I certainly use a lot of coconut cream. My Thai mentor told me that if a recipe absolutely needs coconut milk, you can add some water to the cream for a good substitute. Obviously, coconut cream is richer and “heavier” than the milk, but it’s very much more silky and indulgent, so it really depends on what you’re aiming for.
I certainly don’t have the equipment, patience and frankly, strength to make it from a fresh coconut, but it is definitely worth trying fresh coconut milk and cream if you ever get the opportunity.
Another tip I would recommend is that the product that comes in a tetra-pack is far better than canned, due to the different manufacturing process involved in the canning, which needs a number of additives and different heating methods that are not beneficial to the final product.
Believe me, the cardboard carton product is creamy and separates better if that is a requirement (curries are a prime example).