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Acceptance towards decriminalization of medical marijuana among adults in Selangor, Malaysia

Buying marijuana online in Melaka

Official websites use. Share sensitive information only on official, secure websites. Competing Interests: The authors have declared that no competing interests exist. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The issue of decriminalization of medical marijuana has gained public attention globally due to the decisions of various governments in developed and developing countries who have decriminalized marijuana for medical purposes. The action was the result of the change in perception towards medical marijuana use, which is now believed to be safe, acceptable, and should be decriminalized. Due to the progress of modernization and the wide access to information, the change in perception towards medical marijuana seems to be inevitable and might have already permeated among the public in Malaysia. However, at the moment there is no baseline data to determine any of this claim. To determine the prevalence and factors associated with acceptance towards decriminalization of medical marijuana among adults in Selangor, Malaysia. The study was a cross-sectional study conducted in year among adults aged 18 years old and above in Selangor, Malaysia. The respondents were sampled using a multistage random sampling. The data was collected via self-administered questionnaires and has been analyzed using SPSS version More than half of the respondents in this study The results of the survey show that the current acceptance level towards decriminalization of medical marijuana is considerably high. However, the acceptance is mainly among those who are exposed to the substance and those who perceive low risk of medical marijuana. Thus, a further exploration of this phenomenon is needed, especially by increasing the sample size and expanding the study location to other states. Based on the written evidence from ancient botanical history and traditional texts on herbal medicine, marijuana has been recorded to possess specific medicinal properties and has been used historically to treat medical symptoms such as chronic pain and seizure \[ 1 \]. However, the use of marijuana is much more commonly associated with recreational use, crime, and social problems \[ 2 \]. Thus, in this study, the term medical marijuana is applied to refer to the use of marijuana specifically for medical purposes. In Malaysia, marijuana is listed in the First Schedule \[Sections 2, 11 1 and 17 30 \] under the Dangerous Drugs Act Act where ingestion and possession of marijuana in any form is illegal and a crime and possession of marijuana of more than g despite the intention of use is a severe criminal act punishable by death. Decriminalization, which is defined as removing criminal sanctions against an act, article, or behaviour Svrakic et al. This notion stems from the growing perception that the long, arduous journey of criminalization through the declaration of the war on drugs has been a failure, leading to more violence and corruption \[ 2 \]. Decriminalizing drugs would mean that though the prohibited drug will remain illegal, the person in question will not be severely prosecuted by law for possession or administration of drugs. Instead, the person would be punished with fines, community service or undergo drug treatment. In essence, a less severe punishment than previously legislated \[ 7 \]. In Canada, specifically for medical marijuana, the decriminalization of the substance came in a form of expansion of medical services where patients may gain access to medical marijuana through medical dispensaries under strict measures \[ 8 \]. The approach of decriminalization of drugs has been adopted by more than 25 countries worldwide with significant differences and levels of effectiveness. Among countries that have been adopting decriminalization approaches are Germany, Italy, Switzerland, the Czech Republic, and Portugal, with decriminalization models varying from one country to another to suit the local context \[ 2 \]. The Malaysian government had previously considered decriminalization in a form of a dual-policy approach. However, the focus was more on hard drugs such as heroin and morphine, in which the primary usage method is through intravenous injection, a method posing high risks of transmitting HIV. In the case of marijuana, the issue of decriminalization for medical purposes is related to providing legal access for patients to seek medication in the form of medical marijuana to treat their symptoms or illness, whenever supporting clinical and scientific evidence is available. The exposure to medical marijuana-related information that is widely spread through online media may have influenced how marijuana is being perceived currently, for its risk as a substance, risk of harm of use, and approval of use, resulting in it being reported less to NADA. In the US, these components have been monitored among adults since through a national survey on drug use alongside the other hard drugs. The survey showed that over time marijuana use is more commonly being perceived to be of low risk, low risk of harm, and to have high approval of use \[ 10 \]. Together with other supporting data, marijuana has now been decriminalized in 34 states in the U. However, repetitive exposure to certain concepts from online media sources can easily sway people into perceiving those concepts as true even though they might not be; this change in perception was conceptualized in the cultivation theory by George Gerbner in the s \[ 11 \]. The recent decision by the United Nations Commission on Narcotic Drugs to remove marijuana from Schedule IV of the Single Convention on Narcotic Drugs, in which it was previously listed alongside deadly, addictive opioids, including heroin is expected to spur discussion among the public on the current Malaysian government policy on medical marijuana use. Together with the increasing trend of decriminalization of medical marijuana globally, the public may perceive marijuana not to be as harmful as previously thought. However, there is no current data available on the perception of such components, and the prevalence of acceptance towards decriminalization of marijuana especially among the adult population in our local Malaysian setting. In the case of medical marijuana, though