Systematic review reveals healthcare professionals feel underprepared to guide patients on medicinal cannabis for chronic pain | Research

The takeaway

A review of 26 studies across six countries found healthcare professionals see medicinal cannabis as a viable pain treatment option, particularly compared to opioids, but feel they lack the knowledge, training, and clinical guidelines to prescribe it confidently.

Healthcare professionals, medical educators, policymakers, and patients seeking cannabis guidance.

Knowledge gaps identified as primary barrier across 6 countries

What the researchers found

Seven key themes emerged: MC as a treatment option for chronic pain; willingness to prescribe; legal issues; low perceived knowledge and need for education; comparative safety vs. opioids; addiction and abuse concerns; and perceived adverse effects. Across countries, healthcare professionals consistently identified knowledge gaps as the primary barrier to effective prescribing.

Why it matters

Patients increasingly ask about cannabis for pain, but their healthcare providers often feel unable to provide evidence-based guidance, creating a gap that patients fill with internet research and self-medication.

The numbers in context

26 studies from 6 countries. Seven key themes identified. Healthcare professionals across all disciplines and countries consistently reported low perceived knowledge of medicinal cannabis.

How the study worked

Systematic search of six databases (MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, PubMed) from 2001-2021. Twenty-six studies from the US, Israel, Canada, Australia, Ireland, and Norway were included. Perspectives of physicians, nurses, and pharmacists analyzed using thematic analysis.

What this study cannot tell us

Included studies used heterogeneous methods and populations. "Healthcare professionals" includes diverse roles with different scopes of practice. Publication bias toward English-language studies. Rapidly evolving legal landscape may outdate findings.

How to read the evidence

Systematic search with thematic analysis across 26 studies and multiple countries.

When this study was published

Published in 2022 with searches through March 2021.

The bigger picture

The global consistency of the knowledge gap suggests this is a systemic issue in medical education rather than a country-specific problem, requiring coordinated educational interventions across healthcare systems.

Questions still open

What educational formats would most effectively improve HCP knowledge? Should cannabis prescribing be limited to specialists? How do patients perceive their providers' cannabis knowledge?

Common questions

Do doctors feel comfortable prescribing cannabis for pain?

Generally no. Across 26 studies in six countries, healthcare professionals consistently reported feeling they lacked adequate knowledge, training, and clinical guidelines to prescribe medicinal cannabis for chronic pain, despite many seeing it as a viable treatment option.

How do healthcare professionals view cannabis compared to opioids?

Many HCPs view medicinal cannabis as comparatively safer than opioids for chronic pain management, which contributes to their willingness to consider it as an option even without strong clinical evidence.

Read the original research

Healthcare professionals' perspectives on the use of medicinal cannabis to manage chronic pain: A systematic search and narrative review.

Pain practice : the official journal of World Institute of Pain, 22(8), 718-732

View on PubMed ↗Publisher’s paper ↗

Citation

Cheng, Katherine Y C; Harnett, Joanna E; Davis, Sharon R; Eassey, Daniela; Law, Susan; Smith, Lorraine. (2022). Healthcare professionals' perspectives on the use of medicinal cannabis to manage chronic pain: A systematic search and narrative review.. Pain practice : the official journal of World Institute of Pain, 22(8), 718-732. https://doi.org/10.1111/papr.13161