“I wish I didn’t have to defend myself for not being in pain all the time”: Healthcare Interactions between People with Endometriosis and General Practitioners about Therapeutic Cannabis Use: A Narrative Analysis

The current study explored how people with endometriosis navigate interactions with their general practitioners about cannabis use as a form of symptom management. More specifically, it considered whether, and to what degree, relations of power and notions of stigma featured in participant narratives. A social constructionist lens was utilised to review previous literature exploring accounts of healthcare interactions from the perspectives of people with endometriosis, and people with chronic health conditions, including endometriosis, who use cannabis therapeutically. At the time of the review, I understood there to be no previous publications which centred the experiences of healthcare interactions in people with endometriosis who use or want to use cannabis therapeutically; a gap in the literature which this research aims to remedy in the context of Aotearoa New Zealand. A structural and content narrative analysis was performed to centre participant stories and understand how participants spoke of their experience at a personal, interpersonal, positional and ideological level. Findings suggest that experiences of previously ineffective or undesirable treatments, in addition to embodied experiences of therapeutic effects following recreational cannabis use, were constructed as reason for attempting to discuss cannabis use with general practitioners during healthcare interactions. Similarly, contrasting understandings of cannabis use between participants and general practitioners were framed as criticisms of power imbalances within interactions, especially where discussions about or access to cannabis was limited or denied. Feelings of power (and a lack thereof) featured in participant narratives when discussing their own understanding of cannabis, in comparison to that of their general practitioner, which played an important part in how they came to understand themselves as ‘defenders of cannabis’. Participants associated stigma with social perspectives of cannabis use, with all participants expressing desires to engage in a greater number and quality of discussions about cannabis use with general practitioners. These findings may inform future research about endometriosis and cannabis use, particularly regarding how cannabis as a ‘healthier, more natural’ treatment is understood by people with endometriosis and general practitioners, and whether the stigmatisation of cannabis use in people with endometriosis is experienced across age groups. Implications of these findings for clinical practice include how a denial or silencing of discussion about cannabis can be interpreted as disempowering and stigmatising for people with endometriosis. Recommendations, specifically for general practitioners, include listening to and not dismissing or ‘shutting down’ discussions about therapeutic cannabis use, so that future interactions can promote more open and honest conversations about effective treatment options for people with endometriosis.