How older Canadians access medical cannabis and information about it: A descriptive survey

ABSTRACT

To understand older adults’ perceptions regarding access to medical cannabis and information related to it. We employed cross-sectional survey design to recruit Canadians (≥60 years) who consume cannabis for health purpose(s). Recruitment flyers were circulated to potential sites (e.g. CanAge). Interested participants self-selected to participate by contacting the researcher and completed the online survey. Data were analyzed using descriptive statistics and conventional content analysis. A total of 107 older adults participated in the study. Most sought information from healthcare professionals (HCP) (49.5%) or cannabis retail stores (40.2%) and accessed cannabis via retail stores (56.1%). High cost, judgement from others, and HCP reluctance to prescribe were reported as the common barriers to access. Participants most often sought information related to benefits, safety, and dosage of medical cannabis. Many older adults relied on medically unauthorized sources such as retail stores to access medical cannabis and information related to it. At the policy level, initiatives are needed to help older adults for whom medical cannabis may be appropriate to learn about and access medical cannabis via authorized sources. To ensure safe and effective medical cannabis use, knowledge products about medical cannabis are necessary for older adults.

KEYWORDS:

• Older adults
• medical cannabis
• information access
• descriptive survey
• cannabis access

JEL:

• I10

Introduction

Canada has been at the forefront in legalizing cannabis access and use in the global landscape (Clarke & Fitzcharles,2023). In Canada, cannabis was legalized for medical and recreational use in 2001 and 2018, respectively (Cox,2018; Government of Canada,2019). The government of Canada published the Marihuana Medical Access Regulations (MMAR) in 2001, which first allowed Canadian patients to access cannabis for therapeutic purposes (CTP) (Government of Canada, 2001). The new Marihuana for Medical Purposes Regulations (MMPR) came into effect on 19 June 2013 (Government of Canada, 2012). Patients now could access cannabis for medical purpose with a valid medical document from either a physician or a nurse practitioner (Government of Canada, 2012). The MMPR were later replaced by the Access to Cannabis for Medical Purposes Regulations (ACMPR) in August 2016 which allowed healthcare providers to authorize eligible patients to access, produce, and possess cannabis for medicinal use (Government of Canada, 2016). Once an individual receives authorization, they can obtain medical cannabis from a licensed producer, register to grow it themselves, or designate a person to produce cannabis on their behalf (Government of Canada, 2016). Recreational cannabis does not require authorization and can be obtained from non-medical sources but may also be used by some for medicinal purposes (Baumbusch & Yip, 2021; Statistics Canada, 2019).

Licensed Medical Producers and recreational stores are both regulated and have similar products (with a range of CBD and THC concentrations), but recreational stores have less extensive labelling. Staff at Licensed Medical Producers such as cannabis clinics are trained healthcare providers to provide, while staff at recreational stores are expressly forbidden from providing medical guidance. For Licensed Medical Producers such as cannabis clinics, recommendations are made based on the discretion of the healthcare providers.

Following medical and recreational legalization, cannabis use has soared among older adults (≥60) in Canada more than any other age group (Lowry & Corsi, 2020; Statistics Canada, 2019; Tumati et al., 2022). Between 2004 and 2017 cannabis consumption amongst people aged 65 years and older increased 24-fold (from 0.1% to 2.2%) for women and 10-fold (from 0.4% to 4.0%) for men (Lowry & Corsi, 2020). Similar trends have been reported in other countries (Hazekamp et al., 2013; Kaskie et al., 2017). National survey data show that 52% of older adults (≥65 years of age) consume cannabis exclusively for medical reasons, 24% consume it solely for recreational purposes, and 24% consume it for both medical and recreational reasons (Statistics Canada, 2019). Evidence suggests that older adults use cannabis medicinally to help manage a wide range of health conditions, including pain, nausea, arthritis, anxiety, depression, sleep issues, Parkinson’s disease, inflammatory bowel disease, and to reduce side effects from chemotherapy (Baumbusch & Sloan Yip, 2021; Lum et al., 2019; Mahvan et al., 2017; Smith et al., 2015).

