Medical or Recreational? Cannabis Labels, Relationships & Identity

All thoughts are my own opinions and observations and are for informational purposes only. They are not intended to promote cannabis consumption nor its access, and should not be considered medical advice. Always consult your health practitioner.

Australia does not currently have a regulated adult-use cannabis market.

Though the ACT has some exemptions from criminal liability for possession, most of the legal supply occurs through the medical pathway.

When access to cannabis occurs through a medical pathway, this usually leads to someone being referred to as a patient - they are undergoing medical care or treatment. This can occur in communications directly with a clinician, but it’s often also applied in a wider context too. For some people, being called a “patient” can sometimes position their cannabis use against sickness, pathology or deficiency. It may not always relate to how they understand themselves.

“Language is a powerful tool that can both reinforce and counter stigmatising attitudes...”

The definition of recreational use is the consumption of cannabis for pleasure or enjoyment. And this term is typically also used to encapsulate every other type of consumption that does not fall within the explicit medical context. While recreational use does exist and is valid, there is a vast scope of differing relationships with cannabis. But our language in referencing these relationships and types of consumption tends to be limited. As we’ll explore, the labels of “medical” and “recreational” can not be as easily applied to the human experiences of cannabis consumption and can also be problematic. 

Why the binary exists

It’s important to understand why the medical/recreational binary exists in the first place. In Australia and some other jurisdictions, medicinal cannabis reform has been the strongest path to legal legitimacy while cannabis remained broadly prohibited. But this approach has also had the unintended effect of strengthening the divide between “medical” and “non-medical” use, with the latter often treated as interchangeable with “recreational” use.

The same access pathway that made cannabis legitimate, also helped create the categories used to judge its use. As “medical” use became more accepted while “recreational” use remained associated with moral suspicion, the binary began to reinforce itself. Even now, some people describe their use as medical even when that doesn’t fully fit, because the alternative carries more stigma.

Why this distinction matters

Categories are useful to law, medicine and research institutions for policing, public-health and political messaging purposes. It helps them distinguish between forms of access and use. 

But our current cannabis discourse tends to collapse four different ideas - legal status, clinical rationale, purpose for use and personal meaning - all together. These typically ask:

1. Legal/access status:
How was the cannabis obtained and possessed?

2. Clinical rationale:
Why has a practitioner prescribed it?

“We can reserve the “patient” label for the direct clinician-patient relationship; this word loses gravity whilst used in any other context.”

3. Motive or function of use:
What is the person seeking from this particular use (eg. symptom relief, sleep, pleasure, relaxation, introspection)?

4. Personal meaning/identity:
How does the person understand cannabis's place in their life?

For an individual, the answers to these questions can overlap, but they are not always the same. Someone may legally access cannabis through a medical pathway, have a clinical rationale for pain, use it at a particular moment partly for sleep or relaxation and understand its place in their life as therapeutic, ritualistic or pleasurable.

Far more than two reasons

People consume cannabis for a variety of reasons. Some use it for relaxation, creativity, inspiration, or to cope with boredom and explore new ways of looking at things. Others use it intentionally to self-regulate, relieve stress, wind down after a long day, or assist with rest and sleep. And some may use cannabis for spiritual purposes, such as devotion or prayer. Some of these uses can be therapeutic in intention while others may be oriented toward ritual, exploration or pleasure.

It’s interesting that within our medical discourse, we tend to consider it suspicious if someone enjoys the psychoactive experience of cannabis. But enjoyment shouldn’t automatically decrease its therapeutic legitimacy. Because people can enjoy massage while receiving relief from muscular pain. Exercise can improve health and feel pleasurable. And food can nourish and be relished. But we tend to associate pleasurable cannabis consumption with recreational use only.

“Different motives for cannabis use can exist regardless of the access pathway used”

If we were to explore the distinctions in motives for cannabis consumption, we might find something like:

• Medical - can describe use within a clinical framework to address a diagnosed condition or symptoms. (eg. I’m using cannabis right now to help with my pain)

• Therapeutic - can describe a self-directed experience, which is viewed as helpful, relieving or restorative. Not necessarily medical treatment. (eg. I’m using cannabis right now because I need relief after a stressful day)

• Wellbeing - can include practices leaning toward exploration, reflection, social connection, embodiment, ritual or quality of life. (eg. I’m using cannabis to expand my mind to help me understand this problem better)

• Pleasure - requires no clinical justification at all. (I’m using cannabis to have fun)

These motives aren’t necessarily new identities to be adopted in place of medical or recreational. They relate more to the different dimensions of use.

And in practice, they often overlap.  They can coexist in the same person, even in the same experience. Most importantly, these motives can exist regardless of the access pathway used.

Relationships evolve

It’s also important to recognise that people’s relationship with cannabis is not stagnant and may evolve over time. Some might initially use it for therapeutic purposes and symptom relief and find over time, this changes to a more supplementary, wellbeing or ritualistic relationship. So initially they might relate to the “patient” label but later on, find this suits them less. Conversely, someone might begin cannabis consumption in a more social or recreational manner. This may later transition to therapeutic use, even if the access pathway remains the same. This shows the inherent limitations within our labels: they turn a behaviour or relationship with cannabis into a type of person.

“Identity labels can turn a behaviour or relationship with cannabis into a type of person.”

Stigma

People who use cannabis can experience stigma and discrimination in daily life. And language is a powerful tool that can both reinforce and counter these stigmatising attitudes, views and actions.

“People who use cannabis can experience stigma and discrimination in daily life.”

In jurisdictions where non-medical cannabis is legal, such as Canada and some US states, the term “adult-use” is  replacing “recreational.” “Adult-use” describes the regulatory category without assuming why a person consumes cannabis. Public-health messaging from those jurisdictions adopt this terminology for that reason.

This is what is worth considering, in our communications with those who consume. It’s worth asking ourselves, how do our labels encroach on a person’s identity? And it’s worth asking a consumer without assumption, how do you relate to cannabis?

Asking these questions can help to reduce some of the loadedness associated with our static language and allows the consumer to lead with a little more agency in defining their identity and relationship with cannabis for themselves. We can reserve the “patient” label for the direct clinician-patient relationship; this word loses gravity whilst used in any other context.

Making peace with complexity

Humans have a complex relationship with cannabis. Our language may be limited by the only legal access pathway currently available. Medical/recreational labels can be useful for describing legal or clinical circumstances, but they’re not always relevant for describing a person’s identity or their relationship with cannabis. 

It’s important to note that recognising this does not mean suggesting that every relationship with cannabis is beneficial, because it can also easily become harmful, compulsive or destabilising. 

But perhaps it's time to make peace with this complexity and recognise that our language surrounding cannabis is currently incomplete. If cannabis can hold so much space for us, we can hold space for complex relationships with it too.