Barriers and facilitators to prescribing medicinal cannabis in New Zealand

Abstract

Introduction. The New Zealand Medicinal Cannabis Scheme (NZMCS) was established in April 2020 with the aim of expanding access to quality controlled medicinal cannabis products and developing a domestic medicinal cannabis industry. Yet, two years later, many patients report challenges in utilising the NZMCS, including physicians' reluctance to provide prescriptions for products. Aim. To explore the barriers and facilitators to prescribing medicinal cannabis in New Zealand. Methods. We conducted semi-structured interviews with 31 New Zealand physicians (general practitioners, specialists, and cannabis clinicians) who had discussed medicinal cannabis with patients in the last 6 months. Results. Physicians reported the principal barrier to prescribing medicinal cannabis was the limited clinical evidence to support cannabis therapy. Further barriers included: a perceived lack of knowledge of medicinal cannabis; concerns over professional reputation; social stigma; and the price of products. Conversely, the factors that facilitated cannabis prescribing included patients' and physicians' knowledge of medicinal cannabis; some physicians' desire to avoid patients having to engage with private cannabis clinics; and the timing of prescription requests (ie considering medicinal cannabis after other treatments had been exhausted). Discussion. Further clinical research of medicinal cannabis medications, education and training, and information would support physicians to deliver more informed advice to patients and enhance professional confidence with cannabis therapies.

‘The wild west of medicine’: A qualitative investigation of the factors influencing Australian health‐care practitioners' delivery of medicinal cannabis

“…Negative attitudes towards medicinal cannabis prescribers within the medical community was a novel barrier to prescribing identified in this study, demonstrating how social factors influence prescribing behaviours [45]. While some recent research has shown that practitioners from New Zealand are concerned about damaging their professional reputation by prescribing medicinal cannabis [43, 46], the present study is the first to document prescribing practitioners' experiences of judgement and disesteem within the profession.…”

Patients experiences of therapeutic cannabis consumption in New Zealand

“…Despite these challenges, in New Zealand, there is a burgeoning desire among patients to explore the putative benefits of cannabis therapeutics, as well as some interest by physicians (Gulbransen et al , 2020; Withanarachchie et al , 2023). This is evident in data generated via the Ministry of Health’s New Zealand Health Survey .…”

“…Previous New Zealand research, using an anonymous online convenience survey, found fewer than 5% of respondents got their cannabis products via a GP, with most still accessing cannabis via the underground market or being gifted it by family or friends (Rychert et al, 2020). Despite these challenges, in New Zealand, there is a burgeoning desire among patients to explore the putative benefits of cannabis therapeutics, as well as some interest by physicians (Gulbransen et al, 2020;Withanarachchie et al, 2023). This is evident in data generated via the Ministry of Health's New Zealand Health Survey.…”

Across the spectrum of primary health: from rainbow health to end-of-life care

“…Withanarachchie and colleagues interviewed 31 physicians (GPs, secondary care specialists, and cannabis clinicians) who had discussed medicinal cannabis with patients in the previous 6 months. 10 These doctors reported that their biggest barrier to prescribing was lack of clinical evidence supporting cannabis therapy, but the price of the products for patients and concerns about their professional reputation also limited their use. They were more likely to prescribe when all other treatment options had been exhausted.…”