Growing medicine: Small-scale cannabis cultivation for medical purposes in six different countries

Background: The production and consumption of cannabis for the treatment of medical conditions is of increasing importance internationally; however, research on different aspects of the phenomenon is still scarce. In this article, we report findings from a cross-cultural study of small-scale cannabis cultivation for medical purposes. This kind of comparative study has not been done previously. Methods: The data were gathered with a help of web surveys conducted by the Global Cannabis Cultivation Research Consortium (GCCRC) in Australia, Belgium, Denmark, Finland, Germany and the UK (N = 5313). In the analysis we compare reports of medical motives, for what conditions cannabis is used, whether users have diagnoses for these conditions and whether the use of cannabis been recommended as a treatment of those conditions by a medical doctor. Descriptive statistics are used to show the main commonalities and noteworthy disparities across different countries. Results: Findings from countries were quite similar, even though several national differences in details were found. Growing cannabis for medical purposes was widespread. The majority of medical growers reported cultivating cannabis for serious conditions. Most of them did have a formal diagnosis. One fifth had got a recommendation from their doctor, but in most cases cannabis use was self-medication which was not discussed with their doctors. Conclusion: There is a wider demand for licit access for medical cannabis than currently available in these countries. Ideologically, medical growers can be seen distancing themselves from both the legal and illicit drug markets. From a harm reduction perspective, it is worrying that, in the context of present health and control policies in these countries, many medical growers are using cannabis to treat serious medical conditions without proper medical advice and doctor's guidance

The challenges and benefits of analyzing feedback comments in surveys: Lessons from a cross-national online survey of small-scale cannabis growers

It is common practice in survey questionnaires to include a general open and non-directive feedback question at the end, but the analysis of this type of data is rarely discussed in the methodological literature. While these open-ended comments can be useful, most researchers fail to report on this issue. The aim of this article is to illustrate and reflect upon the benefits and challenges of analyzing responses to open-ended feedback questions. The article describes the experiences of coding and analyzing data generated through a feedback question at the end of an international online survey with small-scale cannabis cultivators carried out by the Global Cannabis Cultivation Research Consortium. After describing the design and dataset of the web survey, the analytical approach and coding frame are presented. The analytical strategies chosen in this study illustrate the diversity and complexity of feedback comments which pose methodological challenges to researchers wishing to use them for data analyses. In this article, three types of feedback comments (political/policy comments, general comments of positive and negative appreciation, and methodological comments) are used to illustrate the difficulties and advantages of analyzing this type of data. The advantages of analyzing feedback comments are well known, but they seem to be rarely exploited. General feedback questions at the end of surveys are typically non-directive. If researchers want to use these data for research and analyses, they need a clear strategy. They ought to give enough thought to why they are including this type of question, and develop an analytical strategy at the design stage of the study

Sharing, group-buying, social supply, offline and online dealers: how users in a sample from six European countries procure new psychoactive substances (NPS).

Given the multiple ways of regulations and market situations for new psychoactive substances (NPS), it is of interest how NPS users procure their drugs in different countries as well as in different user groups. Data comes from a face-to-face and online survey conducted in six EU countries, covering three groups of current (12-month) adult NPS users: (1) socially marginalized, (2) users in night life, and (3) users in online communities. While the supply situation differed considerably between countries, friends were the most prevalent source for buying, followed by online shops and private dealers. Marginalized users were more likely to buy from dealers, while online respondents showed the highest rates for buying online. While buying NPS from online or offline shops was relatively prevalent, we also found high rates for social supply and buying from dealers. A considerable part of this market may be classified as “social online supply,” with private suppliers procuring their drugs online. The market features among marginalized users resemble more those of illicit drug markets than those for other NPS users

Discriminative characteristics of marginalised novel psychoactive users: A transnational study