there is still limited scientific evidence of its medicinal properties in treating various diseases, the claims of its benefits are widely shared, discussed, and promoted among the public. The information on how different countries, especially developed countries, have different policy approaches towards the use of the substance, has also opened a window of discussion among the public. Comparison is inevitable, making the public question the current criminalization approach of the government in handling medical marijuana issues. At the same time, there are no legal procedures provided for qualified patients to get access to medical marijuana in Malaysia. In Germany, medical marijuana can be prescribed by a medical professional in situations where recognized standard treatment options are not available and the prospect of the impact of medical marijuana therapy is not entirely implausible \[ 13 \]. The situation is similar in Thailand where the use of marijuana for medical reasons is allowed with a prescription from either medical doctor, dentist, or registered Thai-traditional medical personnel \[ 14 \]. The aim of this study is to determine the prevalence and factors associated with acceptance towards decriminalization of medical marijuana among adults in Selangor, Malaysia. The results can be used to formulate balanced measures between strategic intervention and the possibility of medical services expansion in terms of access to medical marijuana treatment for affected patients similar to what can be learned from Canada, Germany, and Thailand \[ 15 \]. This cross-sectional study was performed in Selangor, Malaysia. The inclusion criteria for this study were Malaysians aged 18 years and above, residing in Selangor, Malaysia. Selangor has the lowest number of substance abusers and drug addicts per estimated total population per , residents compared with other states, despite being the most populous state in Malaysia as shown in Table 1 \[ 16 \]. We estimated the required sample size for each potentially associated factor and used the highest estimated number. The sample size for this study was calculated using the two proportions formula. A self-administrated questionnaire in two language versions English and Malay in Google Form was used in this study. The questionnaire was divided into three sections. Section 1 consists of 21 mixed questions which collected data relevant to sociodemographic, socioeconomic, and lifestyle factors, and was adapted from a study on support for marijuana legalization and predictors of intentions to use marijuana more often in response to legalization among U. Section 2 consists of 10 questions using a 5-point Likert scale to assess the perception of medical marijuana. The perceived risk of medical marijuana component was adapted from a study on characteristics associated with attitudes towards marijuana legalization in Michigan \[ 19 \]. The perceived risk of harm of medical marijuana uses and perceived approval of use of medical marijuana component was adapted from the study on support for marijuana legalization and predictors of intentions to use marijuana more often in response to legalization among U. Section 3 consists of five questions using a 5-point Likert scale to assess the overall acceptance towards decriminalization of medical marijuana in Malaysia, and was developed from the study on characteristics associated with attitudes toward marijuana legalization in Michigan \[ 19 \]. The total population in Selangor is currently estimated at 6. There are 16 parliamentary and a total of 56 state legislative assembly constituents in Selangor. Each parliamentary constituent will have two to three state legislative assembly constituents. For data collection, a multistage probability random sampling technique was used to select six parliamentary and state legislative assembly constituents. Potential respondents were selected randomly from the selected constituent list using a randomization tool software, as per sample size calculation. The respondents were assessed for eligibility before being invited to participate in the study. This method was selected in order to obtain a workable sample size. Data collection was done gradually in June For the face validity of this study, a pre-testing of the questionnaire was conducted involving 30 members of the community. For content validity, the questionnaire was evaluated by a subject matter expert to ensure that the items used in the instruments were aligned with the study objectives. The questionnaire was then translated to the Malay language to ensure reliability. The translated Malay language questionnaire was validated by a professional content writer and translator for its comprehensiveness and actual meaning in the Malay language. Modifications were done based on the advice of the supervisory committee and the expert on the matter. The magnitude of the reliability of the study was assessed via a test-retest of the questionnaire that was conducted among 30 community members. For the reliability test, the average inter-item correlation AIC for the acceptance towards decriminalization of medical marijuana scale was 0. The desired AIC range to be 0. Both the obtained AIC and alpha values proved the adequate internal consistency for the nine remaining items as shown in Table 2. In descriptive statistics, the data is presented in mean and standard deviation if normally distributed and as median and interquartile range if not normally distributed. Descriptive statistics were used to describe the characteristics of the distribution of respondents by sociodemographics, socioeconomics, perception of medical marijuana, and acceptance towards decriminalization of medical marijuana. The Chi-square test was used to determine the association between the dependent variable and all the independent variables with categorical data. For variables with numerical data, the association was examined by using Independent T-test. Consent from each participant was obtained using an online consent form upon agreement to participate in the study before answering the questionnaire. A total of responses were received with an overall response rate of All the respondents were contacted via WhatsApp or Telegram application with the contact numbers obtained from the community representatives at the study location and confirmed with the name list of voters from the Malaysian