Cannabis Knowledge Research Articles

Knowledge and perspectives about medicinal cannabis in nurses and nursing students in Portugal

Abstract Background The opening up of legislation on medicinal cannabis in recent years has been a determining factor in the growth of this therapy. In Europe, regulation of medicinal use is a reality in several countries. Nurses can play a leading role in its administration, helping to ensure that it is carried out more effectively and assuming a fundamental role in the success of the therapy. It is therefore pertinent to analyze the knowledge of nurses and nursing students in Portugal about medicinal cannabis. Methods Quantitative descriptive study. A self-completion questionnaire was drawn up and made available on the google forms platform. It was face-validated, content-validated and approved by the Ethics Committee. The instrument included sociodemographic data, questions about cannabis knowledge and perspectives. Descriptive statistics were analyzed. Results Out of a total of 610 responses, 318 were nurses and 292 nursing students. Medical cannabis is considered legitimate by 79.6% of nurses and 84.3% of students. When asked about the functions of the endocannabinoid system, 71.7% of nurses and 79.5% of students said they had no knowledge. 88.7% of nurses and 79.5% of students disagreed that they had sufficient knowledge to advise users on the use of medicinal cannabis. Also, 38.4% believe that their patients use cannabis illegally to manage the symptoms of illnesses. Conclusions There is a need for continuing training for nurses and for the undergraduate and postgraduate nursing curricula to include this emerging area. Key messages • The results show that this issue is a public health problem. It reinforces the need to formulate public policies in this area and to implement training for nurses and nursing students. • These measures will be fundamental in preventing the use of illegal cannabis and promoting the safe use of medicinal cannabis.

Comparison of cannabis knowledge, attitudes, and practice between allergists and patients with allergies and asthma

Comparison of cannabis knowledge, attitudes, and practice between allergists and patients with allergies and asthma

Assessing dental student knowledge on cannabis and demonstrating the need for cannabis education.

The American Dental Association advocates for dentists' education on therapeutic and legal issues related to medical cannabis. It is important to understand current knowledge of cannabis and cannabinoids and to have a practical knowledge assessment instrument. This exploratory study is the first of its kind to assess dental students' knowledge of cannabis and aims to determine if there is a need for more instruction regarding cannabis in a dental school's curriculum. Predoctoral dental students at the University at Buffalo School of Dental Medicine were recruited to participate. A validated, anonymous 22-item online survey was adapted and administered to students in all 4 years of the dental program. There was a total of 56 knowledge points. The average knowledge score was 21.6 points (SD=5.2, range: 7-34), corresponding to 38.5% (SD=9.2) of the answers correct. There were no overall differences in knowledge by gender, years in dental school, or by any reported source of formal education on cannabis. Those who reported doing their own research had higher knowledge scores. Most participants knew that there is an endogenous cannabinoid system (72.3%) and that Tetrahydrocannabinol (THC) is responsible for the "high" experienced with cannabis (76.6%). Most participants reported that they did not know the effective doses of THC (58.2%) and Cannabidiol (CBD) (66.7%); few provided an answer for THC (34%) or CBD (17%) in the acceptable range of 2-10mg. Dental students did not have adequate knowledge on cannabis and cannabinoids. Given the rapid expansion of cannabis legalization, additional efforts are needed to integrate cannabis topics into coursework and learning experiences.

Perceptions, Attitudes, and Knowledge of Cannabis and its Use: A Qualitative Study among Herbal Heart Study Young Adult Cannabis Consumers in South Florida