New psychoactive substances (NPS) continue to be considered as a major public health concern in many European countries. The study was implemented within the framework of a transnational project of six European countries (Germany, Hungary, Ireland, Netherlands, Poland, Portugal). Our aim here is to report on the distinct and differentiating characteristics of marginalised NPS users. Three subgroups of a total of 3023 adult NPS users (socially marginalised, night life, online community) were examined regarding their socio-demographic characteristics, substance use, and external motives towards NPS use. Poland and Hungary reported higher rates of NPS use in comparison to traditional controlled drugs. The external/contextual motives did not play a central role in the background of NPS use, the least important motives were alleged legality and non-detectability of these substances. Marginalised (defined as those accessing low threshold harm reduction services) users’ substance use patterns are different from the other two groups in terms of showing more intense and riskier drug use. The most important variables which contributed to be categorised as a marginalised NPS user were lower level education, being older, having an unfavourable labour market position and using drugs intravenously. Contextual motives did not play a decisive role in being categorised as a marginalised user when drug use pattern was controlled. These identified discriminative features of marginalised drug users should inform policy makers to develop and implement tailor-made interventions targeting this user group to successfully tackle the elevated public health concerns associated with NPS use

Sourcing illegal drugs as a hidden older user: the ideal of ‘social supply’

Aims: At a time of growing awareness regarding the non-commercial supply of illegal drugs between friends, this article explores the significance of so-called ‘social supply’ for a group of ‘hidden’ users of illegal drugs aged 40 and over. Methodology: Semi-structured interviews were conducted with 30 users of illegal drugs aged 40 and over who were not in contact with the criminal justice system or treatment agencies regarding their use. Participants were recruited using snowball sampling. Findings: Accessing drugs through the commercial market was considered as a less attractive proposition than social supply by the participants. The majority used only socially supplied drugs, with some engaging commercial dealers when socially supplied product was unavailable. A handful sourced drugs exclusively through the commercial market. Some were home growers of cannabis, and a small number had drifted into social supply themselves. Conclusions: Social supply was seen in a far more favourable light than commercial transactions by our participants, and acted as an ideal against which all other acts of sourcing were compared. Moreover, social supply was often an integral facet of the drug using experience and served to validate and enhance that experience. The relatively benign, non-predatory nature of the social supply engaged in by the participants lends support to calls for some reform of the offence of supply in UK law

How and where to find NPS users: a cross national survey among current users of new psychoactive substances.

Use of new psychoactive substances (NPS) across Europe remains a public health challenge. The study describes potentials and limitations of methods in a transnational survey of recent marginalized, nightlife and online community NPS users in Germany, Hungary, Ireland, the Netherlands, Poland and Portugal (n=3023). In terms of demographic profile, drug use history and type of NPS, different methods reached different segments of the NPS-using population. Last year use of different NPS varied across countries and groups. Respondents used NPS in a variety of settings, with public spaces most common in marginalized group. The study suggests that prevalence rates can reveal a picture of the NPS market that significantly deviates from what law enforcement seizures indicate. Outreach in nightlife settings and peer education are recommended to inform users about health risks and to improve access to drug services and care

Health and social problems associated with recent Novel Psychoactive Substance (NPS) use amongst marginalised, nightlife and online users in six European countries.

Continued diversification and use of new psychoactive substances (NPS) across Europe remains a public health challenge. The study describes health and social consequences of recent NPS use as reported in a survey of marginalised, nightlife and online NPS users in the Netherlands, Hungary, Portugal, Ireland, Germany and Poland (n = 3023). Some respondents were unable to categorise NPS they had used. Use of ‘herbal blends’ and ‘synthetic cannabinoids obtained pure’ was most reported in Germany, Poland and Hungary, and use of ‘branded stimulants’ and ‘stimulants/empathogens/nootropics obtained pure’ was most reported in the Netherlands. Increased heart rate and palpitation, dizziness, anxiety, horror trips and headaches were most commonly reported acute side effects. Marginalised users reported substantially more acute side effects, more mid- and long-term mental and physical problems, and more social problems. Development of country-specific NPS awareness raising initiatives, health and social service needs assessments, and targeted responses are warranted