Cannabis use among Native Americans experiencing pain within two U.S. Northwest clinics: a qualitative study

Abstract Background Cannabis is increasingly used by adults with pain, yet little is known about its current use by Native American people. Objective To describe the perspectives from a sample of Native American adults experiencing pain regarding their use of cannabis and its impacts on pain and related symptoms. Methods We conducted 1:1 semi-structured interviews between June 2023 and September 2024 from a convenience sample recruited from a longitudinal cohort study. We purposively recruited 15 adults who self-identified as Native American and sought medical treatment for pain at two clinics in the U.S. Pacific Northwest. Interviews addressed circumstances causing pain, the type and level of daily pain, use of cannabis for pain management and related symptoms, preferred cannabis products, and why individuals chose to receive care for their pain at their current health clinic. We conducted a thematic analysis using phenomenography with a codebook approach, to identify and describe prominent themes. Results Participants had a median age of 55 years (SE 3.1), 67% were female, and all reported more than one painful condition. We identified three themes: 1) traumatic pain experiences, 2) personalized pain self-management, and 3) Indigenous traditional healing practices. Participants reported experiencing physical, emotional, mental, and spiritual pain that led to adoption of numerous strategies to self-manage their health and pain conditions and promote well-being, including using a variety of cannabis products. Cannabis was described by many as a natural remedy in alignment with Indigenous traditional medicine approaches, despite barriers and challenges in its use. Conclusion This sample of Native American participants reported using cannabis to promote health and well-being as an active response to an array of past traumas and symptoms. Gathering data from larger and more diverse populations could assist with broader understanding regarding the meaning of cannabis use within Indigenous communities. Such information can assist in creating supportive systems and healthcare practices that honor individual preferences and beliefs.