Growing cannabis use among young adults in the United States surpasses research and public understanding, raising health concerns despite potential benefits. Limited research focuses on their knowledge, attitudes, risks, and motivations, especially in states with limited legalization. This study explores cannabis knowledge and attitudes among healthy young adult cannabis consumers to understand their risk and benefit perceptions. Data include a subsample of participants in the Herbal Heart Study, a cohort to examine subclinical cardiovascular risk among healthy young adult (18–35 years old) cannabis consumers and non-consumers. A qualitative thematic analysis of the interviews was performed using a deductive approach driven by the theory of the Health Belief Model to generate categories and codes. Dedoose was used to organize transcripts and coding. A total of 22 young adult cannabis consumers (M age = 25.3, SD = 4.4) were interviewed between May 5, 2021- September 23, 2022. Participants were predominantly female (n = 13) and Hispanic (n = 9) or non-Hispanic Black (n = 7). Five themes were identified: perceived health benefits and risks associated with cannabis use, motivation for cannabis use, knowledge of cannabis, and perceived barriers to cannabis use. Participants discussed knowledge, positive/negative attitudes toward cannabis, and perceived risks/benefits based on personal experience and gathered information. Some showed knowledge deficits, and most wanted more health-related cannabis research. Given the current climate of rising cannabis legalization, availability of novel cannabis products, and societal acceptance, further research and evidence-based cannabis literacy for young adults are essential to keep pace with liberalization trends.

Settling ‘Dagga’? Shifting Frontiers of Cannabis Knowledge and Governance in South Africa

After the South African War (1899–1902), state-makers’ efforts to control ‘dagga’ was controversial on several fronts. But ‘dagga’ also proved a moving target for official classification. Was it a species of Leonotis, common around the countryside? Was it ‘Indian hemp’, understood by some as a habit-forming drug that debilitated wage workers and caused insanity? This paper traces dagga as a multiple object and problematic of governance in South Africa during the years before the formation of the Union of South Africa and into the early decades of the Union period. A focus on three contested boundaries of top-down knowledge-making and policy – botanical taxonomies; colonial geographies; and political-economy – demonstrates dagga’s shifting ontologies across time and space. Together, these empirical snapshots combine as a case study, revealing how the legal reification of a substance as a ‘drug’ involved political processes that were local, dispersed and unresolved. We show how uncertainties and ambivalences about cannabis long remained productive for different brokers and gatekeepers who navigated the frontiers of competing interests. This history is important for understanding the changing politics of cannabis in South Africa, as it became legible for regulation as a ‘dangerous drug’ during the first half of the 20th century.

The development of a Cannabis Knowledge Assessment Tool (CKAT).

Misconceptions about the health risks of cannabis remain prevalent, indicating the need to improve public health messaging and determine the effectiveness of educational programming. Our objective was to develop a standardized questionnaire to measure knowledge about cannabis in the context of cannabis legalization. A Cannabis Knowledge Assessment Tool (CKAT) was created using the Delphi method. A purposive sample of healthcare professionals, policymakers, academics, patients, and students served as the content and development experts. Principal component analysis from the codes identified from open-ended feedback guided the item development. Upon completion, the CKAT was administered as a pre- and post-test in four schools (7th and 9th Grade) in Canada. The data were analysed to determine whether knowledge scores changed after participating in a cannabis education program. Twenty-four experts initially participated in the Delphi process and 18 (75% retention) continued throughout. Principal component analysis identified 3 domains: 1) effects of cannabis on the individual, 2) general information about cannabis, and 3) cannabis harm reduction. The final questionnaire consisted of 16 multiple-true-false questions (64 items) and received a Flesch-Kincaid Grade Level of 6.3, and a SMOG index score of 7.6. The CKAT was completed by 132 students; seventy-three 7th grade and fifty-nine 9th grade students. The baseline mean CKAT score was 46.2 (SD:5.5), which increased to 50.7 (SD:4.6) after the cannabis educational program (p<0.05). A novel tool to measure knowledge of cannabis was developed and piloted in 7th grade and 9th grade students. Future studies are required to test usability and validity of the CKAT in other contexts.

