Physicians' Knowledge, Attitudes, and Perceptions about Medical Cannabis in the United States: A Scoping Review.

Abstract

Introduction: As legalization of medical cannabis (MC) in the USA expands, there remains uncertainty in clinical guidance. Healthcare professionals remain unprepared to communicate to patients the therapeutic outcomes and possible adverse effects of MC utilization. There is limited training provided at all levels of medical education, even for professionals with many years of clinical practice. Additionally, there is minimal scientific research, which delays the development of evidence-based guidelines.

Methods: This review followed established methodological approaches for scoping reviews according to PRISMA-ScR guidelines. Studies were included if they addressed the attitudes and beliefs of medical practitioners in the USA and were published after the year 2000.

Results: There were forty-one studies from January 2013 to February 2025 included in the format of both electronic surveys and qualitative interviews. Participants included US physicians, other healthcare professionals, and medical trainees, representing multiple clinical specialties. Physicians reported lack of confidence in counseling patients or managing their use of MC. Oncologists, emergency medicine physicians, pain management specialists, and primary care physicians perceived that MC is beneficial for managing chronic pain, nausea, loss of appetite, depression, and other symptoms. Obstetric providers had unfavorable perceptions about perinatal use of MC. Physicians practicing in states where the drug has been legalized and those with greater years of practice were more comfortable recommending MC and counseling patients.

Conclusions: US physicians and medical trainees perceived significant knowledge barriers to recommending MC and counseling patients on its therapeutic use. Implementing clear clinical practice guidelines, further education on these drugs in clinical curriculums, and enhancing continuing education offerings would improve prescriber confidence. Increased research could also assist medical professionals in appropriate clinical decision making.