Primary Care Physicians’ Knowledge and Counseling on Cannabis Use in the Country of Georgia: Results of a Mixed-Method Exploratory Study

Abstract

Background: The post-Soviet country of Georgia has recently decriminalized recreational cannabis use, yet implementation of screening for cannabis use in clinical practice remains unclear. This study assesses relevant knowledge, attitudes, and practices of primary health care physicians (PCPs) regarding recreational cannabis use in the country of Georgia. Methods: We conducted a mixed-method study, starting with a cross-sectional survey among PCPs practicing in Georgia. Quantitative data were received from 246 family physicians, using a structured anonymous questionnaire addressing legal awareness, health risk perception, and screening practices. Supplementary qualitative interviews were conducted among 10 PCPs exploring barriers to effective cannabis-related counseling and documentation. Results: Almost all (96.6%) respondents were female, and 55.7% were aged > 51 years. Only 35.6% of physicians reported being familiar with cannabis legislation. The majority associated cannabis use with mental health risks (97%) and increased accident risk (92.4%). Fewer than half acknowledged its legitimate medical applications (eg, chronic pain management). Screening rates were low – only 26.6% documented cannabis use in patient records, and 88.1% had never applied structured criteria to diagnose cannabis use disorders. The qualitative exploration found that time constraints, stigma, and lack of relevant training were the frequently cited barriers. Physicians expressed concern that insufficient knowledge undermines their ability to provide evidence-based counseling, potentially increasing public health risks. Conclusion: Primary care physicians’ preparedness to screen and counsel patients on cannabis use is insufficient in the country of Georgia. Targeted continuing medical education and system-level interventions are essential to bridge this gap and promote safe, informed care.