Despite legalization, cannabis is still often viewed as an illicit drug (Erickson et al., 2013). As a result, it carries considerable stigma for older consumers or potential consumers (Bobitt et al., 2019a; Manning & Bouchard, 2021). Moreover, physicians and nurse practitioners can be reluctant to authorize cannabis access because of several factors, including limited evidence, lack of clinical guidelines, uncertainty regarding indications, concerns that patients requesting medical cannabis may actually want it for recreational purposes, as well as possible side effects (Baumbusch & Sloan Yip, 2021; Bobitt et al., 2019b; Yang et al., 2021; Ziemianski et al., 2015). Consequently, some consumers are reluctant to discuss about cannabis use with their health care providers and rely on unregulated, non-medical sources (e.g. family/friends) to obtain cannabis and information about it (Kamrul et al., 2019; Lum et al., 2019), despite potential safety concerns (Health Canada, 2016).

National Canadian surveys have reported that older adults mainly access cannabis via legal sources such as authorized retailers and online licensed producers (41%), but some (23%) access cannabis from sources such as illicit dealers or from family/friends (Statistics Canada, 2019). Inadequate information about cannabis consumption and the use of cannabis products medicinally without healthcare provider supervision may pose risks to older adults as they may not get adequate information about the dosage, indications, and appropriate use of cannabis (Baumbusch & Sloan Yip, 2021; Ishida et al., 2020) leading to adverse consequences such as drowsiness, dizziness, hallucinations, depression, anxiety, and suicidal ideation (Khoury et al., 2022; Mahvan et al., 2017; Tumati et al., 2022). This is particularly concerning because older adults are at increased risk of adverse drug reactions due to age-related physiological changes, comorbidities, and polypharmacy (Corsonello et al.,2010; Mahvan et al., 2017). It is crucial, therefore, that older adults receive accurate information about cannabis and access it from legitimate, regulated sources.

Although there is growing evidence on medical cannabis use amongst older adults, past studies have mainly assessed the patterns of medical cannabis use by older adults, including indications, adverse effects, types of cannabis consumed, and the sociodemographic characteristics of cannabis consumers (Arora et al., 2021; Baumbusch & Sloan Yip, 2021; Kaufmann et al., 2022; Manning & Bouchard, 2021; Statistics Canada, 2019; Tumati et al., 2022). Few studies have been conducted in Canada (Baumbusch & Sloan Yip, 2021; Tumati et al., 2022) and only (Baumbusch & Sloan Yip, 2021) assessed older adult’s experience of medical cannabis use. Baumbusch and Sloan Yip’s 2021 qualitative study, for instance, involved 12 participants from Ontario and British Columbia, and examined patterns in the accessing of medical cannabis as only a small part of the study. Tumati et al. (2022) used large-scale retrospective survey data but assessed the characteristics of older medical cannabis consumers (e.g. type and amount of cannabis consumed) but did not examine ways of accessing cannabis or information about it. Consequently, we know little about how older adults access and seek information related to medical cannabis across Canada and the perceived barriers they encounter. It is imperative to assess these aspects of older Canadians’ cannabis consumption, particularly given that there is growing number of older adults who are using medical cannabis and more older adults than ever are interested in accessing cannabis-related information. To ensure that older adults are accessing medical cannabis and seeking information related to it from an authorized source, first, we need to assess where they are seeking information, how they are accessing medical cannabis, how comfortable they are accessing cannabis and information in those ways and whether they encounter any barriers. Understanding these aspects of older Canadians’ medical cannabis consumption are fundamental to developing future strategies to help improve safe access to medical cannabis and credible information for older adults. Given that Canada has a unique socio-political and cultural context and that health regulations vary even between Canadian provincial jurisdictions, findings from previous studies may not be applicable in the Canadian context. To address these knowledge gaps, we aimed to:

Objectives

1. Understand older adults’ perceptions of accessing medical cannabis.

2. Assess older adults’ perceptions of accessing information related to medical cannabis.

3. Assess if feelings of being judged influenced older adults’ decision to access cannabis and information about cannabis.

4. Identify the types of information older adults are looking for regarding medical cannabis use.

Methods

We used a cross-sectional survey design and purposive sampling to recruit older Canadians (≥60 years) who consume cannabis to manage one or more health problems. We excluded non-Canadians, people less than 60 years of age, and those who had not previously consumed cannabis. To recruit eligible participants, we identified settings where older adults may access cannabis or related information (e.g. local/provincial/national agencies for older persons such as CanAge and HelpAge, retail stores, medical cannabis dispensaries, and healthcare providers). We contacted relevant organizations via email and explained the purpose of our study, and those who were willing posted our flyers in their workplace and/or on their website. We also used free posts on social media such as Facebook and twitter to advertise our study. Interested participants self-selected to participate by contacting the researchers via email and were screened for eligibility. Eligible participants were then sent an online survey link.