Election Commission. The results from the descriptive statistics are presented in Table 3. The age range of participants involved in this study was 19—67 year-old with an average age of From the sample, the majority of the respondents were online media users Most of the respondents in this study have ever smoked The acceptance rate towards decriminalization of medical marijuana from the respondents in this study was observed to be The results on the associations between acceptance towards decriminalization of medical marijuana and sociodemographic, socioeconomic, and lifestyle factors, and perception of medical marijuana use are presented in Table 4. Multiple logistic regression was performed to assess the impact of independent variables on the likelihood that respondents would report that they had an acceptance towards decriminalization of medical marijuana. The initial model contained 20 independent variables age, gender, ethnicity, level of education, employment status, household monthly income, ever smoked, current smoking status, given up smoking, ever drank, current alcohol drinker, given up alcohol, ever used substance, current substance use, online media user, exposure to medical marijuana-related content, hours spent on online media, perceived risk of medical marijuana, perceived risk of harm of medical marijuana use, and perceived approval of medical marijuana use. The full model had a good fit, indicating that the model was able to distinguish between respondents who reported and did not report an acceptance towards decriminalization of medical marijuana. The model as a whole explained between Other variables were not significant predictors for acceptance towards decriminalization of medical marijuana. Selangor has the lowest number of substance abusers and drug addicts per estimated total population compared with other states and this finding could be explained as those who reside in urban areas have a higher level of awareness on issues regarding drug abuse and addiction and its commensurate risks and danger \[ 20 \]. Similar findings were observed in another study which showed that younger individuals were more likely to accept decriminalization of medical marijuana \[ 19 , 21 \]. This result, however, contradicts other findings which suggested that age was not a significant factor in acceptance towards decriminalization of medical marijuana \[ 22 \]. The majority of the respondents who participated in this study were male The difference could be explained by males having a higher tendency to respond to the survey compared to females. The findings are similar with other studies which found that males were significantly more likely to accept decriminalization of medical marijuana than females \[ 17 , 19 , 21 \]. In this study, the majority of the respondents were Malay The overall acceptance towards decriminalization of medical marijuana in this study is relatively high considering the findings in the United States which showed that Asians were more likely to be unsure or rejected decriminalization of medical marijuana \[ 22 \]. However, using multiple regression analysis, ethnicity was found to be not a significant predictor for acceptance towards decriminalization of medical marijuana. All of the respondents who participated in this study had received formal education to at least primary school level. The results from this study show that acceptance towards decriminalization of medical marijuana was observed to be highest among respondents who held a first degree Almost half of the participants in the sample of this study are working with a private company This finding contradicts the findings reported by other studies that showed employment status was not a significant factor associated with acceptance towards decriminalization of medical marijuana \[ 23 — 25 \]. Further multiple logistic regression analysis shows that employment status is not a significant predictor for the dependent variable in this study. The household monthly income for the respondents involved in the study has been categorized into B40 Analysis of this data shows that household monthly income is not significantly associated with acceptance towards decriminalization of medical marijuana. History of smoking status ranging from ever smoked, current smoker, and those who have given up smoking has been shown to be a significant factor associated with acceptance towards decriminalization of medical marijuana policy \[ 27 \]. From the obtained data, more than half of the respondents who participated in this study reported that they had smoked before The analysis of respondents who have given up smoking also suggests a significant association between the factor with acceptance towards decriminalization of medical marijuana. The finding is consistent with another study that suggested current cigarette smokers had more support for decriminalization of medical marijuana \[ 22 \]. Subsequent analysis by logistic regression shows that factors of having ever smoked, current cigarette smoker, and those who have already given up smoking are not significant predictors of acceptance towards decriminalization of medical marijuana. For alcohol drinking status, history of ever drank, current drinker, and given up alcohol were found to be not significant as factors associated with acceptance towards decriminalization of medical marijuana except for history of or current use of alcohol. Subsequent analysis by multiple logistic regression also shows that ever drank, current alcohol drinker, and given up alcohol are not significant predictors for acceptance towards decriminalization policy for medical marijuana. In the analysis of the substance use status of respondents to this study, the number of respondents who reported themselves as have ever used drugs However, the reported high number could be because the study did not differentiate the intention of use of the substances. The explanation that might fit such responses is the respondents had received the substance from health care facilities as part of their emergency treatment or clinical management. Further analysis by multiple logistic regression shows that ever used substance and current substance use are significant predictors for acceptance towards decriminalization of medical marijuana. Analysis of the online media use status shows that a majority of the respondents were online social media users This