Knowledge, experiences, and attitudes of Australian General Practitioners towards medicinal cannabis: a 2021-2022 survey

Abstract

Background: Medicinal cannabis (MC) products have been available on prescription in Australia for around six years. General practitioners (GPs) are at the forefront of MC prescribing and recent years have seen substantial increases in prescription numbers. This study examined the current knowledge, experiences, and attitudes of Australian GPs around MC. We also compared our findings to those of an earlier 2017 investigation.

Method: We conducted a cross-sectional study using a 42-item on-line questionnaire adapted from our earlier 2017 survey. The current survey was completed by GPs attending an on-line, multi-topic educational seminar. Australian GPs (n = 505) completed the survey between November 2021 and February 2022. Data were synthesised using descriptive statistics. MC 'prescribers' and 'non-prescribers' responses were compared using Pearson's χ2 tests.

Results: While most GPs (85.3%) had received patient enquiries about MC during the last three months, only half (52.3%) felt comfortable discussing MC with patients. Around one fifth (21.8%) had prescribed a MC product. GPs strongly supported MC prescribing for palliative care, cancer pain, chemotherapy-induced nausea and vomiting, and epilepsy, more so than in our 2017 survey. Prescribing for mental health conditions (e.g., depression, anxiety) and insomnia received less support. Opioids, benzodiazepines, and chemotherapy drugs were rated as more hazardous than MC. GPs correctly endorsed concerns around Δ⁹-tetrahydrocannabinol-related driving impairment and drug-seeking behaviour. However, additional concerns endorsed around cannabidiol causing addiction and driving impairment do not agree with current evidence. Consistent with this, many GPs (66.9%) felt they had inadequate knowledge of MC.

Conclusion: Acceptance of MC as a treatment option has increased among Australian GPs since 2017. However, there is a clear need for improved training and education of GPs around cannabis-based medicines to provide increased numbers of skilled prescribers in the community.

Keywords: Cannabinoid; Cannabis; Doctor; General practice; Medicinal cannabis.

Fig. 1

The extent to which GPs support the use of medicinal cannabis to treat certain conditions (n = 505). Abbreviation: CINV: chemotherapy induced nausea and vomiting; MS: multiple sclerosis; PTSD: post-traumatic stress disorder

Fig. 2

Attitudes towards, and perceptions of, MC prescribing and use (n=505). Abbreviations: GP: general practitioner; MC: medicinal cannabis; CBD: cannabidiol; OTC: over the counter. Refer to the Supplementary Materials for a full copy of the survey questions

Fig. 3

Perceived knowledge of MC as expressed by GPs (n=505). Abbreviations: AMA: Australian Medical Association; RACGP: Royal Australian College of General Practitioners; MC: medicinal cannabis. Refer to the Supplementary Materials for a full copy of the survey questions

Fig. 4

Concerns around the safety and efficacy of THC products (Panel A, n=505).Concerns around the safety and efficacy of CBD products (Panel B, n=505). Numbers show percentage of GPs (n=505) endorsing agreement, disagreement, and neutrality around specific concerns

Fig. 5

GPs tended to disagree that MC products were “more hazardous” than commonly prescribed medications (n=505)