Background Canada and Israel are at the forefront in legalizing herbal cannabis for therapeutic reasons. Musculoskeletal complaints are a common reason for persons using medical cannabis, with nearly two thirds of current Canadian authorizations to use cannabis medically carrying a diagnosis “severe pain” caused by “severe arthritis” .
Objectives As rheumatologists are specialised in caring for patients presenting with musculoskeletal complaints, the confidence of rheumatologists' knowledge of cannabinoids was compared in the two countries.
Methods All members of the Rheumatology Associations of Canada and Israel were surveyed by e-mail for their confidence in knowledge of cannabinoids and their perceived competence to prescribe herbal cannabis.
Results The response rate for Canada and Israel was 25% and 20% respectively. Demographics of the responders from both countries was similar for gender, age, and years in practice, but with more Israeli responders in community/private practice, p<0.0001. Three quarters of responders in both countries were not confident about their knowledge of cannabinoid molecules or ability to write a prescription for herbal cannabis. Differences between country responses for Canada vs. Israel were as follows: no role for any cannabinoid treatments, 45 vs 17%, p=0.019, never previously recommended trial any cannabinoid, 70 vs 39%, p=0.0075, some role for pharmacologic or herbal preparations, 30 vs. 48%, p=0.096, willing to prescribe herbal cannabis if other treatments failed, 28 vs 83% p<0.0001. The majority of respondents were not confident to write a prescription for herbal cannabis, 90 vs 78%, p=0.154.
Conclusions Although rheumatologists in both countries lack confidence in their knowledge of cannabinoids in general, Israeli rheumatologists were more open to cannabinoid treatments, with more willingness to prescribe, although the majority lacks confidence in prescribing the herbal product.
Office of the Information Commissioner of Canada, Information request (ATI 2013-00282) under the Access to Information Act, 2013.
Disclosure of Interest M.-A. Fitzcharles Speakers bureau: Lilly, Pfizer, Purdue, Valeant, P. Ste-Marie: None declared, J. Ablin Consultant for: Pfizer, Lilly, MSD, Y. Shir Consultant for: McKesson Canada Corporation, Palladin Inc. Canada