Abstract
BackgroundPeople report using cannabis as a substitute for prescription medications but may be doing so without the knowledge of their primary health care providers (PCPs). This lack of integration creates serious concerns, e.g., using cannabis to treat medical conditions that have established treatment options.MethodsWe conducted an anonymous, cross-sectional online survey among patrons of a medical cannabis dispensary in Michigan (n = 275) to examine aspects of their relationship with their PCP and their perceptions of PCP knowledge related to cannabis.ResultsOverall, 64% of participants initiated medical cannabis use based on their own experiences vs. 24% citing advice from their PCP. Although 80% reported that their PCP knew they currently used medical cannabis, 41% reported that their PCP had not always known. Only 14% obtained their medical cannabis authorization from their PCP. Only 18% of participants rated their PCP’s knowledge about medical cannabis as very good or excellent and only 21% were very or completely confident in their PCP’s ability to integrate medical cannabis into their treatment. Although 86% had substituted cannabis for pharmaceutical medications, 69% (n = 134) of those who substituted reported some gap in their PCP’s knowledge of their substitution, and 44% (n = 86) reported that their PCP was currently unaware of their substitution.ConclusionsPatients frequently substitute cannabis for prescription drugs, often without PCP knowledge. Although most participants disclosed cannabis use to their PCP, their perceptions of PCP knowledge ranged widely and many obtained medical cannabis licensure from an outside physician. Our results highlight the need for standardized physician education around appropriate medical cannabis use.
Highlights
Thirty-five states in the USA have enacted medical cannabis programs
Sciences, Engineering, and Medicine report found evidence supporting the therapeutic value of cannabinoids for chemotherapy induced nausea and vomiting, chronic pain, and multiple sclerosis-related spasticity (National Academies of Sciences, Engineering, and Medicine 2017)
In Michigan, patient registry licenses are valid for two years and individuals can obtain licensure both from their primary health care providers (PCPs) or from an outside provider who must be an MD or DO licensed in Michigan (Marijuana Regulatory Agency LaRA 2020)
Summary
Thirty-five states in the USA have enacted medical cannabis programs. Despite being designated a Schedule I drug under the 1970 Controlled Substances Act in the US (indicating a high potential for abuse and no accepted therapeutic use), a recent National Academies of Sciences, Engineering, and Medicine report found evidence supporting the therapeutic value of cannabinoids (active compounds in cannabis) for chemotherapy induced nausea and vomiting, chronic pain, and multiple sclerosis-related spasticity (National Academies of Sciences, Engineering, and Medicine 2017). The evidence for most conditions allowed by state medical laws (e.g., depression) was insufficient (National Academies of Sciences E, and Medicine 2017; Boehnke et al 2019a). Many individuals using cannabis believe that cannabis is useful for medical conditions with no evidence base (e.g., cancer treatment) (Kruger et al 2020). People report using cannabis as a substitute for prescription medications but may be doing so without the knowledge of their primary health care providers (PCPs) This lack of integration creates serious concerns, e.g., using cannabis to treat medical conditions that have established treatment options
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