Browsing by Author "Wilkins C"
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- ItemBarriers and facilitators to prescribing medicinal cannabis in New Zealand.(CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners, 2023-03-02) Withanarachchie V; Rychert M; Wilkins C; Goodyear-Smith FIntroduction: 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.
- ItemExploring Differences in Daily Vaping of Nicotine and Cannabis among People Who Use Drugs in New Zealand.(Taylor and Francis Group, 2023-06-16) Rychert M; Romeo JS; Wilkins CBackground: Little is known about daily vaping of different substances, particularly cannabis. Aim: To explore daily vaping of cannabis and nicotine products in a sample of people who use drugs in New Zealand. Method: The online New Zealand Drug Trends convenience survey (N = 23,500) was promoted to those aged 16+ via a targeted Facebook™ campaign, with 9,042 reporting vaping in the past six months. Multivariate logistic regression models were fitted to identify predictors of daily vaping of: (i) nicotine e-liquids, (ii) no-nicotine e-liquids, (iii) cannabis e-liquids/oils, (iv)cannabis herb. Results: Forty-two percent of past 6-month vapers used a vaporizing device "daily or near daily" (n = 3,508). Nicotine was most common substance used by daily vapers (96%), followed by dry herb cannabis (12%), no-nicotine e-liquids (10%) and cannabis e-liquid (6%). Daily vaping of no-nicotine e-liquids was associated with abstinence from tobacco use. Frequency of cannabis use was negatively correlated with daily vaping of nicotine liquids and positively correlated with daily vaping of no-nicotine and herbal cannabis. Younger age strongly predicted daily vaping of nicotine and no-nicotine liquids, but the reverse association was observed for daily vaping of herbal cannabis. Māori were less likely to daily vape cannabis herb than NZ Europeans. Daily vaping of both cannabis e-liquid and cannabis herb was associated with medicinal cannabis use. Conclusion: Daily vapers of nicotine and cannabis differed by several characteristics. Younger age group is at risk of daily vaping nicotine and non-nicotine, while herbal cannabis vaping is associated with older and medicinal use, suggesting a need for a nuanced vape policy response.
- ItemGlobal patterns in small-scale cannabis growers' distribution practices: Exploring the grower-distributor nexus.(Elsevier B.V., 2024-06-03) Søgaard TF; Brummer JE; Wilkins C; Sznitman SR; Sevigny EL; Frank VA; Potter G; Hakkarainen P; Barratt MJ; Werse B; Grigg J; Fortin D; Bear D; Lenton S; Jauffret-Roustide M; Kirtadze IBACKGROUND: While the supply of cannabis is commonly assumed to be dominated by criminal gangs, a sizable share of the domestic cannabis supply is provided by small-scale growers. This article examines the nature and scope of small-scale growers' distribution practices, with a particular focus on cross-country differences and variations between different types of grower-distributors, i.e., "non-suppliers", "exclusive social suppliers", "sharers and sellers" and "exclusive sellers". METHODS: Based on a large convenience web survey sample of predominantly small-scale cannabis growers from 18 countries, this article draws on data from two subsamples. The first subsample includes past-year growers in all 18 countries who answered questions regarding their market participation (n = 8,812). The second subsample includes past-year growers in 13 countries, who answered additional questions about their supply practices (n = 2,296). RESULTS: The majority of the cannabis growers engaged in distribution of surplus products, making them in effect "grower-distributors". Importantly, many did so as a secondary consequence of growing, and social supply (e.g., sharing and gifting) is much more common than selling. While growers who both shared and sold ("sharers and sellers"), and especially those who only sold ("exclusive sellers"), grew a higher number of plants and were most likely to grow due to a wish to sell for profits, the majority of these are best described as small-scale sellers. That is, the profit motive for growing was often secondary to non-financial motives and most sold to a limited number of persons in their close social network. CONCLUSION: We discuss the implications of the findings on the structural process of import-substitution in low-end cannabis markets, including a growing normalization of cannabis supply.