Global Drug Policy Observatory, Swansea University, Swansea, UK.
Centre for Research and Information on Substance Abuse, Uyo, Nigeria.
Drug Alcohol Rev. 2023 Feb;42(2):309-317. doi: 10.1111/dar.13559. Epub 2022 Oct 3.
This study explored cannabis use for pain relief among socially marginalised Nigerian women in the context of barriers to pain management.
The study was designed as a qualitative exploratory study of pain experience and management. Sixteen in-depth, individual interviews were conducted with street-involved women who use drugs and had chronic pain. Transcripts were coded and analysed thematically.
Pain was experienced as a pervasive feature of everyday life that disrupted daily routines, affected economic activities, strained social relationships and had adverse effects on health and wellbeing. Participants sought treatment in health facilities, but faced social and health system barriers to service utilisation including financial cost of services, dismissal of symptoms by providers, stigma due to physical appearance, substance use and lack of social support. These barriers encouraged disengagement from services and reliance on cannabis (along with heroin and diverted prescription opioids) for pain management. Cannabis use relieved pain and improved daily functioning, enabling participants to undertake economic activities. However, using cannabis to enhance the effects of opioids and heavy and long-term use owing to pain chronicity and disability generated concerns about harms.
Findings show the therapeutic benefits of cannabis in the face of barriers to pain management. This support calls to explore the potentials of cannabis for pain management for socially marginalised populations and to develop medical guidelines to reduce the risk of adverse health consequences. Therapeutic cannabis, provided based on medical guidance, could improve pain management for socially marginalised populations.
本研究探讨了在疼痛管理障碍的背景下，社会边缘化的尼日利亚女性使用大麻缓解疼痛的情况。
该研究设计为对疼痛体验和管理的定性探索性研究。对 16 名有慢性疼痛且有吸毒史的街头吸毒女性进行了深入的个人访谈。对转录本进行了编码和主题分析。
疼痛被体验为日常生活中无处不在的特征，扰乱了日常生活、影响了经济活动、紧张了社会关系，并对健康和福利产生了不利影响。参与者在医疗机构寻求治疗，但面临社会和卫生系统服务利用的障碍，包括服务费用、提供者对症状的忽视、因外貌、物质使用和缺乏社会支持而产生的耻辱感。这些障碍促使他们不参与服务，并依赖大麻（以及海洛因和 diverted 处方类阿片）来缓解疼痛。大麻使用缓解了疼痛，改善了日常功能，使参与者能够从事经济活动。然而，为了增强阿片类药物的效果而使用大麻，以及由于疼痛的慢性和残疾而长期大量使用大麻，引起了对危害的担忧。
研究结果表明，在面临疼痛管理障碍的情况下，大麻具有治疗益处。这些支持呼吁探索大麻在治疗社会边缘化人群疼痛方面的潜力，并制定减少不良健康后果风险的医疗指南。基于医疗指导提供的治疗性大麻，可以改善社会边缘化人群的疼痛管理。
