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Dutch patients prefer cannabis cafés to pharmacies


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With legal cannabis readily available, the Dutch government's programme for issuing medical marijuana through pharmacies is losing money as stocks pile up because patients seem to prefer buying their stash at authorised cannabis cafés.
Even though cannabis use is decriminalised and marijuana is widely available in hundreds of cannabis cafés known as coffee shops, the Dutch government set up a programme for medical marijuana in September 2001.
It cited studies showing that marijuana can be used to reduce nausea and vomiting in patients undergoing chemotherapy and radiotherapy, to reduce tension in glaucoma patients and to improve the appetite of people infected with HIV or suffering from Aids.
The idea was that patients would prefer a prescription from the pharmacy with a guaranteed strength and quality than take their chances in the commercial coffeeshops but it didn't work out that way.
After a year and a half of the groundbreaking programme, the Dutch Minister of Health Hans Hoogervorst calculated in December last year that the programme generated a loss of almost 400*000 euros ($520*000) in 2004.
Of the estimated 10*000 to 15*000 patients who use cannabis for medical reasons, only 1*000 and 1*500 people have taken part in the medical cannabis programme. The health ministry scaled down its expected yearly sales from between 200kg and 400kg of marijuana to just 70kg.
The government will not yet term the programme a failure but said it is being re-evaluated and a decision on how to proceed would be taken after the summer.
"It appears that doctors are not prescribing as much as we had estimated based on studies," said Bas Kuik, a spokesperson for the government regulated Bureau of Medical Cannabis (BMC).
To James Burton, who was one of the two officially recognised growers of medical marijuana until the government ended its contract with him this year, it is clear what is holding back the programme.
"Problem number one is the price. Medical marijuana is sold at some nine euros a gram while in a normal coffee shop you can get a gram of cannabis at 4,5 to 5 euros," Burton said.
"There is a market out there, just not at this price."
The American knows what he's talking about. As a glaucoma patient he uses marijuana to ease tension.
He was jailed in the US for growing the herb before he moved to The Netherlands in 1991.
"I thought I was in nirvana" because of the liberal Dutch policies on soft drugs, he said.
The use of cannabis has been decriminalised here since the 1970s and the sale allowed through authorised bars known as coffee shops.
Sales are limited to five grams a person and growing marijuana is forbidden.
One of the problems for patients related to the price of medical marijuana is that the Dutch national health service does not reimburse prescriptions and there are only a few private health insurers that do.
At the prices the government charges a 90g a month prescription like Burton has for his glaucoma costs more than 800 euros.
This is simply too much for most patients.
Kuik insisted that the BMC does not make any money from the medical marijuana and explained the mark-up was necessary because of tax, research, sterilisation, packaging and logistics.
He pointed to a possible other reason for the unpopularity of the medical marijuana.
"The medical cannabis is made to be inhaled in a steam treatment or infused and drunk like tea and not for smoking. Maybe that is a disappointment for people expecting to smoke it but of course the ministry of health cannot encourage smoking," he said. - Sapa-AFP

The Hague
All material copyright Mail&Guardian.
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