Background & Aims
In Latin America (LA), the legal status of medical cannabis varies among countries. Although it has been approved for medical purposes in many countries for over five years [1], there have been no studies conducted to assess the extent of its medical use. Despite significant evidence [2, 3, 4, 5] of its therapeutic benefits, the absence of prescription guidelines limits its use, only to those physicians with some knowledge of its application [6]. The aim of the present work is then to describe LA physicians’ perception of medical cannabis use and educational needs.
Methods
We conducted a cross-sectional, observational and descriptive study through a voluntary, self-administered online survey in June 2023. The survey was composed of five domains: socio-demographic data, legal status and access to medical cannabis, clinical practice, educational needs and clinical experience with controlled substances. The content validity of the survey was assessed through a group of experts from various specialties, with experience in education and survey management. The survey was distributed via digital platforms (Email, Facebook, Instagram, and WhatsApp) to physicians across all specialties practicing in Spanish-speaking countries in LA.
Results
The survey garnered 612 responses, predominantly from Mexico (81.2%), followed by Colombia (3.1%) and Argentina (2.4%). The findings revealed that most respondents (74.2%) had no experience in prescribing medical cannabis. Among those who had prescribed it, most had done so for 1-5 patients (15.9%), with a minority prescribing to over 10 patients (6%). A significant majority (84.9%) of the prescribers expressed a desire to enhance their knowledge and skills in medical cannabis prescription. A notable 78.3% of respondents reported receiving no formal education on its use, while 88.2% observed patients self-administering medical cannabis to alleviate symptoms without a prescription. Only 10% of participants considered their knowledge sufficient to counsel patients on medical cannabis, and 87.8%, regardless of their specialty, identified a need for practice guidelines.
Conclusions
Although medical cannabis is legal in many Latin American countries, this study reveals that most doctors either do not prescribe it or do so infrequently, correlating with a lack of adequate knowledge. This research underscores the necessity for targeted education, prescription guidelines, and policy development to facilitate more widespread and appropriate prescribing of medical cannabis in Latin America.
References
[1] Mothers as Pot Legalizers: From Illegality to Morality in Medical Use of Cannabis in Latin America. Rivera. V. 2017
[2] Kendall, D., Yudowski, G. Cannabinoid Receptors in the Central Nervous System: Their Signaling and Roles in Disease. Front. Cell. Neurosci. 2017; 10.
[3] Tramer, M.R. et al. Cannabinoids for control of chemotherapy-induced nausea and vomiting: quantitative systematic review. BMJ. 323, 16–21 (2001).
[4] Otero-Romero, S. Satre-Garriga, J., Comi, G., Hartung, H., Soelberg, P., Thompson, A., Vermersch, P., Gold, R., Montalban, X. Pharmacological Management of Spasticity in Multiple Sclerosis: Systematic Review and Consensus Paper. 2017. Multip Scler J. 22:1386-1396.
[5] Wang, etc al. Medical cannabis or cannabinoids for chronic non-cancer and cancer related pain: a systematic review and meta-analysis of randomised clinical trials. BMJ 2021;373:n1034.
[6] Hordowicz, M.; Klimkiewicz, A.; Jarosz, J.; Wysocka, M.; Jastrz?ebska, M. Knowledge, attitudes, and prescribing patterns of cannabis and cannabinoid-containing medicines among European healthcare workers: A systematic literature review. Drug Alcohol Depend. 2021, 221, 108652.