Research Shows Medical Benefits in Cannabis

 Medical Benefits in Cannabis

Table of Contents

Is there a stigma around medical cannabis?

Existing Evidence on Stigma of Medical Cannabis Patients

The researchers found that, while patients have often been found to face stigma because of their condition, medical cannabis is one of the few treatments where patients are directly stigmatized due to their access to medicine

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Background

An increasing number of countries legalize the use of medical cannabis or allow it for a narrow range of medical conditions. Physicians, and often the patients' general practitioner, play a major role in implementing this policy. Many of them, however, perceive a lack of evidence-based knowledge and are not confident with providing patients with medical cannabis. The objectives of this review are to synthesise findings about hospital physicians' and GPs' experiences, attitudes, and beliefs towards the use of medical cannabis with the purpose of identifying barriers and facilitators towards providing it to their patients.

Methods

Peer-reviewed articles addressing hospital physicians' and GPs' experiences, attitudes, and beliefs towards the use of medical cannabis were searched systematically in PubMed, Scopus, EMBASE, and the Cochrane Library.

Results

Twenty-one articles were included from five different countries in which the medical cannabis laws varied. The studied physicians experienced frequent inquiries about medical cannabis from their patients (49–95%), and between 10 and 95% of the physicians were willing to prescribe and/or provide it to the patients, depending on setting, specialty and experience among the physicians. This review found that physicians experienced in prescribing medical cannabis were more convinced of its benefits and less worried about adverse effects than non-experienced physicians. However, physicians specialized in addiction treatment and certain relevant indication areas seemed more skeptical compared to physicians in general. Nevertheless, physicians generally experienced a lack of knowledge of clinical effects including both beneficial and adverse effects.

Conclusion

This review indicates that GPs and hospital physicians from various specialties frequently experience patient demands for medical cannabis and to some degree show openness to using it, although there was a wide gap between studies in terms of willingness to provide. Hospital physicians and GPs' experienced in prescribing are more convinced of effects and less worried of adverse effects. However, most physicians experience a lack of knowledge of beneficial effects, adverse effects and of how to advise patients, which may comprise barriers towards prescribing. More research, including larger studies with cohort designs and qualitative studies, is needed to further examine facilitators and barriers to physicians' prescribing practices.

Keywords:  Medical cannabis, Physicians, Attitudes, Experiences, Barriers, Facilitators

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Background

In recent years, some countries, including the Netherlands, Italy, Canada, Israel, Australia, and a number of states in the US, have legalized medical use of cannabis when prescribed or provided by healthcare professionals. In most of these countries, the cannabis is dispensed through pharmacies [ 1 ]. Other countries, including Denmark, Norway, Sweden, Poland, and the United Kingdom allow treatment with medical cannabis for a narrow range of medical conditions in patients where all other options of conventional treatment have been tried without reaching treatment targets [ 1 , 2 ] . Most commonly, a specialist with a specific license prescribes the cannabis products, and also pharmacies need a license to supply them [ 1 ]. 

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Medical cannabis has been debated worldwide among physicians and decision-makers, and the use of it remains controversial [ 3 ]. Moreover, the quality of the evidence of potential benefit as well as adverse effects is low [ 4 , 5 ]. Furthermore, cannabis contains tetrahydrocannabinol (THC) which is the euphoric component in cannabis for recreational use [ 6 ], and for this reason it gives rise to concerns about abuse and addiction [ 5 , 7 ]. However, medical cannabis and cannabis for recreational use are different from each other, as medical cannabis is subject to stricter requirements than recreational cannabis in terms of therapeutic safety, cultivation and manufacturing [ 6  ]. Another main component used in some preparations of medical cannabis is cannabidiol (CBD) which is non-euphoric. Depending on the needs to address, THC and CBD is given to patients in controlled, carefully metered doses [ 8 ].

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Generally, physicians play a major role in implementing regulatory policies on the use of medical cannabis, and specifically general practitioners (GPs) who are often the patients' first contact in healthcare systems and an ongoing coordinator of their treatment [ 9 ] . A recent systematic review study reviewed the existing literature concerning all types of health care professionals' personal beliefs, knowledge, and concerns regarding delivery and supply of medical cannabis to patients [ 10 ] . However, it is just as essential to focus on physicians' experiences with patients' demand for medical cannabis and whether they decide to provide it to them [ 11 ].

Hence, in order to fill this knowledge gap, the objectives of this review were to investigate hospital physicians' and GPs' experiences with patients' demand for medical cannabis and prescription practice, as well as their attitudes, and beliefs towards the use of medical cannabis with the purpose of identifying barriers and facilitators towards providing it to their patients.

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