
Experiences of advanced cancer are assembled and (re)positioned with reference to illness, symptoms and maintaining 'wellbeing'. Medical cannabis is situated at a borderline in this and the broader social domain: between stigmatised and normalised; recreational and pharmaceutical; between perception, experience, discourse and scientific proof of benefit. Yet, in the hyper-medicalised context of randomised clinical trials (RCTs), cancer, wellbeing and medical cannabis are narrowly assessed using individualistic numerical scores. This article attends to patients' perceptions and experiences at this borderline, presenting novel findings from a sociological sub-study embedded within RCTs focused on the use of medical cannabis for symptom relief in advanced cancer. Through a Deleuzo-Guattarian-informed framework, we highlight the fragmentation and reassembling of bodies and propose body-situated experiences of wellbeing in the realm of advanced cancer. Problematising 'biopsychosocial' approaches that centre an individualised disconnected patient body in understandings of wellbeing, experiences of cancer and potential treatments, our findings foreground relational affect and embodied experience, and the role of desire in understanding what wellbeing is and can be. This also underpins and enables exploration of the affective reassembling ascribed to medical cannabis, with particular focus on how it is positioned within RCTs.
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Affiliation(s)
- Alexandra Smith
- School of Social ScienceThe University of QueenslandBrisbaneQueenslandAustralia
| | - Rebecca E. Olson
- School of Social ScienceThe University of QueenslandBrisbaneQueenslandAustralia
| | - Nathalia Cordeiro da Costa
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
- School of Public HealthThe University of SydneySydneyNew South WalesAustralia
| | - Maddison Cuerton
- School of Social ScienceThe University of QueenslandBrisbaneQueenslandAustralia
| | - Janet Hardy
- Department of Palliative and Supportive Care Mater Health ServicesMater Research‐University of QueenslandSouth BrisbaneQueenslandAustralia
| | - Philip Good
- Department of Palliative and Supportive Care Mater Health ServicesMater Research‐University of QueenslandSouth BrisbaneQueenslandAustralia
- Department of Palliative CareSt. Vincent's Private Hospital BrisbaneBrisbaneQueenslandAustralia
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Hulaihel A, Gliksberg O, Feingold D, Brill S, Amit BH, Lev-Ran S, Sznitman SR. Medical cannabis and stigma: A qualitative study with patients living with chronic pain. J Clin Nurs 2023; 32:1103-1114. [PMID: 35488381 DOI: 10.1111/jocn.16340] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/29/2022] [Accepted: 04/01/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore the ways in which stigma is experienced, and what strategies are used to manage stigma among patients using medical cannabis to ease suffering from chronic pain. BACKGROUND Various jurisdictions have legalised medical cannabis in recent decades. Despite increasing prevalence and more liberal attitudes towards medical cannabis, it is possible that patients who use medical cannabis experience stigma. DESIGN A phenomenological qualitative study. METHODS Fifteen patients living with chronic pain and licensed by the Israeli Ministry of Health to use medical cannabis to treat pain symptoms for at least 1 year participated in semi-structured interviews. Transcribed data were analysed using thematic analysis to identify themes related to stigma. The manuscript is in correspondence to SRQR EQUATOR checklist. RESULTS Expressions of stigma were more related to 'felt' than 'enacted' stigma. Stigma related to decisions to delay onset of medical cannabis treatment and the ways in which participants managed medical cannabis use during their everyday lives. Participants dissociated themselves from recreational cannabis users, by presenting themselves as responsible normative individuals and engaging in a form of normalisation known as 'normification', emphasising their own discrete and controlled medical cannabis use and cannabis' benefits. CONCLUSIONS Patients experienced 'felt' stigma which had consequences for their self-presentations and medical cannabis use. This suggests that medical cannabis is not normalised in Israel and interventions may be needed to handle stigma related to medical cannabis. RELEVANCE TO CLINICAL PRACTICE The findings emphasise the effects of 'felt' stigma on patients. Aiming to increase the effectiveness of medical cannabis treatment and reducing harms, we suggest that particular focus should be placed on managing stigma at the intrapersonal level. In addition, there may be a need to address stigma at the societal level including social interactions with friends, family and medical personnel.
