The medicinal utilization of hemp has always been an issue of great controversy among healthcare workers around the world (Irvine 2023). Beyond scientific knowledge, the value of medicinal hemp use differs amongst stakeholder groups such as general practitioners, specialists, and patients (Newhart and Dolphin 2023).

Most clinicians are fairly knowledgeable about the medicinal potential of hemp but the extent of knowledge and the quest for more information vary among clinical specialties (Gardiner et al. 2023; Mathern et al. 2023; Crowley et al. 2023)).

The study participants acknowledged the medicinal potential of hemp and outlined multiple indications as recorded in the literature. This notwithstanding, most of these prescribers expressed doubts about the clinical relevance of hemp. This contradiction in knowledge and perceptions among physicians was captured by Zolotov et al. (Zolotov et al. 2018).

In this study, neurologists demonstrated the greatest interest in the clinical value of hemp which can be attributed to the frequent association between the clinical indications for cannabis and the field of neurology (Treister-Goltzman et al. 2000). Generally, physicians are more likely to exhibit support for medicinal cannabis if they are in a specialty field rather than in general practice (Gardiner et al. 2023).

The study also sought to explore the subjective norms associated with a prescriber’s intention to prescribe or consider medicinal hemp. Consistent with the literature, social stigma strongly influences the prescribers’ perceptions of medicinal cannabis (Szaflarski et al. 2020).

Cannabis use is still viewed as an aberrant activity because of its popular description as a recreational drug and its common ties with crime (Szaflarski et al. 2020), (Bottorff et al. 2023).

Among clinicians and the hospital workforce, the stigma is associated primarily with the illicit status of cannabis (Isaac et al. 2023). The ideology that medicinal cannabis is unconventional and falls short of the standards of biomedicine remains a bone of contention among physicians (Zolotov et al. 2018; Rønne et al. 2023; Hout et al. 2023). Generally, physicians are known to feel much more at ease in providing medicinal cannabis when its considered legal within their jurisdiction of practice (Yeroushalmi et al. 2020).

Contrary to the opinions of the interviewees, the existing policy framework of the Ghana Food and Drugs Authority makes provision for the clinical prescription of locally unregistered medicines such as cannabis (Parliament of Ghana 2012).

Despite this inherent policy flexibility to prescribe hemp when needed, the overarching narcotic laws in Ghana have shrouded clinicians’ beliefs about the degree of control they possess on their decision to prescribe or recommend medicinal hemp.

The majority of the study participants described the medicinal use of hemp as illegal in Ghana hence categorized its medical recommendation as outside their voluntary control. As posited by the theory of planned behaviour, the lack thereof of a perceived ease in recommending medicinal cannabis exerts a direct effect on the prescribing behaviour of the clinician (Trafimow et al. 2023), (Kiriakidis 2023).

Stigma with medicinal hemp also tends to be a negative component of the physician–patient relationship (Ryan et al. 2023; Ryan and Sharts-Hopko 2023). Cannabis use is viewed through a sociocultural lens of illicit drug use, and it creates a barrier to physician engagement on this subject (Ryan et al. 2023; Stigma 2023). In South Africa, physicians attributed their discomfiture with cannabis use to the negative or exclusionary position of medical institutions towards cannabis use in medical treatment (Audain 2024) Similar trends were realized in Ghana with the media portrayals of the tramadol crisis as a moral catastrophe (Korem and Id 2023).

With respect to the potential adverse effects of medicinal cannabis, much concern is always attached to the possible diversion from licit to illicit use (Rønne et al. 2023; Hout et al. 2023; Ziemianski et al. 2023)).

This fear that cannabis would be acquired ‘medicinally’ as a valid façade for illicit use has always been a matter of major concern for health professionals (Gardiner et al. 2023).

However, such concerns are not exclusive to medicinal cannabis. All drugs one way or another pose different adverse challenges and the remaining question is, “does the risk outweigh the benefit?” (Ryan and Sharts-Hopko 2023). A study conducted in America reported that approximately 90% of palliative care providers deemed cannabis useful in the treatment of pain, nausea, and appetite loss, whereas more than 50% believed the adverse effect profile was the same or less problematic than conventional alternatives (Luba et al. 2023). In Africa, doctors and pharmacists characterised cannabis as problematic owing to knowledge gaps among prescribers, social barriers, and religion (Kitchen et al. 2024b).

Similar to previous findings in literature, there was general support for medicinal hemp endorsement, but it varied according to medical specialty and practice settings (Gardiner et al. 2023). The clinicians with experience in prescribing medicinal hemp exhibit more certainty with its clinical efficacy and less anxiety with the possible adverse effects (Rønne et al. 2024), (Rønne et al. 2023).

Overall, facilitating favourable attitudes in terms of knowledge acquisition on medicinal hemp and encouraging a more enabling policy environment devoid of stigma exerts a direct effect on a prescriber’s intention to consider hemp in clinical therapy.