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Cannabis for Therapeutic Purposes: Older Adult Perspectives, User Characteristics and Motivations for Use

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Cannabis for Therapeutic Purposes: Older Adult Perspectives, User Characteristics and Motivations for Use Western University Scholarship@Western Electronic Thesis and Dissertation Repository 12-10-2020 10:00 AM Cannabis for Therapeutic Purposes: Older Adult Perspectives, User Characteristics and Motivations for Use Lean Fiedeldey, The University of Western Ontario Supervisor: Smith, Maxwell, The University of Western Ontario A thesis submitted in partial fulfillment of the equirr ements for the Master of Science degree in Health and Rehabilitation Sciences © Lean Fiedeldey 2020 Follow this and additional works at: https://ir.lib.uwo.ca/etd Part of the Health Law and Policy Commons, and the Politics and Social Change Commons Recommended Citation Fiedeldey, Lean, "Cannabis for Therapeutic Purposes: Older Adult Perspectives, User Characteristics and Motivations for Use" (2020). Electronic Thesis and Dissertation Repository. 7541. https://ir.lib.uwo.ca/etd/7541 This Dissertation/Thesis is brought to you for free and open access by Scholarship@Western. It has been accepted for inclusion in Electronic Thesis and Dissertation Repository by an authorized administrator of Scholarship@Western. For more information, please contact [email protected]. ii Abstract and Keywords Use of cannabis among adults 55 years of age and older is increasing. In Q4 of 2018, slightly over half of cannabis users used for therapeutic purposes at least once, where many reported using for both medical and non-medical reasons (mixed use). Research on older adults regarding the use of Cannabis for Therapeutic Purposes (CTP) is fragmented and there are no comprehensive or in-depth studies on their perceptions or self-reported motivations. Understanding in these areas is important to inform policy that takes the protection of public health and safety as central aims. Does policy affect one of, if not both, user and non-user perspectives? Methods: The normalization framework provides a lens through which to study older adult use of CTP, while critical realism serves as the methodological framework. A qualitative flexible deductive approach is applied. Findings: The findings suggest a social acceptance of CTP by non- users, but that the use of healthcare practitioner authorized CTP is not normalized. Government and medical regulatory policy serve as barriers to access authorized CTP, which does not support normalization. In the Canadian context, pain and avoidance of conventional drug use are central factors for the use of CTP. Conclusion: It is understood from the findings that the primary motivator for the use of CTP is to achieve normal goals, goals the participants themselves interpret as normal, distinct from recreational use. Legislative and other policy modifications are required to ensure authorized access to regulated cannabis in order to protect public health and public safety. Keywords: cannabis, marijuana, policy, Canada, Ontario, older adults, seniors, normalization framework, normalization theory, qualitative methods iii Summary for Lay Audience Scientists do not know a lot about older adult views on using cannabis to feel better. “Older adults” means anyone who is 55 years of age or older. The number of older adults who are using cannabis is going up. Over half of all older adults who use cannabis have used it to feel better at least once. To keep older adults healthy and safe, the Canadian government makes rules. Why are there so many older adults using cannabis to feel better? Why are older adults using cannabis to feel better? Do government rules change older adult views? What does that mean for older adult health and safety? To learn more about older adult views the scientists follows guidelines that help them answer their questions. The guidelines the scientists used are called critical realism and the normalization framework. The scientists talked to older adults and wrote everything down word for word. The scientists arranged the thoughts of the older adults using ideas from the guidelines and then added some of their own ideas. The answers to the questions may show that Canadians are okay with using cannabis to feel better, but people do not always go to their doctor for it. Government rules make it difficult to get cannabis to feel better. Older adults in Canada use cannabis to stop feeling pain and to try to use less medicine. After hearing the older adult views, the scientists think that older adults use cannabis to feel like they normally do, which is different than using cannabis for fun. Changes to government rules can help to make sure older adults get their cannabis that makes them feel better from a doctor. Getting cannabis from a doctor helps to make sure it safe to use. iv Table of Contents Abstract and Keywords ................................................................................................................... ii Summary for Lay Audience ........................................................................................................... iii List of Tables ............................................................................................................................... viii List of Figures ................................................................................................................................ ix List of Appendices .......................................................................................................................... x List of Abbreviations ..................................................................................................................... xi Chapter 1: Introduction ................................................................................................................... 1 1.1 Background and Significance ............................................................................................... 1 1.2 Defining Cannabis in Canada ............................................................................................... 2 1.2.1 Non-medical cannabis. ....................................................................................................... 3 1.2.2 Medical cannabis. .............................................................................................................. 3 1.2.3 Health products containing cannabis/prescription drugs. .................................................. 4 1.2.4 Proposed cannabis health products. ................................................................................... 5 1.3 Central Research Problem..................................................................................................... 9 1.3.1 Cannabis use and aging. ............................................................................................... 12 1.3.2 Canadian research initiatives. .......................................................................................... 12 1.4 Study Rationale and Objectives .......................................................................................... 14 Chapter 2: Literature Review ........................................................................................................ 16 2.1 History of Cannabis ............................................................................................................ 16 2.2 Canadian Cannabis Policy .................................................................................................. 17 2.2.1 Surveillance policy....................................................................................................... 18 2.2.2 Federal medicinal policy .............................................................................................. 19 2.2.3 Federal recreational policy ........................................................................................... 21 2.2.4 General provincial and territorial policy ...................................................................... 23 2.2.5 General municipal policy ............................................................................................. 25 2.2.6 Indigenous peoples policy............................................................................................ 25 2.2.7 Veterans affairs policy ................................................................................................. 27 2.2.8 Human rights policy ..................................................................................................... 27 2.2.9 Impaired driving policy................................................................................................ 28 2.2.10 Economic policy ........................................................................................................ 29 v 2.2.11 Policy harms and risks. .............................................................................................. 31 2.3 Canadian Demographics and the Aging Population ........................................................... 33 2.3.1 Non-medical survey data ............................................................................................. 36 2.3.2 Medicinal survey data .................................................................................................. 36 2.4 Cannabis for Therapeutic Purposes .................................................................................... 37 2.4.2 Treatment ..................................................................................................................... 37 2.4.2.1 Approved indications. ............................................................................................... 38 2.4.2.2 Indications. ...............................................................................................................
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