Medical cannabis has undergone a significant resurgence in global healthcare policy and practice. Despite its historical classification as a controlled substance under the 1961 United Nations Single Convention on Narcotic Drugs, which restricted its medical use across Europe, North America, the United Kingdom, and Australia, many countries have since implemented legislation legalizing cannabis based medicines and medical cannabis for therapeutic purposes (1) and this shift reflects growing interest in the potential clinical benefits of cannabinoids.
This policy transformation has not only expanded therapeutic access but has also influenced population-level patterns of cannabis use worldwide (2). A 2024 meta-analysis encompassing data from 33 European, 15 American, and 16 Asian countries demonstrated that jurisdictions with legalized medical or recreational cannabis exhibit markedly higher lifetime prevalence of cannabis use, 12.0% (95% CI: 10.0–14.3), compared to 5.4% (95% CI: 4.3–6.9) in non-legalized regions (3). While systematic reviews suggest that cannabis based medicines and medical cannabis may provide modest relief for conditions such as anxiety, nausea, insomnia, and osteoarthritis related pain, the overall quality of supporting evidence remains heterogeneous, often limiting the strength of clinical recommendations.
In Poland, medical cannabis was legalized in November 2017 (with implementation in 2018), positioning the country among the earlier European adopters (2). Seven years post legalization, a mixed methods study found that most patients perceive prescription access as relatively straightforward. Nonetheless, persistent concerns regarding treatment costs, product quality, and chemovar consistency remain prevalent (4).
At the same time, data collected from clinicians highlight a different perspective: significant barriers to prescribing persist, largely related to systemic and educational gaps. Surveys indicate that over 60% of Polish physicians have received no formal training in cannabinoid based therapies, and more than 70% report feeling inadequately prepared to counsel patients on cannabis based medicines use (2). Despite approximately 54% of physicians encountering patient inquiries about medical cannabis in the preceding 6 months, only around 8% have ever issued a prescription (5). To date, no clinical trials conducted in Poland have definitively confirmed the efficacy and safety of medical cannabis for specific therapeutic indications; consequently, treatment decisions rely primarily on international evidence and the individual clinical judgment of prescribing physicians (6). These findings underscore an urgent need for evidence based clinical guidelines and comprehensive educational initiatives to support safe and effective integration of medical cannabis into the routine medical care. The lack of strong, evidence-based clinical guidelines mainly reflects the limited number of high-quality randomized trials and real-world evidence studies on cannabis and cannabinoid therapies. Overcoming regulatory, commercial, and structural barriers to such research is crucial to build the evidence needed for guideline development, especially given the growing interest in their therapeutic potential across diverse indications (7).
Based on current data from European reviews and monitoring reports, the prevalence of medical cannabis use and the number of prescriptions issued vary significantly across European countries. These differences reflect diverse regulatory frameworks, product availability, and levels of clinical awareness. In Germany, which has had one of the most advanced publicly reimbursed medical cannabis systems since 2017, the number of patients using medical cannabis increased from approximately 1,000 prior to legalization to over 60,000 in 2019, resulting in more than 185,000 prescriptions issued annually (8). Similar trends have been observed in Italy, where national monitoring data (2013–2019) indicate an increase from approximately 400 to nearly 13,000 patients per year, with over 26,000 prescriptions issued in 2019 (8).
Comparative studies across European Union countries suggest that legality and availability do not automatically translate into widespread therapeutic use. Restrictive regulations, lack of reimbursement, and limited physician training continue to pose barriers to access. A review involving 17 European countries found that products such as nabiximols are relatively accessible, whereas the use of herbal cannabis remains hindered by legal and logistical obstacles (9).
Additional data from the Liguria region of Italy demonstrate a steady increase in medical cannabis utilization following the implementation of an integrated clinical and organizational model that improved coordination between physicians, pharmacists, and regional health authorities (10).
Exploring the divergence between clinical medical cannabis policies and legal frameworks across Europe is essential, as recent analysis shows that while some countries regulate cannabis strictly for medical purposes, they often maintain decriminalization rather than full legalization, highlighting a nuanced interplay that impacts patient access and regulatory oversight (11).
Since the legalization of medical cannabis in Poland in 2017, the topic has gained growing visibility in clinical, regulatory, and societal debates. However, despite the increasing number of prescriptions and expanding therapeutic indications, little is known about how the Polish public understands and evaluates the role of cannabis-based therapies. The primary aim of this study was to assess public support for the therapeutic use of medical cannabis, including attitudes toward its legalization and individual readiness to undergo cannabinoid treatment.
A secondary objective was to explore public perceptions of risks, clinical awareness, patient rights, and professional knowledge related to medical cannabis.
This study employed a cross-sectional design based on a structured survey distributed online to a representative sample of adult Polish residents. Data collection took place between 11th and 13th of July 2025, using the computer-assisted web interviewing (CAWI) technique. Respondents were recruited via the Ariadna online research panel, which comprises over 110,000 active members aged 18 years and older and is routinely calibrated to reflect the demographic structure of the Polish population.
To ensure national representativeness, a stratified sampling procedure was used. The initial stratification divided the population into exclusive subgroups based on demographic criteria such as sex, age, type of residence, geographical region, and level of education. Sampling quotas were then matched to population data derived from Statistics Poland (Główny Urząd Statystyczny, GUS), the official institution responsible for demographic and social statistics at the national and regional levels.
Participation in the survey was entirely voluntary, and all respondents provided informed consent prior to participation. The study team developed the conceptual framework and constructed the survey tool. Invitations were distributed individually by email, with a subsequent reminder sent via text message. The survey required completion of all items, ensuring a dataset without missing responses. The final response rate was approximately 22%. Data were collected anonymously and processed in accordance with ethical standards. The study protocol received ethical approval from the Bioethics Committee of the Medical University of Warsaw (approval no. AKBE/39/2025, dated: Febr. 24, 2025).
The study instrument was a structured questionnaire developed specifically for this research, drawing on recent literature concerning medical cannabis policy, therapeutic use, and public health communication. The analytical scope was limited to seven closed-ended questions that addressed key domains relevant to public perception, therapeutic awareness, and health system readiness in relation to medical cannabis.
These items explored respondents’ evaluations of the 2017 legalization of medical cannabis in Poland, their willingness to use cannabinoid-based treatments if recommended by a physician, and concerns about potential unintended consequences such as increased recreational use. Further questions assessed knowledge of medical indications, support for home cultivation under clinical supervision, and perceptions of informational adequacy among both physicians and patients.
All items utilized a five-point Likert scale format (ranging from “definitely not” to “definitely yes”) or multiple-choice response sets. The questionnaire was pilot tested on non-medical adults from the general population for clarity, internal logic, and cultural appropriateness. Recent studies have employed a similar methodological approach (12–14). Minor modifications were introduced following cognitive debriefing to optimize comprehensibility. The final instrument required approximately 8 min to complete.