The Struggles of Cancer Patients in Using Medicinal Cannabis in Australia

Background/Purpose: As cancer patients face long-term health and psychosocial issues from their diagnosis and treatment, many patients are seeking medicinal cannabis to manage their symptoms and treatment side effects. Access to medicinal cannabis for all cancer patients is a health inequality issue that is often based on place of residency rather than evidence-based clinical data. The global landscape of medicinal cannabis is changing with many countries throughout Europe and North America relaxing legislation around medicinal cannabis in recent years. Furthermore, a growing number of states in the U.S. have legalized medicinal cannabis in some form; however, most states prohibit or limit the medical conditions under which cannabis can be prescribed. Australia is lagging behind much of the Western world on this issue. Despite legislation four years ago, complex bureaucracy processes in Australia have meant access to medicinal cannabis remains difficult. This qualitative study aimed to explore attitudes, barriers and concerns of cancer patients from rural/regional Australia to gain a better understanding of the experiences faced in using medicinal cannabis. Methods: A qualitative approach was used to explore the biological, psychological and social factors experienced by cancer patients using medicinal cannabis that impact on their health and wellbeing. Participants (n=16) ranged in age from 36 to 82 years (M62.31, SD9.55) with nine females and seven males. Participants had a mix of cancer diagnoses, with the most common being breast (31%), multiple myeloma (25%) and prostate (19%). Participants engaged in focus groups or semi-structured individual interviews. Results: All focus groups and interviews were audio recorded and transcribed verbatim with participants identifiers removed. Initial coding of curious features across the entire data set began with the use of NVIVO version 12, and then codes were collated and relevant data gathered together to see what potential themes emerged. Review of the themes in relation to coded data, both amongst the coded extracts themselves and then across the entire data set, was completed to see if they were congruent. Thematic maps were used throughout this analysis process. The results of this exploratory study suggest four overarching themes are at play that influence medicinal cannabis use for cancer symptom management and impact theses patient’s health related quality of life. The four themes emerged from the data: perceived benefits, access difficulties, uncertainty and issues of support. Access difficulties and the cost of prescribed medicinal cannabis were concerns for many participants. Findings revealed a need to provide easy access to accurate information and address the barriers faced by cancer patients in using medicinal cannabis. Conclusions: Despite the growing body of clinical evidence, cancer patients may be faced with bureaucratic and social challenges in gaining access to medicinal cannabis that will require advocacy on the micro level. Social workers should consider the roles that might be appropriate for them in advocating for policy and legislation changes around access, cost and other barriers on the macro level.