"Should I Inhale?"-Perceptions, Barriers, and Drivers for Medicinal Cannabis Use amongst Australian Women with Primary Dysmenorrhoea: A Qualitative Study.

Mike Armour,Susanne Armour,Justin Sinclair,Andrew Proudfoot,Jones Asafo Akowuah

doi:10.3390/ijerph19031536

Abstract

Objective: This study sought to investigate the perceptions, barriers, and drivers associated with medicinal cannabis use among Australian women with primary dysmenorrhea. A qualitative study via virtual focus groups involving 26 women experiencing regular, moderate, or greater menstrual pain explored categories including cost, associated stigma, current drug driving laws, community and workplace ethics, and geographical isolation within the context of patient access under current Australian laws and regulations. Results: A qualitative descriptive analysis identified that dissatisfaction with current management strategies such as over-the-counter analgesic usage was the key driver for wanting to use medicinal cannabis. A number of significant barriers to use were identified including patient access to medical prescribers, medical practitioner bias, current drug driving laws, geographic location, and cost. Community and cultural factors such as the history of cannabis as an illicit drug and the resulting stigma, even when prescribed by a medical doctor, still existed and was of concern to our participants. Conclusion: Whilst medicinal cannabis is legal in all states and territories within Australia, several barriers to access exist that require government regulatory attention to assist in increasing patient adoption, including possible subsidisation of cost. The high cost of legal, medicinal cannabis was a key factor in women’s choice to use illicit cannabis. Overall, the concerns raised by our participants are consistent with the broader findings of a recent Australian Senate inquiry report into barriers to patient access to medicinal cannabis in Australia, suggesting many of the issues are systematic rather than disease-specific. Given the interest in use of medicinal cannabis amongst women with primary dysmenorrhea, clinical trials in this area are urgently needed.

Highlights

IntroductionPrimary dysmenorrhea (PD) is the most common cause of period pain (dysmenorrhea) in the absence of any underlying pelvic pathology in adolescents and young women [1]
We know from our team’s previous research that significant pain reductions alone do not necessarily mean women will continue to use an intervention and that other factors such as cost are important in the choice of management strategies [30] and before potentially undertaking clinical trials in this area we aimed to explore the perspectives of Australian women on the barriers and drivers of the potential use of cannabis for primary dysmenorrhea
Recruitment text specified this was a discussion of managing period pain symptoms and the potential role of medicinal cannabis

Summary

Introduction

Primary dysmenorrhea (PD) is the most common cause of period pain (dysmenorrhea) in the absence of any underlying pelvic pathology in adolescents and young women [1]. Period pain is estimated to affect about three-quarters of all women worldwide under the age of 25 [2] and over 90% of young women under 25 in Australia [3,4]. Aside from painful menstrual cramps, other associated symptoms women commonly report include diarrhoea, pain radiating into the back and thighs, headaches, fatigue, fever, light-headedness, nausea, and vomiting [5,6]. This results in a variety of negative impacts, including absenteeism from school or tertiary education both in Australia [3,4,7,8] and worldwide [2], as well as significant productivity losses in the workplace [9]

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Discussion

Conclusion