Exploring the Medical Prescription of Cannabis sp.-Derived Products in Brazil: A National Cross-Sectional Survey

Background/Objectives: Patient access to cannabinoid-based therapies in Brazil has expanded with the availability of regulated Cannabis-derived products (CDPs). This study explored CDP prescribing practices among Brazilian physicians. Methods: Between September 2024 and March 2025, a national online survey assessed physician characteristics, prescribing status, and reasons for non-prescription. Among prescribers, we analyzed CDP formulations, brands, indications, patient age groups, and time to therapeutic response. Bivariate and multivariable analyses identified factors associated with CDP prescribing. Results: A total of 333 physicians participated in the study, including 305 prescribers and 28 non-prescribers. Most CDP prescribers worked in private practice settings (67.9%). Specific training in CDP prescribing was the factor most strongly associated with a higher likelihood of prescribing (adjusted OR, 100.73; 95% CI, 12.77–794.72; p < 0.001), while lack of knowledge was the main reason for non-prescription. Although some physicians reported prescribing national products, imported products remained predominant (75.8% vs. 24.2%). Products provided through patient associations were also frequently mentioned. Predominant indications included mental and behavioral disorders, neurological diseases, and pain. Oil-based cannabidiol (CBD) formulations were the most frequently prescribed and were generally administered orally or sublingually. Older patients were the most frequently reported recipients of CDP prescriptions, and most physicians reported observing therapeutic effects within 30 days. Conclusions: Despite an evolving regulatory framework, clinical practice remains challenged by gaps in clinical training and disparities in patient access.