The Challenge of Deconstructing Media's Influence in Controversial Social Legislation: The Case of Medical Marijuana

Background and Purpose:  There is a cultural revolution in the U.S.: the expansion of legitimacy of a formerly illicit substance, marijuana.  Pharmacologic components of marijuana have FDA approval for use in cancer-related nausea and HIV/AIDs-related anorexia and there is a growing demand for access to medical marijuana for treating pediatric seizure disorders and other conditions.  Marijuana legalization for medical use has been subjected to multiple referendums in the states over the last decade; 23 states now allow marijuana use for medical purposes.

In this study we explored media coverage of medical marijuana prior to the 2014 Florida vote on a constitutional amendment to expand the use of medical marijuana for "debilitatiing diseases as determined by a Florida physician."  We believe social work advocacy for expanded access to medical treatments can be informed through critical analysis of media discourse to deconstruct competing stakeholder influence in social policy legislation.

Methods:  Qualitative content analysis was used to discover trends in how the 2014 Florida state referendum vote on medical marijuana was framed in newspaper content in the month prior to the vote in the state. Lexis/Nexis search was used to identify all newspaper articles with the term "medical marijuana" in Florida in the month between August 1, 2014 to September 1, 2014.  Six pairs of researchers coded 57 media transcripts deductive coding (based on codes derived from framing theory) supplemental by inductive coding for emergent themes .  Transcripts were coded for:  being positive, negative or neutral towards the legislation, for stakeholder representation, and for primary themes within the transcripts. The coding teams independently coded samples of transcripts and then compared coded themes with other teams until data saturation was achieved. 

Findings:  Final coding yielded 24 neutral pieces (42%), 17 positive (30%), and 16 negative (28%).  Analysis revealed the primary themes in media reporting on the medical marijuana amendment fell into the primary themes of: the harms and benefits of marijuana; impacts on crime rates; problems with enforcement of legal uses and sale of marijuana; impacts on the Florida economy; impact on the state's reputation; and physician authority in determining appropriate use. Primary stakeholders identified in media reporting were the criminal justice institutions, the tourist industry, banking, potential growers, and the medical profession.  Polling data from the period of analysis found that the majority of Floridians supported the Amendment, although it failed in the subsequent vote.  This suggests that media reporting may have influenced a public shift from initial support to ultimate opposition to the amendment.  Although the majority of reporting was coded as "neutral" the media seems to have been influenced to disproportionately represent views of powerful stakeholders opposed to the amendment.

Conclusions and Implications:  Findings highlight how the media constructs controversial political issues by identifying powerful stakeholder interests and simultaneously influencing access to important resources.  Patient advocates are challenged to identify themes and sources of resistance to expanded access to controversial types of medical care.