About half a million people in the Netherlands use cannabis to alleviate physical and mental health problems. Yet only a small percentage, around 7,000 patients, receive cannabis with a doctor's prescription. Most patients obtain cannabis without a prescription from coffee shops or grow it themselves. Many people would prefer to access medicinal cannabis through a prescription, but in practice they face numerous obstacles.
These findings come from research conducted by the Trimbos Institute among more than a thousand people who use cannabis for medicinal purposes without a prescription. This is the first study to provide insight into this group and the reasons they do not obtain cannabis through conventional healthcare.
The study shows that people use non-prescribed cannabis for a wide range of conditions, particularly chronic pain and sleep problems. Three-quarters of participants use cannabis for multiple conditions at the same time. According to respondents, cannabis significantly reduces their symptoms and improves their quality of life.
However, using non-prescribed cannabis also carries risks. Many users obtain their cannabis from dispensaries, meaning they often do not know the exact THC or CBD content of the product. Many respondents also express concern about possible contamination. In addition, cannabis is often smoked with tobacco, which is more harmful than other methods such as vaporizing or using cannabis oil.
Access to medicinal cannabis remains limited
The study shows that many people would prefer to have a prescription for medicinal cannabis but face various barriers. Few doctors are willing to prescribe it, and the cost is too high for many patients. There is also a lack of clear and accessible information for both patients and doctors. In addition, the availability of medicinal cannabis products in the Netherlands is limited, and the stigma surrounding cannabis use still plays a role.
Despite these barriers, most patients prefer to use cannabis through official healthcare channels. This allows them to know exactly what the product contains, ensures consistent quality, and removes the need to obtain cannabis from coffee shops or other unregulated sources.
"These are patients who often suffer from serious and long-term health conditions. Like everyone else, they want access to a medication they know helps them, rather than having to rely on unregulated and illegal sources. It is frustrating for them to know that medicinal cannabis is legal in the Netherlands, yet remains out of reach," says Lisa Strada, project leader of the study.
Since 2018, medicinal cannabis has no longer been covered by health insurance. This creates a major problem for many patients. Many live with chronic conditions that prevent them from working or limit their ability to do so, leaving them dependent on low incomes or social benefits. As a result, medicinal cannabis is often unaffordable.
In principle, any doctor can prescribe medicinal cannabis if standard treatments and registered medications are ineffective or cause too many side effects. In practice, however, cannabis is rarely prescribed. "This is largely due to a lack of knowledge," says Strada. "Medicinal cannabis is not a standard part of medical training, and there are limited opportunities for continuing education." Patients also often hesitate to raise the topic with their doctor because they fear stigma.
There is also little reliable government-provided information about medicinal cannabis. As a result, many people search for information on forums and social media, where misinformation can easily spread.
Supply issues
Currently, only five types of cannabis are available by prescription in the Netherlands. Patients indicate that they want more choice, as a wider range increases the chances of finding a product that works for them. People respond differently to cannabis, and what is effective for one person may not work for another. Differences in plant composition also affect how well a product works.
Although medicinal cannabis has been available in the Netherlands for more than twenty years, access through conventional healthcare remains difficult for most patients. Policy changes are needed to improve availability and better align care with patients' needs. This could reduce the use of unregulated cannabis while better protecting patient health.
Source: Trimbos