The survey items captured sociodemographic information and asked about participants’ general experience about cannabis use, methods of accessing cannabis, comfort in accessing cannabis, sources where they seek information about cannabis, whether feelings of being judged influenced their decision to access cannabis and seek information, and the perceived quality of the information they received. Additionally, some open-ended questions asked how participants dealt with situations where they felt judged, barriers to accessing cannabis, and the types of information they sought. Completion of the survey constituted consent to participate in the study. Participants received a $30.00 honorarium in recognition of their time. Data collection occurred from NaN Invalid Date NaN, to NaN Invalid Date NaN.

Ethics approval

We obtained ethical approval from the Research Ethics Office at the University of Alberta (#Pro00112287.). Completion and submission of the online survey constituted implied consent to participate.

Data analysis

We analyzed the quantitative data descriptively using the statistical software SPSS (Statistical Package for Social Sciences (IBM, 2011)). We calculated (relative) frequencies and proportions for categorical variables and median, Q₁, and Q₃ for continuous variables. To analyze responses from the open-ended questions, we used conventional content analysis (Hsieh & Shannon, 2005). First, we organized responses based on their similarities and generated key categories, and then tabulated the frequency and percentage of responses within each category.

Results

Characteristics of participants

A total of 107 older adults participated in this study with a median age of 67.0 (Q₁ 64.0, Q₃ 71.0). Most participants were male (55.1%), from the Prairie Provinces (Alberta, Saskatchewan, and Manitoba) (31.8%) and from cities with less than one million people (43.9%) (Table 1).

Table 1. Summary of participants’ characteristics, presented as median (Q₁, Q₃) or count (%).

Variable		Count (%)
Age (median, Q1, Q3)		67.0 (64.0, 71.0)
Gender	Female	42 (39.3%)
	Male	59 (55.1%)
	Prefer not to disclose	6 (5.6%)
Region	British Columbia	19 (17.8%)
	Prairie provinces	34 (31.8%)
	Ontario	31 (29.0%)
	Quebec	11 (10.3%)
	Atlantic provinces	12 (11.2%)
Location	City (population < 1 million)	47 (43.9%)
	City (population > 1 million)	25 (23.4%)
	Rural (farm or acreage)	3 (2.8%)
	Town or village	32 (29.9%)

General experience with cannabis and perceptions of judgement by others

Univariate summaries of survey items reflecting participants’ general experience with and judgement regarding cannabis are presented in Table 2. Participants generally reported neutral to positive experiences (91.4%) using cannabis and that cannabis mostly or perfectly (75.3%) suited their intended purposes. Less than half of participants (40.0%) reporting feeling that they did not usually have to hide their cannabis use, over half (52.3%) reported feeling that they had to hide it sometimes or most of the time, and 7.6% of participants reporting feeling that they had to hide it always. Among all participants, 8.4% reported that they never used cannabis throughout their life (were new users), while 67.3% of participants reported using it sometimes to always. Over half (61.7%) of participants reported previously feeling (at least sometimes) judged for their desire to use or use of cannabis, but less than 15% of participants reported that feelings of being judged influenced their decision to use or seek information about cannabis ‘quite a bit’ or ‘all the time’.

Table 2. Summary of responses to individual survey items.

Question	Response count (%)
General experience with cannabis
	Negative	Mostly negative	Neither positive nor negative	Somewhat positive	Positive
What was the experience like?	1 (1.0%)	8 (7.7%)	14 (13.5%)	29 (27.9%)	52 (50.0%)
	Not at all	Somewhat		Mostly	Perfectly
How well has cannabis served the purpose you were using it for?	4 (4.0%)	21 (20.8%)		53 (52.5%)	23 (22.8%)
Cannabis use and judgement
	Never	Not usually	Sometimes	Most of the time	Always
Have you used cannabis throughout your life?	9 (8.4%)	26 (24.3%)	43 (40.2%)	24 (22.4%)	5 (4.7%)
Have you ever felt like you had to hide your use of cannabis?	21 (20.0%)	21 (20.0%)	39 (37.1%)	16 (15.2%)	8 (7.6%)
	No		Sometimes		Yes
Have you ever felt judged for your desire to use cannabis, or actual cannabis use?	41 (38.3%)		22 (20.6%)		44 (41.1%)
	Not at all	Not usually	Sometimes	Quite a bit	All the time
Do feelings of being judged impact your decision to use cannabis?	51 (51.5%)	20 (20.2%)	20 (20.2%)	7 (7.1%)	1 (1.0%)
Do feelings of being judged impact your decision to seek information about cannabis?	48 (48.5%)	22 (22.2%)	16 (16.2%)	13 (13.1%)	0 (0.0%)