Cannabis knowledge gaps in nursing education: Pilot testing cannabis curriculum

Cannabis education is recommended for nursing programs; however, knowledge gaps persist. Key objectives of this study were to evaluate prior knowledge deficits, develop an innovative cannabis curriculum, and evaluate efficacy of the curriculum. This pilot study included a pre/postevaluation of 17 students using an online, synchronous educational session. National guidelines were used as a conceptual framework to develop an evidence-based educational intervention inclusive of cannabis pharmacology, the endocannabinoid system, and physiology. Using a paired samples Wilcoxon signed-rank test, a significant increase in both self-assessed (p < .001) and tested knowledge (p < .001) was observed. Students strongly agreed that cannabis education influenced clinical practice. Students strongly recommended that this content be formally integrated into the program curriculum. This study confirmed that cannabis knowledge gaps exist in a single advanced practice nursing program and indicates the benefits of an educational intervention. Further research is needed to validate and generalize these findings.

Physicians' Attitudes and Practices Regarding Cannabis and Recommending Medical Cannabis Use.

Introduction: Medical cannabis users tend not to trust or rely on health care providers regarding cannabis advice. Previous surveys of physicians have focused on favorability toward medical cannabis. The current study assesses how physicians interact with patients regarding cannabis in their day-to-day practice, and whether and how they address important topics such as use patterns and substituting cannabis for medications. We predicted that physicians would generally perceive cannabis dispensary staff and caretakers as not competent in addressing patient health needs and would not be likely to use their recommendations. Methods: Physicians in a university-affiliated health system completed an anonymous online survey. The survey assessed physicians' cannabis related education experiences, perceptions of their knowledge of and competence regarding medical cannabis, and the content of cannabis related discussions with patients. We also examined perceptions of the sources of influence on patients regarding cannabis and physicians' attitudes toward medical cannabis dispensary staff and medical cannabis caregivers (MCCs). Results: A few physicians (10%) had ever signed a medical cannabis authorization form for their patients, consistent with their perceptions of low knowledge and competence in this area. Discussions on cannabis primarily focus on risks (63%) rather than dosage (6%) and harm reduction (25%). Physicians see their influence on patients as weak compared with other information sources and have generally unfavorable attitudes toward medical cannabis dispensary staff and MCCs. Conclusion: Greater integration of medical cannabis knowledge is needed at all levels of medical and clinical education to address the potential harm to patients if they receive no guidance. Continued research is needed to provide a strong scientific basis for developing treatment guidelines and standardized medical education for medical cannabis use.

Cannabinoids and drug metabolizing enzymes: potential for drug-drug interactions and implications for drug safety and efficacy

Introduction Cannabis is an increasingly popular recreational and medicinal drug in the USA. While cannabis is still a Schedule 1 drug federally, many states have lifted the ban on its use. With its increased usage, there is an increased potential for potential drug-drug interactions (DDI) that may occur with concomitant use of cannabis and pharmaceuticals. Area covered This review focuses on the current knowledge of cannabis induced DDI, with a focus on pharmacokinetic DDI arising from enzyme inhibition or induction. Phase I and phase II drug metabolizing enzymes, specifically cytochromes P450, carboxylesterases, and uridine-5’-diphosphoglucuronosyltransferases, have historically been the focus of research in this field, with the much of the current knowledge of the potential for cannabis to induce DDI within these families of enzymes coming from in vitro enzyme inhibition studies. Together with a limited number of in vivo clinical studies and in silico investigations, current research suggests that cannabis exhibits the potential to induce DDI under certain circumstances. Expert opinion Based upon the current literature, there is a strong potential for cannabis-induced DDI among major drug-metabolizing enzymes.

A cross-sectional survey: Exploring future healthcare workers' intention to use cannabis through extended theory of planned behavior.

