Understanding and Rebalancing: A Rapid Scoping Review of Cannabis Research Among Indigenous People.

Evidence-based perspectives on and patterns of cannabis use are vital to addressing ethical, legal, and regulatory controversies, but have not yet been mapped for Indigenous people. We searched five databases and used a rapid scoping review methodology to analyze empirical studies with a primary focus on cannabis and Indigenous peoples. Studies were examined for year of publication, origin of study and author groups, methods, and thematic foci. We analyzed 68 studies with publication dates between1983 and 2022. Approximately 90% of articles were written by authors in the same geographic location as the study population. Seventy-one percent (71%) of the articles were written by authors of multiple articles. Four articles acknowledged author Indigeneity. None contained author positionality statements. The majority of studies utilized mixed methods that integrated both qualitative and quantitative components. Two major categories of focus that emerged from the analysis are substance use disorders and prevalence rates (n=35) and predictors of and motivators for use (n=27), together representing the majority of articles (n=52/68). Impact on mental health (n=6), treatment, and management of cannabis use disorder (CUD) (n=3), legalization and criminalization (n=2), genomic heritability and dependence (n=2), and economics of cannabis use (n=1) were the focus of the remaining articles in the sample. Mixed methods empirical research largely focuses on risks of cannabis use among Indigenous people worldwide. The small, repeating pool of senior authors represents an opportunity for capacity building. A lack of transparency about author positionality and absence of empirical studies that explore the lived experiences of Indigenous peoples and cannabis are significant gaps poised to be filled for future research and regulation.