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Affiliation(s)
- Amany Hulaihel
- School of Public Health, University of Haifa, Haifa, Israel
| | - Or Gliksberg
- Department of Psychology, Ariel University, Ariel, Israel
| | | | - Silviu Brill
- Institute of Pain Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Ben H Amit
- Cannabis Clinic, Reuth Rehabilitation Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shaul Lev-Ran
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Israel Center on Addiction, Netanya, Israel.,Lev Hasharon Medical Center, Netanya, Israel
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Dor M. Three Decades of Cannabis Research: What are the Obstacles? Rambam Maimonides Med J 2022; 13:RMMJ.10486. [PMID: 36394499 PMCID: PMC9622390 DOI: 10.5041/rmmj.10486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
During the past few years, thousands of articles have been published concerning medical cannabis useage. Unfortunately, most publications are case studies or small and poorly designed research projects. In attempting to understand the reasons behind this situation, the obstacles impeding the use of medical cannabis and related research merit more in-depth examination. This editorial looks at some of the issues.
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Steel RT. Medicalising the menace? The symbiotic convergence of medicine and law enforcement in the medicalisation of marijuana in Minnesota. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:1324-1343. [PMID: 35939569 PMCID: PMC9540305 DOI: 10.1111/1467-9566.13513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
The medicalisation of marijuana has occurred rapidly, albeit nonuniformly, across the US and around the world over the past 3 decades. This paper centres on the medicalisation of marijuana in Minnesota-which has one of the most restrictive programs in the country-as a case for evaluating the negotiation of institutional boundaries with the shift from criminalisation to medicalisation after nearly a century of criminal prohibition. Drawing upon Foucauldian discourse analyses of the medical and law enforcement associations' position statements and legislative hearings that shaped medical marijuana policy in Minnesota, this paper demonstrates a symbiotic convergence between medicine and law enforcement through the deployment of shared discursive strategies in their opposition to medical marijuana that reinforce marijuana's criminalised status by solidifying the boundaries between proper medicine and dangerous drugs. Criminal justice and medical institutions draw upon one another's definitions, logics, and practices in a mutually constitutive manner, while still maintaining distinct user subjects and institutional interventions for each based on the user's access to state-approved forms of marijuana. The consequences for the governing of marijuana in Minnesota are explored, as well as the broader implications for the sociological study of medicalisation and criminalisation with respect to the governance of drugs and health.
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Affiliation(s)
- Ryan T. Steel
- Department of Sociology and AnthropologyUniversity of RichmondRichmondVirginiaUSA
- Department of SociologyUniversity of Minnesota (Twin Cities)MinneapolisMinnesotaUSA
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5
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Abalo E. Between facts and ambiguity: Discourses on medical cannabis in Swedish newspapers. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 38:345-360. [PMID: 35308110 PMCID: PMC8899053 DOI: 10.1177/1455072521996997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 11/25/2022] Open
Abstract
Aim: This study examines the discursive construction of medical cannabis
in Swedish newspapers, with the aim of understanding how the
news media recontextualise the medical potential of
cannabis. Design: The study is centred on the concept of recontextualisation, which
focuses on how discourses are reinterpreted and reshaped when
moving from one context to another, with a special focus on
recontextualisation in relation to the media. Methodologically,
the study uses critical discourse analysis to qualitatively
analyse 134 articles of different subgenres, published in four
Swedish newspapers between 2015 and 2020. Results: The study shows that medical cannabis is constructed around myriad
topics and contexts, ranging from news that focuses on the
medical potential of cannabis to articles where medical cannabis
is mentioned in passing and constructed in a more abstract form.
