Most primary care providers did not routinely ask older adults about medical cannabis despite completing cannabis education courses | Research

The takeaway

Among 575 healthcare providers who completed state-approved medical cannabis education in Pennsylvania, most were significantly less likely to ask older adult patients about cannabis use compared to alcohol and tobacco.

Medical educators designing cannabis curricula; health system administrators implementing substance use screening for older adults.

Cannabis-educated providers still rarely discussed MC with older patients

What the researchers found

Primary care providers were more likely to inquire about alcohol and tobacco use than cannabis with older adult patients. Providers did not frequently ask about cannabis use or consider it as a therapeutic option for their older patients, even after completing Pennsylvania Department of Health-approved cannabis education courses.

Why it matters

If even providers who have completed cannabis education courses are not discussing cannabis with older patients, the communication gap may be wider among providers without such training. Older adults are the fastest-growing demographic of cannabis users.

The numbers in context

575 providers surveyed. All had completed state-approved MC courses. Significant difference in asking about alcohol/tobacco vs cannabis (P < 0.05). Providers who had patients ask about MC were more likely to bring it up themselves (P = 0.037).

How the study worked

Cross-sectional survey emailed to 575 physicians, pharmacists, nurse practitioners, and physician assistants who completed Pennsylvania DOH-approved medical cannabis courses between 2018-2022. Respondents had to practice in the Tri-state area and care for older adults.

What this study cannot tell us

Survey respondents may not represent all providers. Low response rate not specified in abstract. Self-reported communication practices may not match actual behavior. Pennsylvania-specific findings may not apply to states with different cannabis programs.

How to read the evidence

Cross-sectional survey of a specific provider population. Self-reported practices may not reflect actual behavior.

When this study was published

2024 study

The bigger picture

The reluctance to discuss cannabis persists despite education, suggesting that knowledge alone does not change clinical behavior. Stigma, legal uncertainty, or lack of evidence-based prescribing guidelines may be stronger barriers than knowledge gaps.

Questions still open

What specific barriers prevent trained providers from discussing cannabis with older adults? Would clinical decision support tools or standardized screening questions increase cannabis-related conversations?

Common questions

Why do doctors avoid talking about cannabis with older patients?

The study identified reluctance despite education, suggesting barriers beyond knowledge gaps. These may include stigma, legal concerns, lack of dosing guidelines, and discomfort with a substance that remains federally illegal.

Should older adults bring up cannabis use with their doctors?

This study suggests that patients who asked about cannabis were more likely to have providers discuss it. Given the low rate of provider-initiated conversations, patients may need to raise the topic themselves.

Read the original research

Primary Care Providers' Communication About Medical Cannabis With Older Adults: A Cross-Sectional Survey.

Journal of primary care & community health, 15, 21501319241295922

View on PubMed ↗Publisher’s paper ↗

Citation

Elbready, Abdallah W; Warner-Maron, Ilene; Glicksman, Allen; Peterson, Andrew M. (2024). Primary Care Providers' Communication About Medical Cannabis With Older Adults: A Cross-Sectional Survey.. Journal of primary care & community health, 15, 21501319241295922. https://doi.org/10.1177/21501319241295922