The Influence of Public Health Policy on Cannabis Consumer Identity

Throughout the peak of cannabis prohibition, openly acknowledging cannabis consumption carried significant risks. 

The label of a “cannabis consumer” was associated with stereotypes like laziness and lack of ambition, risking incarceration, and the severe consequences tied to drug charges. The threat was particularly pronounced for individuals already targeted due to structural racism or those with responsibilities for others.

While cannabis had a rich history as a therapeutic tool spanning millennia, during prohibition, negative identities were deliberately linked to users to discourage consumption. 

In the mid-1990s, a shift occurred with the resurgence of medical cannabis use, catalyzed by the HIV/AIDS crisis and supported by LGBTQ activists. This marked an exception to the prevailing narrative that all cannabis use was abuse. 

Individuals with medical notes from their doctors were exempted from negative stereotypes and categorized instead as “severely ill.”

Initially, medical cannabis was primarily accepted for serious conditions like cancer, HIV, and epilepsy. States such as California, allowing patients and doctors to decide cannabis suitability, faced accusations of using medical cannabis as a guise for broader legalization. 

Early medical cannabis regulations were often stringent, featuring limited lists of approved conditions, with the process of adding new conditions being cumbersome and marked by paternalism.

The Influence of Public Health Paternalism on Cannabis Consumers

Paternalism refers to the behavior of individuals in authority making decisions for others, even if these decisions may be advantageous. Ultimately, this prevents individuals from taking responsibility for their own lives. 

In the United States, instances of public health paternalism include laws on birth control, abortion, drug use, and eligibility requirements for welfare, drug treatment, and pain medication. 

The state’s decision to override medical professionals and restrict access to medical cannabis is a clear example of paternalism which causes ambiguity around the definition of medical cannabis use and confusion among consumers about the nature of their use.

A joint effort aimed to delve into the development of a medical cannabis identity. Conducting a survey among cannabis consumers, particularly those who considered their use recreational only, the study sought to explore their identities and motivations. 

In-depth interviews revealed that even those who identified as recreational consumers reported therapeutic benefits, such as improved sleep or recovery from exercise. However, these reasons were not deemed qualifying conditions in their state, leading them to view their use as non-medical.

According to the study, individuals who self-identified as medical consumers generally rejected the idea that cannabis was a crucial part of their identity (45.6%). In contrast, those holding state-sanctioned medical cards were more likely to consider cannabis an important aspect of their identity (45.5%). 

The study highlighted that paternalistic policies, such as finite lists of qualifying conditions for cannabis use, not only create a disparity in access across states but also influence how consumers perceive themselves, their consumption, and the motivations behind it.