The media have difficulties retaining a conceptual boundary
between medical and recreational cannabis. Moreover, the study
shows that the medical potential of cannabis is discursively
constructed using three different discourses: patient discourse,
strong science discourse, and weak science discourse. Conclusions: The study suggests that there is a widening of the debate on
cannabis in the Swedish public sphere, giving more recognition
to the potential medical use of cannabis. The media, however,
show difficulties in refining discourses on medical cannabis,
which results in an altering between constructions that are
strongly connected to science, and those that are not.
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Edelstein OE. Attitudes and beliefs of medicine and social work students about medical cannabis use for epilepsy. Epilepsy Behav 2022; 127:108522. [PMID: 34999501 DOI: 10.1016/j.yebeh.2021.108522] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 11/28/2021] [Accepted: 12/19/2021] [Indexed: 12/01/2022]
Abstract
The current study sought: (i) to explore whether health profession students possess formal medical cannabis (MC) education, feel prepared to answer questions about MC, and perceive it as an effective therapy for epilepsy; (ii) to assess students' attitudes and beliefs about MC use; and (iii) to explore the associations between students' background characteristics, MC-related attitudes and beliefs regarding its effectiveness for epilepsy. A sample of 310 students (141 from medicine and 169 from social work) voluntarily participated in the anonymous online survey. The vast majority (92.5%) indicated they had no formal education about MC, and only 11.2 % reported being prepared to answer clients' MC-related questions. Participants reported favorable beliefs about MC benefits, the need for training, and recreational marijuana use legalization. Less supportive attitudes were reported regarding MC risks. Prior cannabis use (e.g., self-use, friends, or family) and individuals from a secular background were associated with more positive beliefs about MC benefits and its legalization for recreational purposes. Prior recreational cannabis use [OR=1.541] and having friends who recreationally use the substance [OR=1.891] were associated with the belief that MC is an effective therapy for epilepsy. These findings indicate an urgent need for students' MC education to provide future physicians and social workers with MC-related capacities. Development of curricula and training programs in Israel are encouraged.
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Affiliation(s)
- Offer E Edelstein
- Ben-Gurion University of the Negev, The Spitzer Department of Social Work, Beer-Sheva 841050, Israel.
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Rimon-Zarfaty N, Kostenzer J, Sismuth LK, de Bont A. Between "Medical" and "Social" Egg Freezing : A Comparative Analysis of Regulatory Frameworks in Austria, Germany, Israel, and the Netherlands. JOURNAL OF BIOETHICAL INQUIRY 2021; 18:683-699. [PMID: 34783957 PMCID: PMC8724162 DOI: 10.1007/s11673-021-10133-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 07/05/2021] [Indexed: 05/30/2023]
Abstract
Egg freezing has led to heated debates in healthcare policy and bioethics. A crucial issue in this context concerns the distinction between "medical" and "social" egg freezing (MEF and SEF)-contrasting objections to bio-medicalization with claims for oversimplification. Yet such categorization remains a criterion for regulation. This paper aims to explore the "regulatory boundary-work" around the "medical"-"social" distinction in different egg freezing regulations. Based on systematic documents' analysis we present a cross-national comparison of the way the "medical"-"social" differentiation finds expression in regulatory frameworks in Austria, Germany, Israel, and the Netherlands. Findings are organized along two emerging themes: (1) the definition of MEF and its distinctiveness-highlighting regulatory differences in the clarity of the definition and in the medical indications used for creating it (less clear in Austria and Germany, detailed in Israel and the Netherlands); and (2) hierarchy of medical over social motivations reflected in usage and funding regulations. Blurred demarcation lines between "medical" and "social" are further discussed as representing a paradoxical inclusion of SEF while offering new insights into the complexity and normativity of this distinction. Finally, we draw conclusions for policymaking and the bioethical debate, also concerning the related cryopolitical aspects.