Cannabis is the most extensively abused drug, leading to multiple health burdens such as traffic accidents and psychosis. There is a global wave of legalization of recreational and medical cannabis. This study aimed to understand future healthcare workers' intention to use cannabis through extended Theory of Planned Behavior (TPB). An online cross-sectional survey on cannabis, including validated survey tools and questions on demographics, knowledge, and constructs of the TPB was designed, and distributed during virtual classes in late 2020. Responses were obtained from the Faculty of Medicine of a local university. Nine hundred ninety-six responses were collected, of which 629 were complete and analysed. Age was the only demographic variable associated with cannabis use intention (p = 0.029). Respondents with intention had better knowledge of cannabis. All TPB and additional constructs, including perceived behavioral control (COR = 3.44, 95% CI 2.72–4.35, p < 0.001), descriptive norm (COR = 2.24, 95% CI 1.81–2.77, p < 0.001), injunctive norm (COR = 0.51, 95% CI 0.42–0.61, p < 0.001), attitude (COR = 1.23, 95% CI 1.18–1.28, p < 0.001), knowledge (COR = 1.08, 95% CI 1.03–1.14), and perceived availability (COR = 2.75, 95% CI 2.22–3.40, p < 0.001) were individually associated with intention. In the final multiple logistic regression model adjusted for age, only attitude (AOR = 1.19, 95% CI 1.13–1.25, p < 0.001) and perceived availability (p = 0.004) showed statistically significant associations with intention. Descriptive norm (standardized coefficient = 0.570) had better explanatory power than the injunctive norm (standardized coefficient = −0.143) in the model. Perceived behavioral control was associated with intention among respondents with negative to neutral attitudes towards cannabis (AOR = 2.48, 95% CI 1.63–3.77, p < 0.001), but not among those with positive attitudes. All TPB constructs positively correlated with the intention to use cannabis. Changing the attitudes and perceived control on cannabis use may be useful in preventing cannabis use.

Backgrounds and Trainings in Cannabis Therapeutics of Dispensary Personnel.

A growing body of scientific research indicates that oncology teams tend to offer individuals with cancer little clinical advice regarding medicinal cannabis (MC) and that individuals with cancer instead turn to cannabis dispensaries for MC guidance. Our objective was to investigate dispensary personnel's backgrounds and trainings in MC advising. The study design was semistructured interviews across 13 states with cannabis dispensary personnel in managerial or client-facing positions. Of 38 recruited, 26 (68%) completed interview. The primary outcome was training in MC advising. Researchers targeted thematic saturation and adhered to Consolidated Criteria for Reporting Qualitative Research. Of 26 participants, 54% were female, with an average age of 40 (range: 22-64) years. Half worked in client-facing roles; half worked in managerial ones. Study participants endorsed passionate commitment to their profession, often motivated by personal experience with MC therapeutics. Cannabis dispensaries often privileged sales skills over cannabis therapeutics knowledge when hiring, resulting in uneven baseline levels of cannabis therapeutics expertise among staff. Most participants reported workplace cannabis therapeutics training to be unstandardized and weak. They described dispensary personnel as resourceful in pursuing cannabis knowledge, self-financing learning in off-hours, sampling dispensary products, and exchanging knowledge. Nearly half the participants called for quality, standardized cannabis therapeutics training for dispensary personnel. The many oncology teams who defer to dispensary personnel regarding MC advising rely on a workforce who views themselves as unevenly trained. Further research should include a national survey of cannabis dispensary personnel to learn whether these findings hold true in a larger sample. If so, the oncology community must determine the best approach to clinically advising individuals with cancer about MC.