was unexpected given the study instrument was a self-administrated questionnaire that was distributed to the eligible respondents via WhatsApp or Telegram application which are considered to be social media platforms. A possible explanation for such responses is the questionnaire had been answered by a close acquaintance or family member on behalf of the respondents. Other possible explanations are the respondents might have a different interpretation of what online media is, for example, only Facebook, Instagram, and Twitter are considered as social media but not WhatsApp or Telegram or online portal news which may result in such negative response. The significant result for this item is similar to the results of other studies in terms of a higher level of acceptance among those with higher mean of hours spent on online media \[ 28 , 29 \]. Further analysis by multiple logistic regression on online media use status shows that online media user, exposure to medical-marijuana related content, and hours of online media engagement are not significant predictors for acceptance towards decriminalization of medical marijuana. Perception of medical marijuana that has been assessed in this study consists of the components of perceived risk of medical marijuana, perceived risk of medical marijuana use, and perceived risk of approval of medical marijuana use. Further multiple regression analysis also shows that all the components of perception of marijuana are significant predictors associated with the acceptance towards decriminalization of medical marijuana among the adult population in Selangor, Malaysia. The strongest predictor for reporting an acceptance towards decriminalization of medical marijuana policy is perceived high approval of medical marijuana use, recording an odds ratio of 7. This indicates that respondents who perceive high approval of medical marijuana use are 7 times more likely to report an acceptance towards decriminalization of medical marijuana than those who perceive low approval of use, controlling for all other factors in the model. The adjusted odds ratio for ever used substance is 2. The adjusted odds ratio for current substance use is 2. The adjusted odds ratio of perceived risk of medical marijuana is 5. The adjusted odds ratio of perceived risk of harm of medical marijuana use is 3. The study only looked into the association between sociodemographics, socioeconomics, lifestyle, and perception towards medical marijuana with the acceptance towards decriminalization of medical marijuana but did not assess the dynamic relationships between the evaluated variables due to the cross-sectional study design. This study only represents acceptance towards decriminalization of medical marijuana among the adult population in Selangor which is a highly urban state and may be associated with a high level of awareness towards medical marijuana policy. As the questionnaire was shared with the respondents through the WhatsApp and Telegram applications, there was a tendency for selection sampling bias as those who accept decriminalization of medical marijuana had a tendency to respond to the survey. The respondents could answer the questionnaire privately and freely without the need to worry about any legal repercussions or a breach in sensitive information such as a history of illegal substance use. All data responses are protected, private, and confidential. This is the strength of the study that contributed to the respondents giving truthful responses in the questionnaire, which may explain the unexpectedly high prevalence among respondents who reported themselves as having previously used substances in the data sample. The results of the study show that the current acceptance level towards decriminalization of medical marijuana among the adult population in Selangor, Malaysia is considerably high. Thus, further exploration on this phenomenon is needed, specifically by increasing the sample size and expanding the study location to other states in Malaysia. Based on the findings in this study that shows a high acceptance towards decriminalization of medical marijuana among the adult population in Selangor, Malaysia, it is recommended that the exploration of the acceptance level be extended further to the adult population at the national level and the acceptance level monitored periodically in preparation for dealing with the issue of medical marijuana in the country. A generally high acceptance rate towards decriminalization, with perceived low risk of medical marijuana, low risk of harm from medical marijuana use, and high approval of use of medical marijuana among the general population should be seen as an opportunity to be explored in terms of policy reconciliation, clinical, public health and agricultural research, expansion of medical services, social construct, as well as of crime and economic impact to the country. As the issue of medical marijuana is a medical-related one, a focused study involving medical doctors, pharmacists, medical assistants, nurses, and other health care workers in a public or private setting may provide a different perspective from the point of view of the medical service provider regarding the acceptance of medical marijuana as a medical treatment. Moreover, decriminalization, alongside the right information and continuous education, is one of the approaches that could be considered in dealing with the medical marijuana issue in Malaysia. We are grateful for the full cooperation given by all the staff at the Election Commission of Malaysia to this study. Also, we would like to thank all the generous and kind hearted respondents that participated in the study. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. PLoS One. Find articles by Rahmat Dapari. Find articles by Mohd Hafizuddin Mahfot. Find articles by Mohd Rohaizat Hassan. Find articles by Nazri Che Dom. Muhammad Junaid Farrukh : Editor. Received Sep 2; Accepted Jan 5; Collection date Open in a new tab. Instrument Mean Std. Variable M SD Age year Click here for additional data file. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Perceived approval of use of medical marijuana average score. Accept M SD. Reject M SD. Perceived risk of harm of medical marijuana use. Perceived approval of use of medical marijuana. Perceived risk of medical marijuana. Perceived risk of harm of medical marijuana.

Buying marijuana online in Melaka