Motivations to use cannabis for medicinal purpose

Participants reported several motivations for using cannabis for medicinal purposes. Of our 107 participants, more than half selected a health condition (n = 64), followed by legalization (n = 40), anxiety (n = 18), fun (n = 15), boredom (10), and unsure (n = 2). Those who responded ‘others’ reported: sleep issues (n = 1), back, shoulder and knee pain (n = 1), old age (n = 1), social circumstances rather than alcohol (n = 1), recommendations from a friend (n = 1), performing mundane tasks without arthritic pain (n = 1), and curiosity (n = 1).

Perceived quality of information by source

Table 3 summarizes the sources of information participants consulted and how well they felt those sources answered their questions about cannabis. Participants most commonly identified seeking information from healthcare professionals (HCPs) (49.5%) or cannabis retail stores (40.2%). Friends and the internet were reported to be less helpful than other sources in answering questions. Family members, cannabis growers, and HCPs were most often reported to have answered all of a participant’s questions.

Table 3. Summary of responses to ‘how well were your questions answered?’, stratified by response to ‘what types of people or sources did you seek information from (multiple response)?’.

Source	Marginal count (%)	Response count (%)
		Not at all	Somewhat	Mostly	Answered all my questions
Healthcare professional	53 (49.5%)	1 (1.9%)	5 (9.4%)	26 (49.1%)	21 (39.6%)
Cannabis retail store	43 (40.2%)	0 (0.0%)	9 (20.9%)	21 (48.8%)	13 (30.2%)
The internet	35 (32.7%)	0 (0.0%)	10 (28.6%)	19 (54.3%)	6 (17.1%)
Friend	33 (30.8%)	0 (0.0%)	12 (36.4%)	15 (45.5%)	6 (18.2%)
Family member	22 (20.1%)	0 (0.0%)	4 (18.2%)	5 (22.7%)	13 (59.1%)
Cannabis growers	20 (18.7%)	0 (0.0%)	0 (0.0%)	11 (55.0%)	9 (45.0%)

Comfort with methods of accessing cannabis

Table 4 summarizes the methods participants used to access cannabis and how comfortable they were with those methods. Most participants purchased cannabis at a retail store (56.1%) and fewer used a cannabis grower (25.2%) or medical dispensary (24.3%). Few participants reported accessing cannabis from more than one source. Of the total 107 participants, 14 (13.08%) participants selected cannabis grower and retail stores. Five (4.67%) participants selected both medical dispensary and cannabis retail stores as a source of cannabis for medical purpose. One (0.93%) participant chose medical dispensary, retail store and grower and one (0.93%) chose medical dispensary and grower. Nearly one-third of participants who used a medical dispensary felt at least some anxiety about accessing cannabis from that source, while the rest were typically somewhat or very comfortable. About one-third of participants using a cannabis grower, cannabis retail store, friend, or medical dispensary were very comfortable. Participants were otherwise typically somewhat or very comfortable accessing cannabis.

Table 4. Summary of responses to ‘how comfortable were you accessing cannabis in this way?’, stratified by response to ‘where did you access cannabis?’.

Source	Marginal count (%)	Response count (%)
		Very uncomfortable	Some anxiety	Neutral	Somewhat comfortable	Very comfortable
Cannabis retail store	60 (56.1%)	8 (13.3%)	4 (6.7%)	8 (13.3%)	22 (36.7%)	18 (30.0%)
Cannabis grower	27 (25.2%)	2 (7.4%)	1 (3.7%)	2 (7.4%)	14 (51.9%)	8 (29.6%)
Medical dispensary	26 (24.3%)	2 (7.7%)	8 (30.8%)	2 (7.7%)	7 (26.9%)	7 (26.9%)
Friend	9 (8.4%)	1 (11.1%)	1 (11.1%)	3 (33.3%)	1 (11.1%)	3 (33.3%)
Family member	1 (0.9%)	0 (0.0%)	0 (0.0%)	1 (100.0%)	0 (0.0%)	0 (0.0%)

Results of conventional content analysis

Table 5 summarizes the findings of our conventional content analysis of the open responses on how older adults respond to feeling judged for cannabis use, the types of information they sought, and barriers they encountered while accessing cannabis and information about it. The number of responses to each question varied, so the frequency and proportion of responses were calculated accordingly. In situations where participants felt judged, they most frequently reported justifying/explaining their cannabis use or ignoring the judgement of others. A small proportion sought to keep their use hidden or otherwise avoid judgement. When seeking information, participants were most often looking for information about benefits/uses of cannabis with respect to health issues as well as information about products, safety, and dosing. The most-reported barriers to accessing cannabis were high cost and judgement/disapproval from others. Limited access or HCPs’ refusal to inform participants about cannabis were reported less commonly. About one-quarter of participants reported no barriers to accessing cannabis.

