Addressing cannabis use in primary care: GPs' knowledge of cannabis-related harm and current practice

Abstract

Cannabis is the most commonly used illicit drug in the UK. In 2004, it had a considerably higher prevalence rate compared to other drugs: 10.8% compared to 2.0% ecstasy, the second most prevalent drug (Eaton et al., 2005). Although the UK has historically had the highest rates of cannabis use in Europe, the situation has stabilized since the late 1990s, with the UK now having the fourth highest prevalence rate in Europe (Eaton et al., 2005).

Screening and managing cannabis use: comparing GP’s and nurses’ knowledge, beliefs, and behavior

“…Consistent with previous research [18,20-22], GPs and nurses identified not having enough skills, patients not being receptive, and not having enough time as common reasons for not engaging in screening and intervention for cannabis use. Not believing that cannabis use is the most important issue was a new common barrier identified in this study.…”

“…In addition, three items assessed beliefs regarding role legitimacy—factors related to the appropriateness of a GP or nurse to intervene with someone’s cannabis use [21,25,27,28] and were rated on a Likert scale from 0 ( disagree completely) to 4 ( agree completely) . One item assessed attitudes regarding cannabis use policy ( Cannabis use should be illegal / decriminalized / available for medical use ) [22,29]. Four open-ended items assessed behavior related to screening, intervention, and referral [22,28,30].…”

“…One item assessed attitudes regarding cannabis use policy ( Cannabis use should be illegal / decriminalized / available for medical use ) [22,29]. Four open-ended items assessed behavior related to screening, intervention, and referral [22,28,30]. Participants responded to these items with numbers (e.g., I have screened ____ patients for cannabis use in the last month ).…”

“…Further, the content of a typical substance use brief intervention is not well known [16] and commonly disregarded as ineffective [18,20]. Many doctors and nurses have reported avoiding substance use discussions due to anticipated negative reactions from patients, believing that patients will not be honest about their substance use, not having enough training and resources, and time constraints [18,20-22]. Conversely, doctors and nurses report that having readily available support services, quick and easy screening instruments and counseling material, more training, and evidence of the successful impact for early intervention would lead to their greater involvement in screening and intervention [16,20,22].…”

“…In a UK survey of 97 GPs, most believed that cannabis use posed a health risk and may lead to mental health problems, but less than half believed that they had adequate knowledge about cannabis use, and only a third felt confident in their ability to advise patients about their cannabis use [22]. In addition, around half believed that GPs should refer patients with cannabis-related problems to specialist drug services, with only a third believing it was appropriate to treat cannabis dependence in primary care.…”