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By Taneia Surles
For decades, marijuana (cannabis) was considered a solely recreational drug. However, recent research has revealed that marijuana has medicinal properties that may alleviate symptoms and improve medication side effects for patients with chronic conditions, including cancer. Some symptoms that may be improved include chronic pain, nausea, muscle spasticity, and sleep disturbances.
Medical marijuana is now legal across most US states and has been in use since 1996, with California being the first state to legalize it through the Compassionate Use Act of 1996. Unfortunately, getting medical authorization for it remains a problem, particularly if you are a Black or African American patient.
The Connection Between Socioeconomic Factors and Access to Medical Marijuana
A study published in Cannabis in March 2023 examined the barriers to accessing cannabis among cancer patients at a Pennsylvania cancer treatment center. The study aimed to identify whether social determinants of health — that is, the social and environmental conditions that affect health, such as safe housing, racism, and language skills — are linked to cannabis access.
Out of 1,053 participants, 33 percent reported using cannabis since receiving their cancer diagnosis. Black patients were less likely to have a medical certification for cannabis, with only 28 percent reporting they had certification compared with 46 percent of white patients.
Males of all races and Black patients were more likely to smoke cannabis than use any other form, and were more likely to illegally purchase it from unlicensed sellers or dealers. In addition, cancer patients with a lower income purchased cannabis based on price and how easily they could obtain it — for example, buying from unlicensed dealers or sellers, friends or family members, and internet sellers, or growing the plant themselves.
“Our study showed that factors that drive health disparities in the United States, such as race and income, are related to whether a patient has access to cannabis, where they get cannabis, and what forms they use,” says Rebecca Ashare, PhD, the study’s lead author and associate professor of psychology at the University at Buffalo in New York.
“Unfortunately, these data are consistent with other ways in which systemic factors, like racism and inequitable distribution of income, impact whether patients have equitable access to ways to manage cancer-related symptoms,” says Dr. Ashare.
Why Black Patients Have Lower Access to Medical Marijuana
Black cancer patients have lower access to medical cannabis for several reasons:
Cannabis Policies Vary by State
In the United States, 38 states, three territories, and the District of Columbia allow the use of medical marijuana products, according to the National Conference of State Legislatures. However, there are conflicting state and federal policies due to the classification of marijuana as a Schedule 1 substance, which are substances deemed most likely to be abused and lead to physical dependence.
“Part of what is confusing about the cannabis policy is that it varies widely by state, and it changes so rapidly,” says Ashare. “It's hard for patients — and providers — to keep up.”
Because of this classification, there’s not much evidence-based research doctors can refer to when providing education and treatment.
Effects of the War on Drugs on Black Communities
The war on drugs was a campaign initiated by former President Richard Nixon in 1971 to increase the presence of federal drug control agencies and enforce mandatory sentencing for drug-related offenses. This campaign led to many Black people receiving mandatory minimum sentences for drugs like crack cocaine and marijuana.
The war on drugs left a lasting impact on communities of color, and some may believe medical cannabis is not worth the risk. Despite the legalization of marijuana in most states, Black people are more likely to be arrested than white people for possessing marijuana, according to a research report published in 2020 by the American Civil Liberties Union.
“Decades of the ‘war on drugs’ and state and federal policies associated with the
criminalization of drug use disproportionately impacted people of color and may have created a sense that there is too much risk involved with getting a medical certification,” says Ashare.
Provider Bias Against Black Patients
Implicit and explicit bias by medical professionals may contribute to disparities in cannabis access among Black cancer patients. Implicit bias in healthcare is negative attitudes and beliefs towards certain races, ethnicities, genders, or other personal qualities that occur automatically and unintentionally. Results of a survey published in 2021 by Urban Institute demonstrated that, of 39 Black participants, many had received unfair judgment by healthcare providers or staff, knew a friend or family member who experienced discrimination, had delayed treatments or misdiagnoses, or hesitated to seek medical care due to fear of discrimination.
A review published in 2018 in Social Science and Medicine reported that healthcare providers across various specialties and levels of training had pro-white and anti-Black, Hispanic, Native American, or dark-skin bias. In addition, higher implicit bias was associated with disparities in treatment recommendations, pain management, empathy, and expectations of patient-provider relationships.
How Can Black Patients Safely Access Medical Marijuana?
If medical marijuana is legal in your state, here are some tips for getting a certification card for treatment of cancer symptoms.
Speak to a Doctor With Experience in Medical Marijuana Treatment
Start your journey by speaking to a licensed healthcare provider that prescribes medical cannabis.You can use Marijuana Doctors, a platform that provides a directory of doctors and facilities prescribing medical marijuana. Or, you can ask your primary care physician to refer you to a practice.
“These professionals can assess the patient's medical history, treatment plan, and potential interactions with other medications,” says Ann Russo, LCSW, the clinical director and psychotherapist at AMR Therapy. “They can also provide guidance on the appropriate strain, dosage, and consumption methods specific to the patient's cancer-related symptoms, such as pain, nausea, or loss of appetite.”
Look for Licensed Dispensaries
Research nearby dispensaries to ensure that they’re licensed to sell medical cannabis. Russo recommends dispensaries and pharmacies that “offer high-quality medical cannabis products and comply with legal and safety standards.” You can check out Leafly, Weedmaps, or Leafbuyer to find one near you.
If you happen to stop by a dispensing pharmacy and want to confirm that they’re licensed simply scan the store’s QR code with your smartphone. The QR code should pull up all the licensing information for the dispensary. If a QR code is unavailable, some states, like California, have a website to find licensed dispensaries by license number, name, or other description.
Educate Yourself on Medical Marijuana Laws
“It's crucial for patients to educate themselves on the laws and regulations surrounding medical cannabis in their jurisdiction,” says Russo. “This knowledge empowers them to communicate effectively with healthcare providers, discuss their treatment goals, and make informed decisions about their care.” Visit government websites and review journals such as the Journal of Cannabis Research or the The New England Journal of Medicine to get the most accurate information regarding medical cannabis.
Monitor Your Health and Push for Adjustments in Treatment if Necessary
Store all your medical records in a folder or digital file and closely track your symptoms to detect changes. “By keeping detailed records of their symptoms, treatment outcomes, and any side effects experienced, patients can advocate for appropriate adjustments to their treatment plan if needed,” says Russo.
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