QMJC November 2022: Autoethnography and stigma around medical cannabis use
Faculty and doctoral students from Drexel University’s Dornsife School of Public Health met in November 2022 to discuss an autoethnographic exploration of cannabis use, from the perspective of a patient who used cannabis for medical reasons. The group talked about intersecting and internalised types of stigma, and how the author’s identities as a woman, mother, and wife compounded the stigma she experienced, and contributed to the social disapproval of her cannabis use.
Four members of the Department of Community Health and Prevention at Drexel University’s Dornsife School of Public Health took part in a one-hour discussion via Teams on 3 November 2022.
The article authored by Regina Nelson represents an autoethnographical exploration of medical cannabis use. It describes the story of a middle-aged woman living in New Mexico, United States, who concealed self-medication with cannabis for most of her adult life. The author depicts her story as a transition from the ‘closeted’ stage to being an open medical cannabis patient.
Original article: One woman’s journey as a medical cannabis patient. By Regina Nelson. Published in Penumbra (2015).
Stigma is used as a theoretical framework to connect personal experiences with a broader sociocultural context in which the use of a controlled substance, such as cannabis, is stereotyped and devalued. The article shows how stigma contributes to diminished self-esteem, de-prioritising health needs and physical suffering, and advocates for the normalisation of cannabis as a medication.
Members were impressed by Nelson’s story and particularly struck by the extent of stigma perceived by the author. The group noted that the author continued hiding her cannabis use even after becoming an authorised medical user.
The author was a 50-year-old woman, a mother and a grandmother, and each identity contributed to the social disapproval of her cannabis use
The discussion mainly focused on the intersectionality of stigmas as a cross-cutting theme of the study. The group discussed how the use of cannabis, a controlled substance, intersected with the author’s multiple social roles of being a woman, mother, grandmother, and wife, among others. Members argued that the interplay of motherhood and cannabis use made the author particularly vulnerable to the potential loss of parental rights.
One member said that the main theme of the manuscript resonated with a recent publication by Matt Reid, which concluded that stigma associated with cannabis use still exists in a post-prohibition society and that stigma can be amplified within certain vulnerable subpopulations. The group felt that the Nelson article exemplified that point as the author was a 50-year-old woman, a mother and a grandmother, and each identity contributed to the social disapproval of her cannabis use. Some members also felt that the story could have provided more detail on the author’s race and ethnicity, as well as her socioeconomic status, to better understand the potential consequences of disclosing cannabis use.
In addition to examining intersecting stigmas around cannabis use (i.e. the stigma felt from others, or ‘social stigma’), the group discussed how the author coped with and eventually overcame internalised stigma. In particular, the group noted that reflections about the therapeutic efficacy of cannabis – particularly, the favourable comparison of cannabis with conventional pain medications – helped the author justify her medical cannabis use as something that was done for the right reasons. One member noted similarities between this article and his earlier research, which examined pathways to becoming a medical marijuana user among young adults. Similar to the story described by Nelson, young adults initiated cannabis use in social or recreational settings, but later transitioned into medicinal use through discovery of medicinal utility of cannabis in private settings. The member felt, however, that cannabis use by young adults might be less socially stigmatised as compared to cannabis use by an older adult woman and a mother.
The group concluded that autoethnography is an impressive method for in-depth exploration of people’s lives and felt inspired to use biographical interviews in their future research. Members argued that Nelson’s relatively short article touched upon multiple angles of the lived experiences of a female adult medical cannabis patient. The group also discussed how autoethnography can support medical cannabis patients as a social group by making patients’ voices heard and eventually changing the public narrative around medical cannabis use.
Editor’s note: The SSA has previously used the term ‘cannabis-based medical products’ rather than ‘medical cannabis’, but on this occasion retained ‘medical cannabis’ to reflect the language used in the original article, which focused on the lived experience of the author.
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