Predictors of medicinal cannabis users' willingness to utilise a new prescription Medicinal Cannabis Scheme in New Zealand.

AIM: To investigate medicinal cannabis users' intentions to transition to the new prescription Medicinal Cannabis Scheme (MCS) in New Zealand. METHOD: An online survey of 3,634 past-year medicinal cannabis users completed prior to implementation of the MCS in New Zealand in April 2020. Logistic regression models were fitted to identify predictors of intended future engagement with the MCS. RESULTS: Seventy-eight percent of respondents were aware of the new MCS and 66% intended to use it. Higher income (OR=1.57), younger age (OR=1.02) and smoking cannabis (v. vaping (OR=2.0) or oral ingestion in edible form (OR=2.22)) predicted intention to engage with the MCS. Conversely, Maori (OR=0.63) and those who grew their own cannabis (OR=0.52) were less likely to intend to engage with the new prescription MCS. CONCLUSION: The lower intended engagement with the MCS by Maori, lower income groups and those who home-grow cannabis may reflect their perceptions of the MCS as restrictive and expensive.

Issues in the establishment of a therapeutic cannabis market under Jamaica's Dangerous Drugs Amendment Act 2015.

INTRODUCTION: In 2015, Jamaica became the first Caribbean country to decriminalise personal cannabis possession, legalise home cultivation and establish a commercial therapeutic cannabis market via the passage of the Dangerous Drugs Amendment Act (DDAA). AIM: To critically analyse implementation of the legal therapeutic cannabis market under the DDAA. METHODS: Synthesis of findings from semi-structured face-to-face interviews with 22 key informants (KIs) from the government, industry, academia and NGO sector, unstructured interviews with illegal growers, and field observations of licensed and illegal operators. RESULTS: KIs identified a number of challenges in implementing therapeutic market provisions under DDAA, including a limited buy-in from key government agencies; delays in developing a framework for quality assurance; and lack of access to banking services. Public sector actors stressed the challenges imposed by the UN drug conventions and need to maintain favourable diplomatic relationship with the US federal government, with the consequence of prioritising enforcement to prevent diversion and inversion. Implementation of the Alternative Development Programme in two traditional cannabis-growing communities experienced challenges with land titles and frictions in local communities. High compliance costs and limited skills to meet the envisioned medical standards presented barriers for traditional farmers. Many KIs conceptualised the purchasing of cannabis from the regulated market as "recreational" rather than medical, reflecting the marketing and limited information on medical applications at point of sale. Licensees' reliance on foreign investment puts local industry at risk of predatory shareholder agreements, but also provides needed investment and expertise. CONCLUSION: External international factors (e.g. UN treaties, correspondent banking with the US) and conflicting domestic government agency visions for the reform played a significant role in the DDAA implementation. As cannabis law reform spreads beyond Western jurisdictions, consideration of pre-existing social, cultural and economic conditions of developing countries will be important.

Exploring medicinal use of cannabis in a time of policy change in New Zealand.

AIMS: To explore patterns of medicinal cannabis use prior to implementation of the new Medicinal Cannabis Scheme (MCS) in New Zealand. METHODS: An anonymous online convenience survey of 3,634 last-year medicinal users of cannabis promoted via Facebook™ from May to August 2019. RESULTS: Fifty percent of the sample were female, 18% were Maori and the median age was 38 years. The medical conditions for which cannabis was most often used were pain (81%), sleep (66%) and mental health conditions (64%). Respondents perceived cannabis to be an effective therapy and reported reducing use of other pharmaceutical medicines. Fifty-two percent reported side effects from cannabis use, including increased appetite (29%), drowsiness (12%), eye irritation (11%), dependency (10%), memory impairment (10%) and lack of energy (9%). Smoking was the dominant route of administration. Nearly half (47%) had discussed their use of cannabis with a medical professional in the previous year, while 14% had requested a prescription and 5% accessed a prescribed cannabis-based product (mostly oral CBD). CONCLUSION: Respondents self-medicated with cannabis to treat a wide range of health complaints. Only half discussed medicinal cannabis use with their medical professional, and a minority requested a prescription and used a prescribed cannabis-based product.