Lena Yannella

​

The problem:  Although patients need a health care provider’s recommendation in order to get access to legal medical cannabis, little is known about how well prescribing providers know about cannabis laws.

​

Why do this study?  In Washington State, both medical and recreational cannabis are legal, and a variety of health care professionals are allowed to issue medical cannabis authorizations for their patients. This study explores health care professionals’ knowledge, attitudes, practices, and sources of information in advising their patients on medical cannabis usage.

 

The study:  The survey received responses from 310 eligible health care professionals, of which about 30% were naturopaths, 27% were physician’s assistants, 27% were nurse practitioners, and 17% were physicians. It asked questions regarding knowledge of state law, attitudes about medical cannabis, and practices related to medical cannabis authorizations. For example, in terms of knowledge, respondents were asked to identify whether certain conditions qualify a patient for medical cannabis authorization. Although 93% of health care professionals correctly identified cancer as a qualifying condition, only 29% correctly identified traumatic brain injury. More than a third (41%) mistakenly believed that Parkinson’s disease as a qualifying condition for medical cannabis authorization in Washington state. Health care professionals also struggled to answer questions about laws and regulations regarding medical cannabis.  For instance, 60 percent did not know whether all qualifying patients may possess the same amount of cannabis.  For information, respondents relied on (in descending order): other health care professionals, continuing education, and scientific journals. Overall, 63% believed that cannabis should be legalized at the federal level and 71% supported the use of cannabis to reduce the use of opioids against chronic pain. However, only 18.5% of respondents reported issuing a medical cannabis authorization, half of whom had issued less than ten. When respondents were asked why they did not issue authorizations to patients, 58 percent responded that they did not feel they had the knowledge and skills necessary to provide authorizations.

 

Conclusions:  As cannabis legalization become more widespread, health care professionals must learn more about the effects, risks, and benefits associated with medical cannabis. Health care professionals must be sufficiently prepared and educated to rationally approach the drug as a treatment option.

 

What does this study add?  This study uncovered a diverse range of knowledge, attitudes, and practices with respect to medical cannabis, underscoring the necessity of standardized education such that health care professionals can appropriately inform and advise their patients.

 

Funder:  This study received funding from the State of Washington Initiative Measure No. 502.

 

Author conflicts:  None

 

Commentary: (David Casarett MD)  This study provides good evidence that medical legalization isn’t enough to provide patients with adequate access to cannabis.  These providers had many mistaken beliefs about the cannabis laws in their state.  Moreover, they said that their uncertainty about medical cannabis was a major barrier to providing an authorization for their patients.  States that legalize medical cannabis and expect health care providers to be responsible for authorizations need to take a much more active role in encouraging and providing education so that health care providers can be active partners with their patients.