Psychedelic Medicine: New evidence for hallucinogenic substances as treatments

Abstract Introduction Many countries are changing their regulations for prescribing medical cannabis. As gatekeepers, physicians significantly impact patient access to cannabis treatments. It is important to explore how physicians view prescribing cannabis in terms of their existing beliefs, knowledge, possible concerns and personal perceptions. Methods Individual, semi‐structured telephone interviews were undertaken with 14 New Zealand physicians from various specialties. The interviews were thematically analysed using a phenomenological approach. Results The physician–patient relationship was of extreme importance in making prescription decisions, driven largely by trust in the patient. Barriers to prescribing included concern over possible side effects, the quality and standardisation of medication, uncertainty about indications and equity concerns from the high cost for lower socio‐economic patients. Some physicians held concerns over their liability and risks to their reputation if issues arose for patients. Discussion and Conclusion The way physicians regard prescribing medical cannabis is based on their personal beliefs and knowledge built up over their medical career. It is important that these are taken into consideration in the design of future guidelines to help alleviate uncertainties and reduce barriers for informed prescribing. While our research and previous research find that physicians generally will follow clinical guidelines based on institutional logics (i.e. the standardised approach to medicine), we find that physicians often allow their personal construals to determine their perceptions and prescribing behaviour to a considerable extent when they practice medicine. Our findings have implications for Continuing Medical Education, marketing and regulation for medical cannabis, especially about the wording of guideline adherence.

Exploring the medical cannabis prescribing behaviours of New Zealand physicians

The Characteristics of Clinical Trials on Cannabis and Cannabinoids: A Review of Trials for Therapeutic or Drug Development Purposes

Background: There has been a recent uptick in interest regarding the therapeutic properties of cannabis. Evidence exists to support the role of medical cannabis (MC) in chronic illness management for conditions such as posttraumatic stress, pain, and cancer. The majority of physicians in the United States report not knowing how to prescribe or answer questions about MC and receive minimal education about it during training. As MC becomes more socially acceptable with federal legalization in process, new physicians will encounter patients looking for information on the utility and safety of MC. The goal of this research was thus to assess the perceived knowledge, beliefs, and perceptions of medical students towards MC, and to obtain a better understanding of factors that may influence their attitudes. Methods: A descriptive, cross-sectional study design was used to investigate the medical students’ knowledge, attitudes, and perceptions regarding MC. Quantitative data were collected from 526 medical students (years one to four) via an anonymous, online, 32-item questionnaire to determine if perceived knowledge, concerns about the potential negative effects of cannabis, and certain beliefs would significantly contribute to their attitudes toward MC. Hypothesis testing was conducted using Spearman-rank order correlation and multivariate linear regression analyses. Results: A statistically significant regression equation was found: (F(4, 428)=114.826, p<.001 with an R2=0.518 [adjusted R2 =0.513]) indicating greater perception of knowledge about MC, lower concern for possible negative effects of MC use, greater belief in federal legalization of MC, and greater belief in the federal legalization of recreational cannabis significantly contributed to a higher score on positive attitudes and perceptions toward MC. Moreover, while many participants reported physicians should be able to prescribe MC, they reported that little if any MC education had been provided. Conclusions: This study identified the knowledge, concerns, and perceptions of medical students regarding MC as well as several factors contributing to their attitudes about it. Favorable attitudes toward MC among patients exist and as its popularity and acceptance among patients continue, more may be asking their physicians about symptomatic and curative treatment with cannabis-based products. Results from this research have the potential to assist medical educators in understanding students’ perceptions about MC to help guide innovative and contemporary curricular advances as a public health imperative.

Predictors of Medical Students’ Perceptions About Medical Cannabis

Background There has been increased attention given to understanding the uses of medical cannabis (MC) for symptom management of various medical conditions. Physicians receive minimal training in medical school and rely mostly on anecdotal evidence; by proxy, medical students generally do receive formal training in MC. It is unknown how medical students perceive MC, including its efficacy, appropriateness in medicine, its possible adverse effects, and its value for patients. This study investigated medical students’ perceived knowledge, beliefs, and attitudes toward MC to better understand their knowledge about and attitudes toward MC. Method Using a semi-structured interview guide, eight focus groups were conducted with 83 medical students via Zoom virtual meeting platform (Zoom Video Communications, Inc., San Jose, California, United States) in June 2022. The interviews were guided by the following content areas: (1) beliefs about cannabis' therapeutic utility, (2) perceived knowledge about MC, (3) the role of the physician regarding MC, (4) concern for cannabis’ adverse effects, and (5) MC education in the school curriculum. Data were analyzed using thematic analysis, an iterative, systematic process of coding patterns, and emerged themes in the interview data to explore medical students’ perceptions about MC. Themes were validated based on whether each theme captured distinct parts of the interview data and whether their content cohered meaningfully. Results Four themes emerged from the focus group interviews investigating medical students’ perceptions of MC: (1) erroneous beliefs about MC, (2) unreliable sources of information, (3) mixed attitudes toward legalization, and (4) desire for MC education while in medical school. Attitudes regarding MC in general, including legalization, varied by United States state of origin of the student and exposure to MC (e.g., use by family member). Conclusion MC seems to be a significant issue for medical trainees who might be required to recommend it to patients and manage coexisting therapies. Cultivating new knowledge about students’ perceptions and perceived knowledge about medicinal options and dosing of MC is critical for medical educators as they design undergraduate curricular initiatives for future physicians.

