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Table 10 Barriers: specific to cannabis

From: Using a qualitative sub-study to inform the design and delivery of randomised controlled trials on medicinal cannabis for symptom relief in patients with advanced cancer

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Driving restriction

Requirement that MedCan participants abstain from driving

The only thing that’s stopping me is not being able to drive… Public transport is something that I’ve never used, ever and most times where I’ve lived it’s just not convenient. (P42F, declined)

To be stuck home not driving and it’d just kill the quality of life. The only thing that helps keep my sanity these days is I play a bit of golf. If I can’t get there, well, I would just be sitting and moping around at home. (P39M, declined)

Fear of getting ‘high’

Perceived risk of experiencing an altered state

I’m a logical thinking person. Cannabis is going to have me off with the fairies…. I don’t know that, if it’s going to have me off with the fairies. I’m not going to have a full life if I’m off in the clouds somewhere. (P39M, declined)

Cost

Prohibitive cost of medicinal cannabis following the trial

I was told that once it got - if it got legalised and all the rest of it, it was going to be $300 or $400 a [pop] …. that’s out of the reach for a lot of people. Why are they even doing it if we’re not even going to be able to afford to have it? (P31F, declined)

Staying on cannabis

Risk of being assigned to the placebo arm

I know that half the people in it will be on placebos. I don’t think I can afford to be off the [non-trial] cannabis... Once you’re on it it’s very important that you stay on it, especially if you’ve got ongoing problems. That’s why I wouldn’t want to be part of the [trial]. If I was to have it and know it was cannabis I’d be happy to be monitored but as far as having the risk of having a placebo, there’s no point in that. (P38F, declined)

Preference for unaltered cannabis

Perception that community acquired cannabis was purer

I know of some people who have done research and they said there’s a couple of little nasties in [the medicinal cannabis]... Where I’m getting it from, their base is totally coconut oil, so it’s not having any little nasties in it. Don’t ask me about the nasties because I don’t understand. (P46F, declined)