Table 5. Summary of categories identified in a conventional content analysis of open responses.

Category	Response count (%)
How do you deal with situations where you feel judged? (n=62)
Justify/explain that consumption is a medicinal and legitimate treatment for a health condition	26 (41.9%)
Ignore/dismiss the judgement of others	15 (24.1%)
Keep cannabis use hidden or avoid judgemental people	9 (14.5%)
React emotionally (e.g. anger, sadness)	5 (8.0%)
Concede or change consumption habits	4 (6.4%)
Have never been judged	2 (3.2%)
Other (Don’t know what to do, don’t know right or wrong)	1 (1.6%)
Have you encountered any barriers accessing cannabis? If so, please describe them (n=64)
Cost	14 (21.8%)
Judgement or disapproval from others	8 (12.5%)
HCP refusal to authorize/support access	7 (10.9%)
No or limited ways to access cannabis	6 (9.3%)
Denied access due to ageism	1 (1.5%)
What types of information were you looking for? (n=75)
Information about cannabis use and benefits for health-related issues	32 (42.6%)
Information about cannabis products, safety, dosing, and cost	20 (26.6%)
Information about side effects or harms of cannabis	13 (17.3%)
Information about service and support	6 (8.0%)
Other (attitude towards marijuana, information about the legality of marijuana, information about quitting marijuana, relationship between physical condition and marijuana)	4 (5.3%)

Discussion

This study aimed to assess older adults’ perceptions of their information-seeking and access to cannabis for health reasons using an online survey. Our findings indicate that participants sought information and cannabis from multiple sources, including HCPs and other medically unauthorized sources such as cannabis retailers, cannabis growers, online sources, family, and friends. It is also worth noting that, although most participants reported contacting HCPs for cannabis-related information, they primarily accessed cannabis via retail stores. This is concerning because participants were accessing cannabis from unauthorized sources such as cannabis retailers who are licensed to deliver cannabis or information for recreational use and not for medical use. Our findings builds on one previous Canadian study (Baumbusch & Sloan Yip, 2021) which found that participants mainly relied mainly on non-licensed stores and unauthorized individuals, including their family/friends, to access cannabis and information. A study conducted in the US (Bobitt et al., 2019a) indicated multiple factors related to why participants mainly relied on cannabis retail stores rather than HCPs to access cannabis. Those factors included ease of access, difficulty in finding a prescriber for the medical program, cost to visit a medical provider, having to go outside of their health insurance to find a provider, lack of openness among health care providers to discuss cannabis, and lack of knowledge among health care providers about cannabis use for medical purposes.

While our focus in this study was only to explore descriptively on how older adults access cannabis/information, participants did report several barriers which might explain why they access cannabis/information via unauthorized sources. Cost was the most common, which is consistent to the finding from recent U.S.-based study (Manning & Bouchard, 2021). In Canada, health insurance coverage for medical cannabis is very limited both in terms of access and coverage (e.g. most supplementary health plans provide very minimal coverage and only for limited conditions) (Sun Life Financial, 2018). Cost may be an issue regardless of whether cannabis is purchased through a retail store or from licensed medical producers, where most participants accessed it.

Our participants identified that judgement or disapproval from others was another barrier they encountered. Stigma about cannabis use exist among people of all ages (Jones & King, 2014; Link & Phelan, 2001) and older adults specifically (Yang et al., 2021). When older adults perceive judgment or disapproval from others, they may be hesitant to discuss cannabis use with others, including healthcare providers. Consequently, older adults may access cannabis or seek information about it from non-medical sources such as retail stores, family/friends where they can maintain anonymity (Butler et al., 2023).