https://www.cureus.com/articles/109215-medical-students-attitudes-knowledge-and-beliefs-about-medical-cannabis-a-qualitative-descriptive-study.pdf

Medical Students’ Attitudes, Knowledge, and Beliefs about Medical Cannabis: A Qualitative Descriptive Study

Background Recently, the renewed global interest in cannabis’ therapeutic properties has resulted in shifting attitudes and legislative policies worldwide. The aim of this systematic review is to explore the existing literature on medical professionals’ and students’ attitudes and knowledge regarding medicinal cannabis (MC) to assess any relevant and significant trends. Methods This systematic review was conducted in accordance with PRISMA guidelines. Using PubMed and Google Scholar, a literature search was performed to identify studies pertaining to healthcare professionals’ and medical students’ knowledge and attitudes regarding MC. There were no search limits on the year of publication; however, studies without primary data (e.g., abstracts, systematic reviews, meta-analyses) and non-English language papers were excluded. Studies were coded according to the following research questions: (1) Do respondents believe that cannabis should be legalized (for medicinal and/or recreational purposes)? (2) Are respondents confident in their level of knowledge regarding cannabis’ clinical applications? (3) Are respondents convinced of cannabis’ therapeutic potential? 4) What current gaps in knowledge exist, and how can the medical community become better informed about cannabis’ therapeutic uses? and (5) Are there significant differences between the knowledge and opinions of healthcare students versus healthcare professionals with respect to any of the aforementioned queries? Chi-square tests were used to assess differences between medical students and medical professionals, and Pearson’s bivariate correlations were used to analyze associations between survey responses and year of publication—as a proxy measurement to assess change over time. Results Out of the 741 items retrieved, 40 studies published between 1971 and 2019 were included in the final analyses. In an evaluation of 21 qualified studies (8016 respondents), 49.9% of all respondents favored legalization (SD = 25.7, range: 16–97%). A correlational analysis between the percentage of survey respondents who support MC legalization and year of publication suggests that both medical students’ and professionals’ support for MC legalization has increased from 1991 to 2019 ( r (19) = .44, p = .045). Moreover, medical professionals favor the legalization of MC at a significantly higher rate than students (52% vs. 42%, respectively; χ 2 (1, N = 9019) = 50.72 p < .001). Also, respondents consistently report a strong desire for more education about MC and a substantial concern regarding MC’s potential to cause dependence and addiction. Pearson’s correlations between year of publication and survey responses for both of these queried variables suggest minimal changes within the last decade (2011–2019 for addiction and dependence, 2012-2019 for additional education; r (13) = − .10, p = .713 and r (12) = − .12, p = .678, respectively). Conclusion The finding that both medical students’ and professionals’ acceptance of MC has significantly increased in recent decades—in conjunction with their consistent, strong desire for more educational material—suggests that the medical community should prioritize the development of MC educational programs. MC is far more likely to succeed as a safe and viable therapy if the medical professionals who administer it are well-trained and confident regarding its clinical effects. Limitations include a lack of covariate-based analyses and the exclusion of studies published after the literature search was performed (June 2019). Future research should analyze studies published post-2019 to draw temporal comparisons and should investigate the effect of numerous covariates (e.g., gender, religiosity, prior cannabis use) as newer studies gather data on these factors [PROSPERO Registration: CRD42020204382].

https://scholarship.claremont.edu/cgi/viewcontent.cgi?article=1102&context=pitzer_theses

A Systematic Review of Medical Students’ and Professionals’ Attitudes and Knowledge regarding Medical Cannabis as a Proxy for Forecasting Trends in the Medical Community’s Acceptance of Therapeutic Hallucinogens

Jared Weisman

Papers

A Systematic Review of Medical Students’ and Professionals’ Attitudes and Knowledge regarding Medical Cannabis as a Proxy for Forecasting Trends in the Medical Community’s Acceptance of Therapeutic Hallucinogens