Cannabis has been used by humans for millennia, dating back to the earliest civilizations. Historically, its use was as commonplace as tobacco, alcohol, and caffeine (Crocq 2020). Archaeological and textual evidence suggests that cannabis played a role in both daily life and ritual practices across cultures (Maguire 2020; Heilig 2011). Its therapeutic properties were known and utilized long before the emergence of modern pharmacology. Ancient Chinese, Indian, and Middle Eastern medical traditions incorporated cannabis to alleviate pain, inflammation, and other ailments (Balant et al. 2021; Pisanti et al., 2018). In recent years, the use of medical cannabis has increased significantly worldwide (United Nations, 2022).

While legal and clinical aspects of medical cannabis have been extensively studied, its sociocultural dimensions - especially religious influences - remain under-explored. Religion is not only a major determinant of individual beliefs and social norms (Mazur 2020), but also a central force in shaping health-related behaviors and clinical decision-making (Borges et al. 2021; Koenig et al., 2012). Several studies have confirmed a link between religious affiliation and attitudes toward cannabis use (Clobes and Gagnon 2022; Felson et al. 2019; Ferrara 2021; Gritsenko et al. 2020; Nie and Yang 2018; Rafei et al. 2023; Siddiqui et al. 2022). These theoretical frameworks provide a foundation for understanding the observed differences in physicians’ and nurses’ attitudes across religious groups.

Despite the growing scholarly interest in religious perspectives on cannabis, empirical research directly examining the views of religious leaders remains scarce. Nevertheless, religious authorities are widely recognized as influential opinion leaders within their communities, particularly on moral and health-related issues. Their interpretations often guide believers’ attitudes toward medical interventions, including cannabis use, and may either reinforce or moderate formal doctrinal positions (Koenig et al., 2012).

Each religion approaches cannabis use through its unique theological and moral frameworks. In Judaism, references to cannabis can be traced back as early as the Exodus (ca. 1220 BCE). Polish anthropologist Sula Benet argued that cannabis appears in the Hebrew and Aramaic Bible and the Talmud, often in the context of religious rituals (Koltai et al. 2022; Pisanti et al., 2018). In modern Jewish discourse, rabbinical rulings have drawn a clear distinction between medical use, which is generally permitted, and recreational use, which is largely prohibited. In Islam, cannabis use in the Middle East began approximately two centuries after the Prophet Muhammad’s death (Abdulrahman 2024; Ghiabia et al., 2018). During the Prophet’s time, cannabis (known as “hashish” or “grass” in Arabic) was not recognized, and thus no prohibition is mentioned in the Quran (Marino 2022; Nahas 1982; Pisanti et al., 2018). In modern Islamic contexts, recreational use of cannabis is strictly forbidden, while its medical use is permitted (Shirah and Ahmed 2020). In Christianity, recreational use of cannabis is generally opposed, while its medical use is permitted, as indicated in the Catechism of the Catholic Church, which identifies drug use as sinful unless intended for medical purposes (Dhanasekaran et al. 2022). The Druze religion is a closed and secretive philosophical religion with doctrines accessible only to a select group of religious leaders known as the Uqqal (“wise men”). A broader group of lay followers, the Juhhal (“ignorant ones”), remain unfamiliar with the deeper tenets of the faith (Weisber 2022). Despite extensive searches, no official stance regarding medical or recreational cannabis has been identified.

Beyond religious affiliation, other factors such as the level of religiosity, educational background, gender, and personal familiarity with cannabis users may also influence attitudes toward its medical use (Amoateng and Bahr 1986; Edelstein et al. 2020; Cameron et al. 2023; Cuttler et al. 2016; Desmond et al. 2008; HaGani et al. 2021; Marsiglia et al. 2005; Rafei et al. 2023; Sokratous et al. 2023). Nonetheless, religion remains a dominant cultural force shaping public and professional perspectives on health interventions, especially those involving controversial substances (Mazur 2020).

In Israel, due to changes in governmental policies, there has been a notable rise in medical cannabis use, as well as in the number of licenses issued to oncology patients, which increased from 6.8 to 9.4% between 2014 and October 2018 (Sznitman 2020). Northern Israel provides a unique setting for exploring these dynamics. Its population is highly diverse and multicultural, comprising significant communities of Jews, Muslims, Christians, and Druze. This religious heterogeneity allows for a comparative analysis of attitudes across different belief systems within a shared geographical and healthcare context. The Ziv Medical Center, located in the Galilee region, serves as a microcosm of this diversity, in terms of both its patients and its healthcare staff. Despite the growing significance of medical cannabis, no empirical study has yet examined how religion influence healthcare professionals’ attitudes toward its use in Northern Israel. Moreover, the attitudes of Druze professionals - who represent a substantial portion of the regional healthcare workforce - remain entirely unexamined in the scientific literature.

This study addresses these gaps by investigating the relationship between religion and attitudes toward medical cannabis among physicians and nurses in Northern Israel. It is the first study to explore this topic in a multicultural Israeli context and to include Druze and Christian participants as a distinct religious group. By doing so, the study aims to contribute to culturally sensitive healthcare policy and education. This study is guided by two main hypotheses: (1) There will be differences in attitudes and beliefs about medical cannabis based on religious affiliation. (2) Religious affiliation will moderate the differences in attitudes and beliefs toward medical cannabis.