Firstly, I would recommend that we could be asking our patients about medicinal cannabis use. While it is gratifying to see that doctors are the most likely health worker to discuss medicinal cannabis use with users, I suspect we are missing out on giving some patients a chance to discuss their cannabis use. The medical conditions listed in the survey may help identify medicinal cannabis users presenting in general practice. It would be helpful to enquire about cannabis use in patients with mood disorders, chronic pain, gastrointestinal conditions and menstrual disorders. If we are proactive on this issue then we can start to explore the area of harm reduction in medicinal cannabis use.
Smoking is one major concern many respondents mentioned.
Concurrent tobacco administration, given its highly addictive nature, is another area of potential harm. Vapourisers are becoming available for inhaling cannabis vapour without combustion and their availability will be a great help in removing the harm associated with smoking. Patients would be well advised to use medicinal cannabis orally, although some respondents reported more variable effects and side effects when taking cannabis this way. The risk of arrest and prosecution was a major concern to most medicinal cannabis users who replied to the survey. Concerns about variability in supply, quality and high street prices were also mentioned by many of the respondents.