This study presents a comprehensive analysis of public attitudes toward medical cannabis in Poland. The findings demonstrate that a substantial majority of respondents support the legalization of medical cannabis and indicate a willingness to consider such treatment if medically justified. Nevertheless, this expressed acceptance may not fully correspond to an informed or practical readiness to engage with cannabinoid-based therapies. A critical review by Silczuk et al. (15) highlights the terminological confusion surrounding medical and non-medical cannabis. Moreover, actual clinical exposure remains minimal, as reflected by the very low proportion of respondents reporting a physician’s recommendation for medical cannabis. This discrepancy raises important questions regarding whether public endorsement is grounded in accurate knowledge and personal experience, or rather influenced by a broader approval of policy liberalization. Additionally, these findings highlight the limited integration of medical cannabis into routine clinical practice in Poland, suggesting that favorable public opinion alone is insufficient to ensure effective implementation without concomitant systemic, clinical, and educational initiatives.

Real-world experiences during the early phase of the COVID-19 pandemic in the United States revealed that access to medical cannabis can be disrupted by external crises. While some patients reported stable or increased use, others experienced treatment interruptions due to reduced availability and limited healthcare support, emphasizing the need for resilient systems and adaptive regulatory frameworks (16). Similarly, even in routine settings, physician authorization does not guarantee use. A recent study from an academic medical center found that fewer than half of certified patients actually purchased cannabis, citing high costs, registration burdens, and limited access to dispensaries. Many therefore continued to rely on unregulated products, despite reporting symptom relief, as these options were more accessible and affordable (17).

Patient surveys conducted in dispensary settings have shown that individuals using medical cannabis for anxiety frequently report symptom improvement, minimal adverse effects, and high satisfaction with treatment. However, these findings should be interpreted with caution, as they are based on a self-selected population of active users and do not capture individuals who discontinued treatment. In addition, the surveys often lacked systematic data on product composition (e.g., THC versus CBD content) and did not clarify whether the reported benefits were sustained in the long term. Inhalation methods, especially vaporization, were most commonly used, and most patients perceived access as relatively easy and affordable (18). These self-reported findings suggest both high perceived efficacy and a preference for specific administration routes.

In contrast, clinician attitudes remain cautious. A systematic review revealed that although a majority of physicians report receiving patient requests for medical cannabis, a much smaller proportion are willing to prescribe it, largely due to insufficient clinical knowledge and concerns about efficacy, safety, and counseling (19). Importantly, this reluctance also reflects the broader absence of high-quality evidence, which stems from regulatory and medico-legal constraints, the mismatch with traditional pharmaceutical models, commercial barriers, and the heterogeneity of cannabis-based products studied across multiple conditions (15). Studies from Ontario similarly show that physicians reluctant to authorize medical cannabis often cite neurocognitive risks, psychiatric comorbidities, and lack of clear indications as primary reasons (20). Those with prior prescribing experience tend to be more confident in its therapeutic value, underscoring the importance of structured education and clinical exposure. At the national level, the Canadian Medical Association (CMA) has also highlighted such concerns in its policy statement on cannabis for medical purposes, particularly emphasizing the limited scientific evidence, medico-legal liability, and challenges tied to pharmaceutical regulation and prescribing frameworks (21).

Our findings reflect this disconnect. Although public support is high, fewer than one third of respondents believe that physicians in Poland possess sufficient knowledge about medical cannabis, and even fewer trust that patients are adequately informed. These perceptions are consistent with Canadian research, where users report therapeutic benefits and reduced use of opioids and sedatives, yet face barriers such as limited provider guidance and reliance on alternative information sources (17, 22). A study from Thailand further confirmed that healthcare workers and health volunteers differ in training needs and attitudes, pointing to the necessity of role-specific education tailored to local contexts (23). Comparable challenges have been documented in other jurisdictions: recent Israeli, Canadian and North American data underscore the growing demand for evidence-based physician training and system-level guidance (24–30), while Australian and New Zeelands studies highlight both therapeutic potential and persistent regulatory and clinical barriers to implementation (31, 32). Together, these findings suggest that despite cultural and policy differences, the need for structured education and clear regulatory frameworks is a common international theme. This becomes particularly evident when public perceptions are contrasted with legislatively defined frameworks. In Poland, for example, the law does not specify a closed list of indications, yet respondents most frequently mentioned cancer and chronic pain conditions that also rank among the most common reasons for medical cannabis authorization in other countries.