HCP refusal to authorize cannabis access was another barrier reported by participants. According to the cannabis regulation in Canada, individuals must obtain authorization from HCP to access medicinal cannabis via authorized sources such as licensed cannabis producers, sellers or prescribers (Government of Canada, 2016). However, several studies have concluded that HCPs are reluctant to authorize access due to limited clinical guidelines, a dearth of evidence on medicinal cannabis use, concerns around potential side effects, and lack of knowledge among HCPs (Balneaves et al., 2018; Baumbusch & Sloan Yip, 2021; Butler et al., 2023; Ziemianski et al., 2015). Many older adults may thus rely on non-medical sources to seek information or access medicinal cannabis. Therefore, clinical guidelines and cannabis education for HCPs are warranted.

In our study, participants most commonly sought information related to benefits for health issues and potential side-effects of consuming cannabis, which adds to growing evidence that older adults are increasingly using cannabis for medical purposes (Baumbusch & Sloan Yip, 2021; Bobitt et al., 2019a; Chandiok et al., 2021; Kaufmann et al., 2022; Manning & Bouchard, 2021; Tumati et al., 2022; Yang et al., 2021). Participants rationalizing or justifying their cannabis consumption can be understood as a social distancing mechanism to avoid being seen as part of a stigmatized group (Ashforth & Kreiner, 1999; Garcia et al., 2005; Meisenbach, 2010). Research demonstrates that people generally avoid stigmatization by evading sources of stigma or by concealing the stigmatized behaviour, here cannabis consumption (Jones & King, 2014; Link & Phelan, 2001).

The majority of participants reported positive experiences with cannabis use, which could be because cannabis fulfilled their intended purpose of treating their health problem(s). Despite the legalization of medical-use cannabis more than two decades ago, more than half of our participants felt the need to hide their cannabis use at least sometimes. This could reflect the implicit stigma that still prevails among older adults themselves or in society (Erickson et al., 2013; Manning & Bouchard, 2021). Notably, relatively few participants reported that their feelings of being judged impacted their decision to seek information and access cannabis for medical use. This could be attributed to the recreational legalization of cannabis (Baumbusch & Yip, 2021), which might have encouraged participants to consider using it medicinally.

Policy and practice implications

Given that many older adults accessed medical cannabis and information from unauthorized sources, initiatives are needed to help guide older adults access to medical cannabis when warranted and related information via authorized sources. Older adults sought various information related to dosage, benefits, and the side effects of medical cannabis. Therefore, knowledge products in lay language should be made available to inform older adults about medical cannabis use. Cost was reported as one of the major barriers to access cannabis, hence, government should make provisions to include medical cannabis health insurance coverage to make access more affordable. Similarly, provisions to provide specialized knowledge and training on medical cannabis use to HCPs is necessary so that they can impart information on the safe and effective use of medical cannabis.

Limitations and directions for future research

This study has several limitations. The cross-sectional design of our study and the self-selection of participants limits the extent to which our results can be reliably generalized and likely introduce some bias into our results. Although we tried to recruit participants from all provinces, the majority were from the Prairie Provinces. However, it is noteworthy that Alberta has a disproportionately high percentage of Canadian medical cannabis patients in 2018–2019, 33%–37% of registered medical cannabis patients in Canada lived in Alberta (Government of Canada, 2019), which may help to explain their overrepresentation in our sample. Since we relied solely on participants’ self-reports to determine whether they were medicinal cannabis users, it is possible that they were also recreational users. Also, we did not specify in our survey if retail stores were regulated or unregulated, and participants may have mistakenly believed cannabis purchased from a retail store was medical as reported in previous studies (Baumbusch & Sloan Yip, 2021; Butler et al., 2023). Because of these limitations, our findings need to be interpreted with caution.

Further qualitative studies are needed to explore the precise reasons why older adults choose certain sources, particularly unauthorized sources vs authorized to access cannabis for health purposes and information related to it, particularly in the Canadian context. Reasons behind why HCPs may or may not prescribe medical cannabis to older adults need further exploration. As this is an initial exploratory study of medical cannabis amongst older persons, more research with representative samples from all provinces is needed to investigate the topic in greater depth.

Conclusion

Our findings suggest that older adults are motivated to use cannabis to manage their health problems. However, they are still reluctant to access cannabis and related information from HCPs and instead often rely on unauthorized sources. This study highlights that cost, judgement/disapproval from others and HCP’s reluctance to prescribe are common challenges for older adults in our sample. These barriers need to be addressed at both policy and practice levels by providing adequate knowledge products about medical cannabis to health care students, educators, HCPs, retailers and older adults, and financial support to older adults to ensure they access medical cannabis and information related to it from licensed and informed sources.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The work was supported by the Canadian Social Sciences and Humanities Research Council, award [430-2021-00003].