Objective: To gather data on the cannabis-related prescribing practices, and views regarding potential risks and benefits of cannabis, among experts caring for patients with PD.

Background: The legalization of the medical use of cannabis for PD has bypassed the traditional drug approval process, leaving physicians to educate themselves about risks, benefits, and evidence based practices to better guide patients toward safe and appropriate decisions.

Methods: An anonymous 73-item, English-language, online survey was conducted through SurveyMonkey® and included movement disorders neurologists at all NPF centers of excellence. Descriptive statistics were analyzed.

Results: There were 56 responders representing centers across 5 countries, including 14 states in the US. Only 23% described having any formal education on cannabis. 80% reported having patients with PD who used cannabis, and 95% reported being asked to prescribe cannabis. A majority (52%) reported taking a neutral position on cannabis use to their patients, but only 9% discouraged it while 39% encouraged it. The majority of physicians felt the literature supported the use of cannabis for nausea (87%, n=48), anxiety (60%, n=33), and pain (86%, n=47), but responses were divided with regard to motor symptoms. Most physicians expected cannabis to lead to improvement in appetite (93%, n=50), pain (85%, n=46), nausea (80%, n=44), and anxiety (67%, n=37) in PD. Some positive effects were also expected for tremor, rigidity, and dyskinesias. The majority of physicians expected that cannabis would worsen motivation (59%, n=32), sleepiness (60%, n=31), balance (50%, n=27), and hallucinations (69%, n=37) in PD. Most felt that cannabis would have negative effects on short-term memory (75%, n=42), long-term memory (55%, n=31), executive functioning (79%, n=44) and driving (96%, n=54). The physicians agreed that cannabis deserved more attention in medical education (93%, n=52). Many did not feel that cannabis should be made recreational (50.0%, n=28), but many felt it should be allowed to be prescribed for medicinal purposes (69.6%, n=39).

Conclusions: This is the first study on cannabis use to provide data on the practices, beliefs, and attitudes of expert PD physicians. There exists a lack of consensus in practice that likely reflects a general knowledge gap and paucity of high quality data on cannabis to guide clinical practice.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/medicinal-cannabis-for-parkinsons-disease-a-survey-of-practices-beliefs-and-attitudes-among-providers-at-npf-centers-of-excellence/