Surveys from different regions likewise reveal large gaps in clinical preparedness. In Florida, certifiers reported reliance on dispensary staff and inconsistent communication with other providers, as well as a strong need for structured education on interactions, condition-specific evidence, and harm reduction strategies (33). A cross-sectional study of medical cannabis providers revealed similar variability in practice, including inconsistent dosing guidance and reliance on self-directed learning in the absence of formal guidelines. Most patients were cannabis-naïve, placing a significant educational burden on clinicians (34). Polish data mirror these concerns. Many physicians lack knowledge of the legal framework, pharmacology, and clinical effects of cannabinoids. Male physicians and those with less professional experience tended to score higher in knowledge assessments, but overall familiarity was low (35).

International experience illustrates the impact of regulatory design. In Canada, requiring physician authorization for access to licensed producers initially led to higher patient enrollment in the medical program, as this was the only legal route to obtain cannabis before the legalization of non-medical use in 2018. Following legalization, cannabis became widely accessible to all adults, which reduced the gatekeeping role of physicians and was accompanied by a decline in medical program participation. Nonetheless, Canadian data suggest that formal medical authorization still contributes to safer, better-informed use: authorized users were more likely to obtain regulated products, report fewer side effects, and consult healthcare professionals (36, 37).

Attitudes toward medical cannabis were influenced by sociodemographic factors. In our study, respondents over 50 were more likely to support legalization. Interestingly, those aged 30 to 39 expressed lower willingness to accept medical cannabis treatment. Individuals with moderate economic status were less supportive than those reporting low income, which may reflect differences in access to information or health services. Participants were most familiar with the use of medical cannabis in oncological, neurological, and chronic pain conditions, while psychiatric and inflammatory indications were less recognized. This suggests a need for public education on the full therapeutic scope. Support for home cultivation was associated with prior experience, male gender, younger age, and urban residence. These findings point to experiential and demographic factors shaping views on patient autonomy in cannabis use. Patient perspectives reinforce the importance of perceived efficacy and symptom relief (38). In Florida, most patients reported high satisfaction with medical cannabis use for conditions like chronic pain, depression, and arthritis, though cost remained a common concern (39). A California study tracking transitions in medical cannabis patient status found that individuals who maintained status used more cannabis but reported lower use of other drugs, whereas those who discontinued primarily reported reduced cannabis use. While these findings have been interpreted as suggesting a potential harm reduction role for medical cannabis, the evidence remains limited and should be viewed with caution given the observational design and reliance on self-reported data (40).

Beliefs about system-level competence were associated with prior experience, male gender, and non-urban residence. These patterns may reflect either greater exposure to cannabis or perceptual bias among users. A study of New Zealand physicians found that prescribing decisions were influenced by product quality, side-effect profiles, patient–provider relationships, and concerns about professional liability and cost barriers. Clinicians emphasized the need for clear guidelines to support ethical, equitable prescribing (41).

Finally, the 2023 Cannabis Clinical Outcomes Research Conference (CCORC) highlighted major themes in medical cannabis research, including methodological challenges, the need to clarify risks and benefits, and data gaps in vulnerable populations. Current shortcomings in the evidence base include the limited number of high-quality randomized controlled trials, small and heterogeneous study populations, and insufficient data on long-term safety and effectiveness across diverse patient groups. To address these gaps, both pragmatic real-world evidence studies and traditional clinical trials are needed, with complementary strengths in external validity and methodological rigor. Ongoing research and robust clinical data will be essential to guide evidence-based policymaking and medical education (42).