Impact of cannabis knowledge and attitudes on real-world practice

BackgroundIncreased cannabis consumption worldwide challenges allergists because of an upsurge in cannabis allergy and need to discuss cannabis with patients. ObjectiveTo determine the knowledge, attitudes, and practices regarding cannabis among allergists and their approach to recognizing and diagnosing suspected cannabis allergy. MethodsThe International Allergist Canna Knowledge, Attitudes, and Practices Survey was completed by members from 3 International Allergy Societies. Survey questions included the following: 13 on cannabis attitudes, 7 on cannabis knowledge, and 4 on real-world allergy practices. Knowledge level was dichotomized and Statistical Package for the Social Sciences TwoStep Cluster Analysis grouped participants by attitudes. Multivariate analysis determined the relationship of knowledge and attitude to practice delivery. ResultsOf 570 eligible surveys started, 445 (78.1%) were completed. Participants were 49.7% of female sex, 65.9% aged 24 to 56 years, approximately 70% in practice for more than or equal to 10 years, and 29.2% practicing in an area where cannabis use is illegal. Of the respondents, 43.1% reported consulting on patients with suspected cannabis allergy and 54.7% had undertaken skin prick testing, in vitro cannabis testing, or both. Statistically significant differences were found between the 3 societies for most variables analyzed. Analysis of attitudes revealed 3 clusters named Traditional, Progressive, and Unsure. Those with more progressive attitudes toward cannabis and who had more knowledge were more comfortable speaking to patients about cannabis and more often asked patients on how often and how they used cannabis (all P < .001). ConclusionVarying knowledge and attitudes toward cannabis affecting comfort communicating with patients about cannabis were found in members of 3 allergy societies supporting the need for more cannabis research and education.

What are the experiences of patients using cannabis for pain? A systematic review of qualitative studies

Cannabis is used by over 250 million individuals worldwide for a wide range of medical and recreational purposes. The most common health condition for which medicinal cannabis is used by patients is pain. To date, no review has summarized qualitative data from studies seeking to understand patients’ subjective experiences with cannabis for pain management, thus making this the objective of this systematic review. MEDLINE, EMBASE, AMED and CINAHL were systematically searched from database inception to May 15, 2020. English-language studies were eligible if they reported qualitative data surrounding patients’ experiences with using cannabis for pain. Relevant data were extracted and a thematic analysis was conducted. Of 1741 titles and abstracts screened, 8 studies were included in this review. Four major themes emerged from our thematic analysis, as follows: (1) problems with cannabis use; (2) benefits of cannabis use; (3) patients’ experimentation with and knowledge of cannabis; and 4) physicians’ lack of experience with cannabis for pain therapy. Patients using cannabis for pain reported experiencing several side effects, however, there were also numerous perceptions of benefits such as pain reduction. It is important that patients feel comfortable inquiring about medicinal cannabis should they choose to pursue it as a therapeutic option; healthcare providers should, therefore, be aware of the stigma that exists surrounding its use. Future qualitative research should aim to understand patients’ experiences with using different strains, dosages, and methods of cannabis administration, as well as their attitudes and concerns associated with cannabis legalization.

Assessing Health Care Providers' Knowledge of Medical Cannabis.

Introduction: Many health care providers would benefit from greater knowledge and awareness of medical cannabis, even if they choose not to integrate it into their medical practice. Unfortunately, health care providers generally report low knowledge of medical cannabis and cite this lack of knowledge as a barrier to making patient recommendations. It is important to understand health care providers' medical cannabis knowledge and its correlates. However, few studies have rigorously assessed clinically relevant cannabis-related knowledge, instead typically focusing on attitudes toward cannabis and perceived knowledge. Methods: Physicians in a university-affiliated health system completed an anonymous online survey. The survey assessed participants' basic demographics and medical experience, experiences with cannabis education, beliefs about their knowledge of and competency regarding medical cannabis, and knowledge of medical cannabis in relation to the current scientific evidence. Results: The average level of medical cannabis knowledge was 58% correct, with scores ranging from 39% to 78% correct. Perceived cannabis knowledge predicted actual knowledge, and those who pursued self-initiated study or attended a lecture on medical cannabis had higher knowledge levels. Conclusion: Levels of factual knowledge about medical cannabis among physicians were moderate. Our results highlight the mismatch between physician knowledge and cannabis policy. We offer our brief, 10-min assessment as a baseline for characterizing cannabis knowledge, acknowledging that the content and interpretation may change as knowledge advances.

