Cannabis-Related Problems,Adverse Events,Clinical Experiences and Barriers to Intervening: Perspectives of Health Care Providers in Washington State

Abstract

Background:

Patients presenting with cannabis-related adverse events (AEs) and other problems are becoming increasingly prevalent in health care settings across the U.S. and Canada, increasing the burden on providers and health systems. Understanding how healthcare providers perceive and respond to cannabis AEs can inform medical training and clinical practices, health policy, and systems-level interventions.

Methods:

The study was conducted in Washington State, a U.S. state that legalized cannabis for non-medical use in 2012. Health care providers were invited to complete an anonymous online survey between December 2024 and March 2025, eliciting frequency and seriousness of various cannabis-related AEs, related clinical practices and procedures, knowledge and confidence addressing such problems, level of concern, and barriers and facilitators to identifying and intervening in such events.

Results:

Three hundred and eighty-eight valid survey responses were included in the analysis. Most respondents were mdical doctors and worked in hospitals or primary care clinics. Thirty-five percent of respondents reported seeing cannabis AEs and use-related problems frequently (at least 2-3 times a month) in clinical practice. Severe cyclic vomiting was most common (70% reported it ever occurred) and was second to psychosis as “most serious” (33% and 34%). While most providers saw screening and intervening as important (90%), only 39.1% reported universally screening for cannabis and identified many barriers to intervening.

Conclusion:

Health care providers in a legal cannabis state have encountered AEs and other complications related to cannabis use, and many are concerned about their frequency and severity. According to study participants, expanding access to clinical guidelines, validated tools, referral pathways, and specialized training may enhance their willingness and capacity to screen and intervene effectively.