Stigma is the largest invisible barrier in healthcare blocking honest communication about medical cannabis.
For decades, cannabis has been the elephant in the exam room, the family secret nobody talks about, and the hidden tattoo many people feel compelled to cover.
Despite thousands of years of medicinal use across cultures, cannabis continues to be one of the most misunderstood subjects in healthcare.
For decades, cannabis has been the elephant in the exam room, the family secret nobody talks about, and the hidden tattoo many people feel compelled to cover.
Despite thousands of years of medicinal use across cultures, cannabis has been singled out in modern society as something dangerous, shameful, and closely associated with drug abuse and addiction.
As a result, conversations about cannabis have often been silenced—not because of a lack of interest, but because of fear, misunderstanding, and stigma.
Today, evidence continues to emerge regarding cannabis, the endocannabinoid system, and the potential role of cannabinoids in supporting health and wellness.
Yet many healthcare professionals receive little or no formal education about cannabis during their training.
“The greatest barrier is not a lack of science or patient interest. The greatest barrier may be stigma itself.”
Stigma influences education, policy, research, professional conversations, and ultimately patient care.
Until healthcare professionals are willing to address stigma openly, meaningful conversations about cannabis will remain difficult – and worse yet, unspoken.
What Is Stigma?
Merriam-Webster defines stigma as a set of negative and unfair beliefs that a society or group of people have about something.
Researcher Erving Goffman, whose work remains foundational in stigma research, described stigma as a part of the self that is socially devalued until it becomes morally offensive.
How Stigma Affects Patient Care
Stigma in healthcare prevents both patients and providers from bringing the topic of cannabis into the conversation.
The use of cannabis is often viewed as deviant or criminal behavior – even when individuals are fully complying with state laws.
Because of this stigmatization, patients who use cannabis may choose not to disclose their use to healthcare providers.
The result is incomplete medical histories, missed opportunities to discuss potential drug interactions, and poorer health outcomes.
Education Begins in Our Schools
Stigma in healthcare continues to perpetuate itself, beginning in medical schools.
A 2024 study found that medical students frequently held inaccurate views about medical cannabis, relied on unreliable information sources, and expressed differing beliefs about legalization.
Importantly, students consistently reported wanting more education about medical cannabis during their professional training.
Researchers also found that student perspectives varied depending upon the state in which they lived and their family’s previous exposure to cannabis.
Nursing schools demonstrate similar educational gaps.
Although more than 90% of surveyed nursing students believed cannabis has therapeutic benefits (N=1,346), nearly three-quarters reported receiving no formal education about medical cannabis during nursing school.
Students also expressed a strong desire for evidence-based education.
Perhaps most concerning was where students reported obtaining their information.
Many cited news or media sources (N=829), while others said their primary education came directly from patients themselves (N=383).
Education—not stigma—should shape clinical conversations.
Why Patients Remain Silent
Limited education, combined with decades of societal stigma surrounding cannabis, naturally creates fear and hesitation – for both patients and healthcare providers.
It is not simply limited knowledge that prevents honest discussions.
Both patients and providers often hesitate to bring up the topic at all.
We cannot expect patients to receive meaningful education about a subject when healthcare professionals possess limited knowledge and stigma continues to dominate the conversation.
Studies confirm that many patients are reluctant to disclose cannabis use to their healthcare providers.
When patients perceive stigma during clinical encounters, they are significantly more likely to withhold important information regarding their cannabis use.
Replacing Stigma with Education
Awareness is always the first step toward solving a problem.
Lack of education, stigma, and personal beliefs all influence a healthcare provider’s ability to discuss cannabis openly.
Several interventions can help address these barriers.
1. Anticipate stigma.
Being aware that stigma exists encourages healthcare providers to conduct unbiased, neutral, and routine cannabis screening and assessment.
2. Improve healthcare education.
Healthcare providers need evidence-based education.
The science of cannabis medicine -and the endocannabinoid system– deserves consideration alongside every other physiological system taught in healthcare education.
3. Normalize the conversation.
Routine, nonjudgmental discussions of cannabis during healthcare assessments help reduce fear while making disclosure easier and more comfortable for patients.
Moving Forward
When healthcare providers create more opportunities to discuss medical cannabis in a respectful and nonjudgmental manner, stigma begins to lose its power.
If we continue avoiding these conversations, we will never move beyond the stigma.
Our patients deserve to speak openly about every aspect of their health.
We must replace stigma with education.
The true heroes are the patients who choose to discuss medical cannabis despite fear of judgment.
Healthcare providers must also act courageously by educating themselves so they can engage patients in honest conversations, even when stigma persists.
“We must replace stigma with education.”
The courageous leaders in healthcare are those who choose curiosity over fear.
They are willing to speak openly about cannabis despite uncertainty.
They are willing to acknowledge the elephant in the exam room, bring hidden conversations into the light, and replace silence with conscious communication.
Stigma survives in silence.
Only when we speak honestly—with our patients, our colleagues, and our families – about the science, medicinal value, potential risks, and benefits of medical cannabis will stigma finally become the silent one.
Speak out.
References
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Simon & Schuster.
Hathaway, A. D., Comeau, N. C., & Erickson, P. G. (2011). Cannabis normalization and stigma: Contemporary practices of moral regulation. Criminology & Criminal Justice, 11(5), 451–469. https://doi.org/10.1177/1748895811415345
King, D. D., Gill, C. J., Cadieux, C. S., & Singh, N. (2024). The role of stigma in cannabis use disclosure: An exploratory study. Harm Reduction Journal, 21(1), Article 21. https://doi.org/10.1186/s12954-024-00929-8
Merriam-Webster. (n.d.). Stigma. In Merriam-Webster.com dictionary. Retrieved May 25, 2026, from https://www.merriam-webster.com/dictionary/stigma
Skliamis, K., Benschop, A., & Korf, D. J. (2022). Cannabis users and stigma: A comparison of users from European countries with different cannabis policies. European Journal of Criminology, 19(6), 1483–1500. https://doi.org/10.1177/1477370820983560
Wang, G. S., et al. (2022). Medical students’ attitudes, knowledge, and beliefs about medical cannabis: A qualitative descriptive study. Cannabis and Cannabinoid Research. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC9502535/
Parmelee, R. A., & Clark, C. S. (2022). Nursing students’ knowledge, skills, and attitudes regarding medicinal cannabis care. Journal of Nursing Regulation, 13(3), 13–23. https://doi.org/10.1016/S2155-8256(22)00082-5
