Barriers and facilitators to prescribing medicinal cannabis in New Zealand
Vinuli Withanarachchie
1 * , Marta Rychert 1 , Chris Wilkins 1
+ Author Affiliations
- Author Affiliations
1 Shore & Whāriki Research Centre, College of Health, Massey University, Auckland, 1010, New Zealand.
Journal of Primary Health Care 15(2) 135-146 https://doi.org/10.1071/HC22122
Published: 2 March 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
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.
Keywords: access to medicines, cannabinol, CBD, general practice, medical marijuana, medicinal cannabis, physicians, primary health care.
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