Children’s Knowledge of Cannabis and Other Substances in States with Different Cannabis Use Regulations

Background: Public acceptance of cannabis continues to increase across the US, yet there has been little research on how cannabis legalization affects young children. The present study compared knowledge of cannabis and other substances among children living in states with different cannabis laws and examined whether the association between such substance knowledge and externalizing behavior varies by state cannabis regulations. Methods: Participants were from the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®) at the baseline assessment (N = 11,875, ages 9–11, collected from 2016 to 2018). Chi-square difference tests were used to compare nested models testing group differences in knowledge of substances and the association between externalizing disorder/behavior and substance knowledge as a function of state legality of cannabis use (recreational, medical, low THC/CBD, none). Results: Children living in states with more permissive cannabis laws had a greater knowledge of cannabis and reported more alcohol experimentation. In contrast, knowledge regarding alcohol, tobacco, and other illicit drugs was not greater in children from states with more permissive cannabis laws. Externalizing disorder/behavior was not significantly associated with cannabis knowledge in any group and not significantly different across groups. The association between externalizing disorder/behavior and illicit drug knowledge was significant only in states with the recreational and medical use laws but did not differ significantly across groups. Conclusion: Children living in environments with more permissive cannabis regulations have greater knowledge of cannabis, but not other substances, and report more experimentation with alcohol.

Highs and downs: A scoping review of public opinion about cannabis, alcohol and tobacco in Canada.

Since the legalisation of cannabis in October 2018, Canada has emerged as a privileged place for research on the properties of this substance, its health effects, but also on its relation with public opinion. However, this scoping review points out the complexity of tracing the evolution of Canadian public opinion on cannabis based on available scientific data. This review follows the guidelines of the Joanna Briggs Institute and summarises more than 60 years of research on Canadians' public opinion, perception and knowledge of cannabis. The study also includes alcohol and tobacco in order to provide a meaningful comparison between substances. One hundred and sixty-one references selected from over 30 000 studies, with the oldest dating back to 1956, show that public opinion on cannabis is under-studied in Canada compared to alcohol and tobacco. Young people and students are among the most studied populations, unlike Aboriginal communities, immigrants and elderly people. The study reveals the absence of experts in public opinion and political communication, and calls for an imperative need for theoretical frameworks rooted in the work of social scientists. These findings do not suggest slowing the rate of publication on alcohol, tobacco, youth or students. Rather, they encourage increasing the rate of publication on other substances used and on other groups also targeted as being particularly at risk of misuse. New studies need to measure and contribute to the understanding of Canadian public opinion on cannabis in comparison with public policies currently in place.

Knowledge about and attitudes towards medical cannabis among Austrian university students

BackgroundThe relevance of medical cannabis (MC) increases; and, educating those who are at the forefront of patient care is imperative. Yet, research on medical students’ expertise and opinions is still scarce. ObjectiveThis study set out to evaluate Austrian medical students’ knowledge about and attitudes towards MC and compare them with other academic disciplines. Additionally, gender was controlled for. MethodsAn online survey was conducted with N = 404 students enrolled in (1) medical studies, (2) studies with a medical background and (3) studies without a medical background. ResultsIn contrast to non-medical students, 64 % of medical students said they learnt about MC at the university. Although students were confident about their knowledge, they struggled to differentiate between CBD and THC. Chronic pain, oncological diseases and palliative care were the most frequently cited indications, psychiatric indications, however, were mentioned less often. Medical students were more reserved in their attitudes towards increasing medical usage and legalizing cannabis than the two other groups. Also, they were more skeptical about whether physicians should be allowed to prescribe MC and whether they should be obliged to offer it. Males showed more confidence regarding cannabis knowledge and were more favorable of legalizing and prescribing cannabis; females perceived cannabis as more physically addictive and as a gate-way drug. ConclusionsConsidering that beliefs and attitudes shape behavior, it is expected that future health care professionals will struggle with recommending cannabis for medical treatment. A coordinated approach for medical training is needed to ensure high standard medical care.