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Affiliation(s)
- Nitzan Rimon-Zarfaty
- Department of Medical Ethics and History of Medicine, University Medical Centre Göttingen, Humboldtallee 36, 37073, Göttingen, Lower Saxony, Germany.
- Department of Human Resource Management Studies, Sapir Academic College, D.N. Hof Ashkelon, 7915600, Hof Ashkelon, Israel.
| | - Johanna Kostenzer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, P.O. Box 1738, 3000 DR, The Netherlands
| | - Lisa-Katharina Sismuth
- Department of Medical Ethics and History of Medicine, University Medical Centre Göttingen, Humboldtallee 36, 37073, Göttingen, Lower Saxony, Germany
| | - Antoinette de Bont
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, P.O. Box 1738, 3000 DR, The Netherlands
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Ruheel MA, Gomes Z, Usman S, Homayouni P, Ng JY. Facilitators and barriers to the regulation of medical cannabis: a scoping review of the peer-reviewed literature. Harm Reduct J 2021; 18:106. [PMID: 34649577 PMCID: PMC8515704 DOI: 10.1186/s12954-021-00547-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/17/2021] [Indexed: 01/01/2023] Open
Abstract
Background In recent decades, several political, legislative, judicial, consumer, and commercial processes around the world have advanced legalization efforts for the use of medical cannabis (MC). As the use of MC evolves through legislative reform, with an increase in public acceptance and therapeutic potential, a need exists to further investigate the facilitators and barriers to MC regulation. Methods A scoping review was conducted to identify the facilitators and barriers associated with the implementation of MC regulations. MEDLINE, EMBASE, AMED and PsycINFO databases were systematically searched; no restrictions were placed on geographic location/jurisdiction. Eligible articles included those that evaluated the MC regulatory framework of one or more countries. Results Twenty-two articles were deemed eligible and included in this review. Themes identified include: (1) effects of conflicts, mindset, and ideology of state population, (2) the use of comparisons to analyze MC regulation, and (3) the need for more knowledge, advice, and empirical/clinical evidence to inform future MC policies. Conclusion Policymakers should be aware of facilitators to the MC regulation implementation process, such as the influence of state and federal congruence, increased transparency, and the incorporation of stakeholder concerns, in order to effectively respond to a growing societal acceptance of MC and its use among patients. Given a comprehensive understanding of these influential factors, policymakers may be better equipped to meet the consumer and commercial demands of a rapidly evolving MC regulatory environment.
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Affiliation(s)
- Mohammad Ali Ruheel
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Zoya Gomes
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Sana Usman
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Pargol Homayouni
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
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Datta RP, Hanemaayer A. Getting real about nominalism again: Special forum introduction. JOURNAL FOR THE THEORY OF SOCIAL BEHAVIOUR 2021. [DOI: 10.1111/jtsb.12279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Ronjon Paul Datta
- Department of Sociology, Anthropology, and Criminology The University of Windsor Windsor Ontario Canada
| | - Ariane Hanemaayer
- Department of Sociology Brandon University Brandon Manitoba Canada
- Centre for Research in Arts, Social Sciences and Humanities University of Cambridge Cambridge United Kingdom
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Wagner A, Polak P, Świątkiewicz-Mośny M. From community of practice to epistemic community - law, discipline and security in the battle for the legalisation of medical cannabis in Poland. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:316-335. [PMID: 33283285 DOI: 10.1111/1467-9566.13217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 10/02/2020] [Accepted: 10/25/2020] [Indexed: 06/12/2023]
Abstract
Although public debates on cannabis are ongoing in many countries, there are currently no EU-wide rules for either medical or recreational use of cannabis. Numerous studies have illustrated that creating such rules is a complex challenge. The battle over the legalisation of medical use of cannabis in Poland is a good example for analysing the mutual impact of the social practices that various actors perform through and by the discourses in the field of health care: how they discursively create their own roles and take positions and how they shape the coalitions and opposition in trying to achieve their strategic goals. This article aims to reconstruct and explain how different types of knowledge are discursively used to sustain or question power relations in the healthcare field. The dispersed knowledge-power influences social actors, who try to define or redefine social practices and aspire to guide them in the healthcare field. The presented approach allows authors to go beyond the social actors' perception vs institutional regulations and to analyse discursive actions as elements of the complex networks of meanings activating various type of resources. Those dynamic networks, involving the different (and sometimes the same) actors in the different actions, open the new fields of rationality. Starting by identifying the crucial actors and their discursive actions visible in the mainstream press discourse, we will reconstruct three types of groups related to medical cannabis. We will then investigate three types of dispositives - law, discipline and security - to investigate the relations between discursive and non-discursive elements. The proposed analysis belongs to the Critical Discourse Analysis (CDA) paradigm and includes investigation of the media discourses and in-depth interviews with the identified actors.
