Browsing by Author "Withanarachchie V"

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    Barriers 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 F
    Introduction: 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.
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    Exploring hidden risks and empowerment in women’s acquisition of medicinal cannabis from illegal markets: a qualitative study
    (Taylor and Francis Group, 2025-03-21) Withanarachchie V; Rychert M; Wilkins C
    Background: Women are a growing consumer base for medicinal cannabis (MC) in jurisdictions where it has been legalised, however, many still purchase MC from the unregulated illegal market. Little is known about women’s experiences of buying MC from these male-dominated illegal drug markets. This study explores women’s lived experiences accessing MC from illegal markets in New Zealand (NZ) to inform the need to ehance MC schemes for women. Methods: In-depth interviews with 15 women who purchased MC from the illegal market post MC legalisation. A qualitative description approach analysed their experiences, supplier relationships, and safety. Results: MC legalisation has facilitated a pathway to prescriptions, however, women face barriers including less disposable income, prioritising family expenses, and sexist attitudes among health professionals. Illegal markets were described as intimidating, with reports of sexual harassment, assault, and robbery. A novel finding waswomen-only social media groups for safety and supplier monitoring. Participants felt responsible for their own safety, as reporting to police posed legal risks. Conclusion: Women face gende-specific vulnerabilities when buying MC illegally, including safety risks and exposure to unregulated products. The findings are often overlooked in MC policy discussions, highlighting the need for gender-informed MC access.
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    Exploring women’s intentions to seek medicinal cannabis prescriptions in New Zealand using the theory of planned behaviour
    (Taylor and Francis Group, 2025-03-13) Withanarachchie V; Rychert M; Wilkins C
    Background: Women are an emerging demographic for legal medicinal cannabis (MC) in New Zealand and overseas, yet their information sources and prescription pathways remain underexplored. This study examines how women learn about MC and the factors influencing their prescription decisions, including motivations tied to prior cannabis experience. Methods: Interviews with 23 women who sought MC prescriptions in the last 12 months. The Theory of Planned Behaviour guided the deductive thematic analysis to explore the factors influencing their intention to seek MC prescriptions. Results: Participants were primarily motivated by positive online testimonies from other women MC consumers. Unregulated forums, social media, and cannabis clinics websites provided accessible channels for MC information, supporting self-guided treatment and perceptions of prescription pathways (private cannabis clinics vs. regular physicians). Past negative experiences with medical professionals influenced these choices. While some women feared stigma and judgement, others felt empowered to prioritise their needs and challenge gendered views of cannabis. Conclusion: The TPB model showed that positive beliefs about MC, accessible prescriptions, and support encouraged legal MC use, while stigma and negative physician interactions discouraged it. Digital platforms enabled self-guided treatment, however, limit reliable information. Credible online resources are needed to support women’s growing interest in MC.
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    Motherhood and medicinal cannabis.
    (John Wiley and Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs., 2025-02-18) Withanarachchie V; Rychert M; Wilkins C
    INTRODUCTION: Women are emerging as a key demographic for medicinal cannabis (MC) use in countries that have implemented MC reforms. However, research on mothers' experiences of consuming MC remains limited beyond studies on perinatal outcomes. This study explores mothers' diverse experiences of consuming MC in New Zealand under the legal MC scheme. METHODS: Interviews with 15 mothers using MC via prescriptions, the illegal market or both in the last 12 months. Thematic analysis focused on MC use in parenting, MC conversations with children, societal stigma and risks. RESULTS: Mothers reported MC as an important facilitator of their ability to positively parent their children, enabling them to manage their own health needs (i.e., anxiety, endometriosis and arthritis). High costs of legal products hindered access to MC. Participants expressed unique risks that mothers face accessing the unregulated market for MC like being deemed a 'bad mother' and losing custody of children. Stigma was countered with narratives of empowerment through proactive MC conversations with children and agency by self-medicating with MC despite the judgement they may face for being a parent that uses cannabis. DISCUSSION AND CONCLUSIONS: Mothers felt managing their health with MC allowed them to be more present parents and better tolerate the stressors of motherhood. In-depth exploration of discussing MC with children and anticipating these conversations was a novel finding. Most mothers tried to destigmatise MC in conversations by classifying it in the same category as other medications and discussing its therapeutic benefits. Few were cautious about having these conversations too early.
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    The role of cannabis clinics in the health system: a qualitative study of physicians' views in New Zealand
    (BioMed Central Ltd, 2023-01-04) Withanarachchie V; Rychert M; Wilkins C
    Background Privately-owned cannabis clinics have sprung up in many jurisdictions where medicinal cannabis has been legalised and provide an alternative pathway for patients who are unable or unwilling to access a prescription for cannabis-based medicinal products from their usual healthcare providers. Aims This study aimed to explore physicians’ views on cannabis clinics, including their perceptions of the role cannabis clinics play in the wider health system. Methods A qualitative study using in-depth, semi-structured interviews with thirty-one physicians affiliated with private and community clinics in New Zealand (including cannabis clinicians, GPs, and specialist doctors). The interviews were conducted from July to December 2021. Data were transcribed and analysed using inductive thematic analysis. Results Cannabis clinicians positioned themselves as (1) “service providers”, facilitating consumer access to cannabis prescriptions and products, and (2) “educators”, providing advice to patients and the wider physician community. While general practitioners and specialists recognised the benefits of specialised cannabis clinics (i.e., knowledge of products and a non-judgmental environment), they questioned the limited evidence of clinical efficacy for cannabis, potential financial conflicts of interests of cannabis clinicians that may blur their clinical judgement, and the risk of compartmentalising patients’ healthcare. Conclusions Our paper raises a number of challenges with attempting to integrate cannabis clinics into the wider health system.