Canadian AIDS Society, Ottawa, Ontario, Canada; Centre for Addictions Research of British Columbia, University of Victoria, Victoria, British Columbia, Canada.
Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada.
Int J Drug Policy. 2014 Jul;25(4):691-9. doi: 10.1016/j.drugpo.2014.02.009. Epub 2014 Feb 28.
There is increased interest in the therapeutic potential of cannabis in recent decades. Canada, the Netherlands, Israel and some states in the United States have developed programs to allow access to cannabis for therapeutic purposes (CTP). In Canada, enrollment in the federal CTP program represents fewer than 5% of the estimated users of CTP. The discrepancy between the number of Canadians who report using CTP and the rate of utilization of the federal CTP program suggests the existence of barriers to access to this program.
In the present study we employ a health services analytical framework to examine barriers to access to CTP among 628 current CTP users. We define barriers to access as areas of poor fit between clients and services. We use five dimensions of accommodation, accessibility, availability, affordability, and acceptability to examine access to CTP.
Our findings reveal that it is difficult for Canadians to find a physician to support their application to access CTP. Accessing CTP from unauthorized sources was common; only 7% of respondents accessed CTP exclusively from authorized sources. Access to CTP was positively associated with the presence of medical cannabis dispensaries, which were not included in the regulatory regime. Access to CTP varied by medical condition and general quality of health. Affordability of CTP was a substantial barrier to access.
Strategies need to be developed to encourage scientific inquiry into CTP and address the barriers to access to CTP and the stigma and controversy that surround CTP and strain patient-physician relationships.
近几十年来，人们对大麻治疗潜力的兴趣日益增加。加拿大、荷兰、以色列和美国的一些州已经制定了计划，允许出于治疗目的使用大麻（CTP）。在加拿大，联邦 CTP 计划的参与者人数不到估计的 CTP 使用者的 5%。报告使用 CTP 的加拿大人数量与联邦 CTP 计划的利用率之间的差异表明，进入该计划存在障碍。
在本研究中，我们采用卫生服务分析框架，研究了 628 名当前 CTP 用户获得 CTP 的障碍。我们将获取障碍定义为客户与服务之间适配不良的领域。我们使用五个维度的适应性、可及性、可用性、可负担性和可接受性来检查 CTP 的获取情况。
我们的研究结果表明，加拿大人很难找到支持他们申请获得 CTP 的医生。从未经授权的来源获取 CTP 很常见；只有 7%的受访者仅从授权来源获得 CTP。获得 CTP 与医疗大麻药房的存在呈正相关，而这些药房不在监管制度范围内。获得 CTP 的情况因医疗条件和整体健康状况而异。获得 CTP 的负担能力是一个很大的障碍。
需要制定策略，鼓励对 CTP 进行科学研究，并解决获得 CTP 的障碍，以及围绕 CTP 的耻辱和争议，这些问题会影响医患关系。