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Affiliation(s)
| | - Paulina Polak
- Institute of Sociology, Jagiellonian University, Krakow, Poland
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11
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Rosenberg D, Sznitman SR. Regional differences in possessing medical cannabis license: a cross-sectional study. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1851409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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12
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Zarhin D. The trajectory of "medical cannabis" in Israel: Driving medicalization in different directions. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 82:102809. [PMID: 32516686 DOI: 10.1016/j.drugpo.2020.102809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/16/2020] [Accepted: 05/25/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Although researchers, laypersons and policymakers have been debating about the "medicalization of cannabis" for years, few have attempted to unpack this phrase and clarify what it actually means. The present qualitative research addresses this issue by tracing the trajectory of "medical cannabis" (MC) in Israel. METHODS This article draws on multiple sources, including in-depth interviews, parliamentary protocols, conference observations, policy documents, and media coverage. RESULTS The analysis shows that while patients, growers, and certain physicians advocated for a more inclusive type of cannabis medicalization, other physicians and sick funds strove to curtail this medicalization; for its part, the Ministry of Health (MoH) attempted to find a pathway that would bridge their conflicting standpoints. In the first phase of medicalization patients' and regulators' trajectories coincided; however, they diverged in the second phase as regulators sought to transform MC into a standardized medication in line with the biomedical model. Patients and physicians criticized the new policy reform and highlighted some of its negative effects on patient care. The trajectories of patients and regulators then intersected in a way that led to some alterations in the MC trajectory. CONCLUSION This study enhances our understanding of how MC was, and is still being, incorporated into medicine in Israel. The study illuminates the plurality of meanings that have been assigned to the concept of medicalization and the contingent nature of MC. Additionally, this study sheds light on the under-investigated role of regulators as drivers of the medicalization of "solutions," and it shows how different engines of medicalization may drive the process in diverging directions.
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Affiliation(s)
- Dana Zarhin
- Department of Sociology, Faculty of Social Sciences, University of Haifa, Israel; Department of Sociology, Brandeis University, Waltham, MA, USA.
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13
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Weinstein G, Sznitman SR. The implications of late-life cannabis use on brain health: A mapping review and implications for future research. Ageing Res Rev 2020; 59:101041. [PMID: 32109605 DOI: 10.1016/j.arr.2020.101041] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/12/2020] [Accepted: 02/23/2020] [Indexed: 12/11/2022]
Abstract
While medical and recreational cannabis use is becoming more frequent among older adults, the neurocognitive consequences of cannabis use in this age group are unclear. The aim of this literature review was to synthesize and evaluate the current knowledge on the association of cannabis use during older-adulthood with cognitive function and brain aging. We reviewed the literature from old animal models and human studies, focusing on the link between use of cannabis in middle- and old-age and cognition. The report highlights the gap in knowledge on cannabis use in late-life and cognitive health, and discusses the limited findings in the context of substantial changes in attitudes and policies. Furthermore, we outline possible theoretical mechanisms and propose recommendations for future research. The limited evidence on this important topic suggests that use in older ages may not be linked with poorer cognitive performance, thus detrimental effects of early-life cannabis use may not translate to use in older ages. Rather, use in old ages may be associated with improved brain health, in accordance with the known neuroprotective properties of several cannabinoids. Yet, firm conclusions cannot be drawn from the current evidence-base due to lack of research with strong methodological designs.
