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Knowledge, attitudes, and concerns about medical cannabis among U.S. healthcare professionals
Lakshmi Kumar1, Erin Wang2, David S Mathai3,4
1Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr, Baltimore, MD, 21224, USA.
Background:
Cannabis is among the most widely consumed psychoactive substances, with increasing consumption due to growing legalization for medical and non-medical use. As access expands, healthcare providers are faced with clinical challenges, despite variability in knowledge and attitudes on cannabis use in clinical practice.
Methods:
We conducted an anonymous, cross-sectional web-based survey of U.S. healthcare professionals to assess knowledge and attitudes regarding cannabis use in clinical settings. Participants completed demographic items, self-report measures of cannabis-related beliefs and attitudes, and an objective knowledge assessment covering cannabis therapeutic indications, risks, and mechanisms of action. Descriptive analyses were conducted, followed by multivariable linear regression models examining whether demographic characteristics, knowledge, or concerns predicted openness to the clinical use of cannabis.
Results:
Among 879 respondents (71% female; 86% White; mean age = 46 years), 89% reported having patients who use cannabis. The sample included mental health professionals (29%), registered nurses (25%), physicians (18%), and advanced practice providers (15%). Participants rated their self-reported knowledge highest for cannabis's risks (mean = 4.1/5), followed by therapeutic indications (mean = 4.0/5), and mechanisms of action (mean = 3.5/5). In contrast, objective knowledge check scores were generally low across these domains (13-64% correct). Personal experience (76%) and popular media (73%) were the most endorsed sources of cannabis-related knowledge. Overall, most respondents (87%) endorsed the therapeutic promise of cannabis, 74% reported openness to recommending medical cannabis, and 95% supported its legal medical use. Commonly cited concerns regarding clinical use of cannabis included lack of trained providers (35%), possible patient exploitation (22%), recreational misuse (21%), and risk of psychosis (20%). Greater openness to clinical use was associated with higher self-rated knowledge, younger age, professional role, and lower levels of concern.
Conclusions:
Although most respondents reported having patients who use cannabis and were largely supportive of medical cannabis use, objective knowledge gaps and limited formal training were evident. These findings suggest a need for structured clinical training on cannabis pharmacology, dosing, contraindications, and legal and ethical frameworks, as well as better monitoring of cannabis use to support safe and informed patient care.
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