Gaps in medical marijuana policy implementation: Real-time perspectives from marijuana dispensary entrepreneurs, health care professionals and medical marijuana patients

Abstract

Aims: There is a need for greater understanding of the recursive processes involved in drug policy development and its impact on stakeholders. The aim of this study was to examine the challenges of implementing marijuana policy in Massachusetts, where recent policy shifts have occurred. Methods: Qualitative data were generated from ethnographic field notes, media reports, public records and in-depth interviews with 25 stakeholders, including six medical marijuana dispensary entrepreneurs, eight health care professionals and 11 medical marijuana patients. Data were triangulated using a grounded theory approach. Findings: Stakeholders expressed confusion and misunderstanding, and demonstrated that they held conflicting interpretations of the policy and regulations. Analyses revealed gaps in policy development and implementation that are organised by three specific core implementation processes and the themes of transparency, communication and education. Conclusions: Findings show a need for more transparency in implementation processes, a more effective mode of communicating regulations, and a comprehensive plan for medical marijuana education. Based on our findings, we provide recommendations to help policymakers in the US and other countries considering legalisation of marijuana or other drugs.

Keywords:

• Cannabis
• education
• ethnography
• policy
• qualitative research
• public health
• health care provider
• drug education

Acknowledgements

We thank our student assistants, Scott Rau, Chrysanthos Nicholas, Tom Hay and Brendan Clifford, for their help with data collection and the Valente Centre and the Dean of Arts and Sciences at Bentley University for the funding to conduct this research.

Declaration of interest

There are no conflicts of interest to report.

Notes

1. Over time, municipalities started demanding very lucrative perks in exchange for the letter of non-opposition, which some stakeholders were calling "extortion." The more highly financed dispensary entrepreneurs were reported to pay up to $200,000 a year and 2.5% of gross sales to obtain the non-opposition letter needed for approval to open.