Cannabis education in United States Pharmacy Colleges and Schools

AbstractIntroductionGiven the rapid change in legal status and rise in cannabis use within the United States (U.S.), pharmacists will increasingly require competence in issues related to cannabis, especially for medical use. Pharmacy students and professionals in other health fields report low levels of cannabis knowledge, and medical cannabis users report that their knowledge is mostly from their own experiences and the internet. Several pharmacy organizations have advocated for pharmacists' education on therapeutic and legal issues related to medical cannabis.ObjectivesTo determine the extent to which cannabis and its medical use are covered in the educational curricula of U.S. schools and colleges of pharmacy, plans for future coverage of medical cannabis, and differences by the state‐level legal status of cannabis.MethodsPharmacy schools and colleges located within the U.S. were identified via the Accreditation Council for Pharmacy Education website. A 19‐item survey was developed by researchers with experience in curriculum development and pharmaceutical issues related to cannabis. One individual from each school provided detailed information on the inclusion of medical cannabis/marijuana topics in their Doctor of Pharmacy program.ResultsTwo‐thirds (67%) of programs responded to the survey. Most programs (85.4%) had content on medical cannabis available in their curriculum, 53.1% in their required curriculum, 65.6% in their elective curriculum, and 33.0% in both their required and elective curricula. A small proportion (16.7%) had a stand‐alone medical cannabis elective course. Stand‐alone electives had the most comprehensive coverage of cannabis topics. General required and elective courses had minor differences in comprehensiveness.ConclusionResults demonstrate a moderately rapid expansion in cannabis coverage in pharmacy curricula, although coverage of cannabis topics is rarely comprehensive. Additional efforts are needed to integrate cannabis into coursework and experiential learning experiences.

A qualitative study of VHA clinicians' knowledge and perspectives on cannabis for medical purposes.

The legalization of cannabis is expanding across the USA, and its use has increased significantly, including among Veterans. Although the Veterans Health Administration (VHA) abides by the classification of cannabis as a Schedule I substance, it recently recommended that clinicians discuss cannabis with their patients. Little is known about VHA clinicians' perspectives on and knowledge of cannabis. We sought to better understand clinicians' attitudes, beliefs, knowledge and communication with patients regarding cannabis. We conducted semi-structured phone interviews with 14 VHA clinicians. Interviews were audio-recorded, transcribed verbatim and analysed using qualitative thematic analysis. VA clinicians described ambivalence towards cannabis for therapeutic purposes and identified several factors that inhibit conversations about cannabis use with their patients including discomfort with the lack of product standardization; lack of research examining the effectiveness and risks of cannabis use; unfamiliarity with pharmacology, formulations, and dosing of cannabis; and uncertainty regarding VHA policy. Clinicians had differing views on cannabis in the context of the opioid crisis. VA clinicians face challenges in navigating the topic of medical cannabis. Educational materials about cannabis products, dose and harms would be helpful to clinicians.

Cannabis in Kenya

In 2018, Kenneth Okoth, a member of Parliament for the Kibra Constituency in Kenya, introduced a Marijuana Control Bill in parliament. Okoth’s bill sought to legalise the growth and use of cannabis, establish a system for the registration and licensing of cannabis growers and users, promote the use of cannabis for medicinal purposes, and increase public awareness of cannabis. This last point is critical in that Okoth understood that public knowledge of cannabis was shallow at the very moment when the country was debating prohibition, and he considered public awareness a critical component of this debate. Undoubtedly, the shallowness stems from a dearth of scholarship on cannabis in Kenya and East Africa. This study attempts to close the gap on the historiography of cannabis in Kenya. It historicises cannabis before the country’s independence in 1963, revealing that the British colonial government sanctioned cannabis for medicinal use but prohibited it for recreational purposes among Africans. The essay grounds the history of cannabis in Kenya within a longer history of making and re-making citizens and contributes to a more complex understanding of how bodies, goods, and ideas move across time and space.