Dr’s Want More Info Before They Start Prescribing Medical Cannabis Says Queensland University of Technology

Introduction

Current literature suggests that cannabis was first used medicinally by the ancient Chinese before spreading throughout the rest of the world.[1, 2] Although there is difficulty discerning medicinal and non-secular use during early periods, it was by anecdote that cannabis was passed down and considered medically useful.[2, 3] Cannabis continued to be used medicinally until the early-20^th century.[4] It was this period of time that saw the prohibition of opium and coca leaves with prohibition extending to cannabis due to its psychoactive properties. The penultimate prohibitive effort was the signing of the 1961 United Nations Single Convention on Narcotic Drugs.[5] Under this convention, cannabis was considered to have an extremely limited therapeutic value while simultaneously being considered to be a high risk of dependence and misuse.[5] Subsequently, generations of health professionals were educated in a system where cannabis was considered purely illicit. More recent studies have demonstrated, however, a plausible rationale for therapeutic action.[6–8] Yet, there are difficulties translating these findings into practice due to a number of issues surrounding the creation of evidence. For instance, it has been very challenging to perform clinical trials on herbal cannabis due to the enduring illicit status of cannabis across much of the world. Furthermore, studies performed on pharmaceutical cannabis preparations often lack consistency in the products and composition of cannabinoids used which makes comparison of trial results hard. Among others, these difficulties are commonly acknowledged in studies examining cannabinoid preparations alongside calls for further large, robust randomised controlled trials to confirm the effects of cannabinoids relative to safety and efficacy.[9–12]

A public vote saw the State of California approve the use of medicinal cannabis in 1996.[13] Since this time, many other jurisdictions have legislated for medicinal cannabis.[14] Although all jurisdictions are using different regulatory frameworks, common among all is the involvement of a health professional in the delivery of medicinal cannabis.[15, 16] For purposes of this study, ‘delivery’ includes authorisation and supply. Depending on the jurisdiction, authorisation can include medical recommendations or prescribing, while supply involves the dispensing and administration of medicinal cannabis.[15, 16] It is for this reason that a review of health professionals’ beliefs and knowledge of medicinal cannabis is important. Without the support of these key stakeholders it is likely that many who may benefit from medicinal cannabis will not receive therapy. By working to better understand the broader context in which health professionals deliver medicinal cannabis, further strategies can be devised to change health professional behaviour moving forward.

The principal aim of this study is to systematically review the existing literature surrounding health professional beliefs, knowledge, and concerns within the context of delivering medicinal cannabis. It is important to note that this study is neither positioned in support or against the availability of medicinal cannabis. As per the aim, the position of this study is to strictly report the beliefs, knowledge, and concerns of health professional delivering medicinal cannabis.

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216556