To Treat or Not to Treat? Polish Physicians' Opinions about the Clinical Aspects of Cannabinoids-An Online Survey.

Martyna Joanna Hordowicz,Agnieszka Leonhard,Maria Wysocka,Jerzy Jarosz,Małgorzata Czaplińska,Anna Klimkiewicz

doi:10.3390/jcm11010236

Martyna Joanna Hordowicz, Agnieszka Leonhard + Show 4 more

Open Access

https://doi.org/10.3390/jcm11010236

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Abstract

Introduction: Medical cannabis’ importance in Poland increased dramatically following its legalization as the 12th country in Europe in 2017. However, no studies have been published to give insight into Polish physicians’ opinions about medical cannabis. Objectives: To investigate physician’s opinions about cannabinoids’ utility in clinical practice, concerns regarding their safety profile, and their clinical experience with cannabinoids. Methods: The survey using a self-developed tool was conducted online; participants were physicians with or without specialist training. Participation was voluntary. Physicians were recruited through personal networks, palliative care courses, and Medical Chambers. Results: From June to October 2020, we recruited 173 physicians from 15/16 voivodeships. The largest age group (43.9%; n = 76) was 30–39 year-olds. A similar proportion declared they never used cannabis and did not receive any training regarding cannabinoids (60% for both). Only 15 (8%) ever prescribed medical cannabis, although about 50% declared knowing suitable patients for such therapy, and 53.8% had at least one patient proactively asking for such treatment in the last 6 mo. The most common indication chosen was pain: chronic cancer-related (n = 128), chronic non-cancer (n = 77), and neuropathic (n = 60). Other commonly chosen conditions were alleviation of cancer treatment side-effects (n = 56) and cachexia (n = 57). The overall safety profile of THC was assessed as similar to most commonly used medications, including opioids; NSAIDs and benzodiazepines were, however, perceived as safer. Conclusions: Polish physicians favored the legalization of medical cannabis. However, it is of concern that a limited number have any experience with prescribing cannabis. The creation of clear guidelines to advise physicians in their routine practice and education about pain management and the risks related to the consumption of recreational cannabis for medical conditions are needed.

Highlights

Medical cannabis’ importance in Poland increased dramatically following its legalization as the 12th country in Europe in 2017
We investigated the point of view of medical cannabis legalization and use and factors that might influence doctors’ opinions
We found that younger physicians were more open to legalization and increasing the number of products and use of cannabis in the treatment of their relatives

Summary

Introduction

Medical cannabis’ importance in Poland increased dramatically following its legalization as the 12th country in Europe in 2017. No studies have been published to give insight into Polish physicians’ opinions about medical cannabis. Physicians were recruited through personal networks, palliative care courses, and Medical. Western medicine has used cannabinoids from the XIX Century until the mid-XX Century when Cannabis sativa-based tinctures and extracts spread thanks to Sir. William O’Shaughnessy, Sir William Gowers, and other physicians. Cannabis sativa contains over 100 phytocannabinoids, which are most important from the medical and legislative point of view [3]. Cannabis, including the industrial type, bears the stigma of a dangerous drug, a serious hazard to human health [4,5]. The 1961 Convention of the United Nations set principles for Cannabis sativa cultivation for purposes other than industrial, whereas the

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