School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
Institute for Pain Medicine, Rambam Health Care Campus, Haifa, Israel; Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Int J Drug Policy. 2018 Jul;57:4-10. doi: 10.1016/j.drugpo.2018.03.025. Epub 2018 Apr 10.
Medical cannabis policies are changing in many places around the world, and physicians play a major role in the implementation of these policies. The aim of this study was to gain a deeper understanding of physicians' views on medical cannabis and its possible integration into their clinic, as well as to identify potential underlying factors that influence these perceptions.
Qualitative narrative analysis of in-depth interviews with twenty-four Israeli physicians from three specialties (pain medicine, oncology and family medicine).
Physicians disclosed contrasting narratives of cannabis, presenting it as both a medicine and a non-medicine. These divergent positions co-existed and were intertwined in physicians' accounts. When presenting cannabis as a non-medicine, physicians drew on conventional medicine and prohibition as narrative environments. They emphasized the incongruence of cannabis with standards of biomedicine and presented cannabis as an addictive drug of abuse. In contrast, physicians drew upon unconventional medicine and palliative care as narrative environments while presenting cannabis as a medicine. In this narrative, physicians emphasized positive hands-on experiences with cannabis, and pointed to the limits of conventional medicine.
Physicians did not have a consolidated perspective as to whether cannabis is a medicine or not, but rather struggled with this question. The dualistic narratives of cannabis reflect the lack of a dominant narrative environment that supports the integration of cannabis into medical practice. This may in turn indicate barriers to the implementation of medical cannabis policies. An awareness of physicians' views and the different levels of their willingness to implement medical cannabis policies is essential for policy developments in this evolving field.
世界各地的医疗大麻政策正在发生变化，医生在这些政策的实施中发挥着重要作用。本研究旨在更深入地了解医生对医用大麻的看法及其可能融入他们诊所的情况，并确定影响这些看法的潜在因素。
对来自三个专业（疼痛医学、肿瘤学和家庭医学）的 24 名以色列医生进行了深入访谈的定性叙事分析。
医生们对大麻的描述截然不同，将其既视为药物又视为非药物。这些不同的立场在医生的叙述中并存并交织在一起。当将大麻描述为非药物时，医生们借鉴了常规医学和禁止作为叙述环境。他们强调大麻与生物医学标准的不一致性，并将大麻描述为一种使人上瘾的滥用药物。相比之下，当将大麻描述为药物时，医生们则利用非常规医学和姑息治疗作为叙述环境。在这种叙述中，医生们强调了与大麻的积极实践经验，并指出了常规医学的局限性。
医生们对于大麻是否是一种药物并没有一个统一的看法，而是对此感到困惑。大麻的二元叙事反映了缺乏一个支持将大麻融入医疗实践的主导叙事环境。这反过来可能表明在实施医用大麻政策方面存在障碍。了解医生的观点以及他们实施医用大麻政策的不同意愿水平，对于这一不断发展领域的政策制定至关重要。