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Cannabis and synthetic cannabinoid exposure reported to the Israel poison information center: Examining differences in exposures to medical and recreational compounds. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 77:102711. [DOI: 10.1016/j.drugpo.2020.102711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 02/09/2020] [Accepted: 02/14/2020] [Indexed: 01/30/2023]
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15
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Vulfsons S, Minerbi A, Sahar T. Cannabis and Pain Treatment-A Review of the Clinical Utility and a Practical Approach in Light of Uncertainty. Rambam Maimonides Med J 2020; 11:RMMJ.10385. [PMID: 32017678 PMCID: PMC7000155 DOI: 10.5041/rmmj.10385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Over the past decade the phenomenon of cannabis as a legitimate form of treatment for pain has overwhelmed the medical community, especially in the field of pain. From a status of a schedule 1 substance having no currently accepted medical use and being considered to have high potential for abuse, its use has mushroomed to over 50,000 legal medical users per year in Israel alone. There appear to be many reasons behind this phenomenon-medical, sociological, and economical. Thus, what is cannabis? An abusive substance or a medication? Should it be incorporated into current biomedical practice, and how should it be administered? Finally, what is the evidence for the beneficial and detrimental effects of cannabis? This article reviews and discusses the current literature regarding the beneficial and the detrimental effects of medical cannabis in the treatment of pain. We further discuss the problems and challenges facing the medical community in this domain and offer a practical approach to deal with these challenges.
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Affiliation(s)
- Simon Vulfsons
- Institute for Pain Medicine, Rambam Health Care Campus, Haifa, Israel
- Rappaport School of Medicine, Technion Institute of Technology, Haifa, Israel
- To whom correspondence should be addressed. E-mail:
| | - Amir Minerbi
- Institute for Pain Medicine, Rambam Health Care Campus, Haifa, Israel
- Alan Edwards Centre for Research on Pain, Montreal, Quebec, Canada
| | - Tali Sahar
- Pain Relief Unit, Department of Anesthesia, Hadassah Medical Center, Jerusalem, Israel
- Supportive Care & Pain Relief Clinic, Clalit Health Services, Jerusalem District, Israel
- Department of Family Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Sznitman SR, Barratt MJ, Decorte T, Hakkarainen P, Lenton S, Potter G, Werse B, Wilkins C. Do medical cannabis growers attempt to produce cannabis with different cannabinoid concentrations than recreational growers? DRUGS AND ALCOHOL TODAY 2019. [DOI: 10.1108/dat-06-2019-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
It is conceivable that cannabis cultivators who grow for medical purposes aim to improve the therapeutic index of their cannabis by attempting to produce particular concentrations of CBD and/or THC. The purpose of this paper is to examine whether small-scale medical cannabis growers differ from those growing for recreational reasons in terms of self-assessed concentrations of THC and CBD in the cannabis they grow.
Design/methodology/approach
Data collection was conducted online from a convenience sample of 268 cannabis growers visiting a popular Israeli cannabis internet forum. χ2 and Kruskal–Wallis H were used to test bivariate associations between medical and recreational cannabis cultivators in terms of self-assessed cannabinoid concentrations.
Findings
In total, 40 percent of cannabis growers reported that they grow for medical purposes. Medical cannabis growers were more likely to report that they thought they knew the cannabinoid concentrations of the cannabis they grew and they reported higher self-assessed concentrations of THC, but not CBD.
Originality/value
Compared to recreational growers, medical cannabis growers are more likely to strive to be informed in terms of the content of their cannabis. Medical growers may also be attempting to grow more potent THC but not CBD cannabis.
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