Dutch Medical Cannabis Users Avoid Prescriptions Due to Cost, Stigma, and Product Limitations | Research

The takeaway

Qualitative interviews with 33 Dutch people using non-prescribed cannabis medicinally revealed barriers including high cost, limited product variety, physician unfamiliarity, and stigma from the prescribed cannabis system.

medical cannabis program administrators, health policy researchers, patient advocates

What the researchers found

Despite over two decades of legal prescribed cannabis, most Dutch medical users obtain it from unregulated sources. Barriers to prescribed access included cost, limited product selection, physician lack of knowledge/willingness to prescribe, stigma associated with requesting cannabis, and restrictive program design. Participants felt the prescribed system did not meet their therapeutic needs.

Why it matters

The Netherlands has one of the world's oldest medical cannabis programs, making it a valuable case study for why patients may not use formal channels even when they exist. These barriers likely affect medical cannabis programs worldwide.

The numbers in context

33 qualitative interviews. Over 20 years of legal medical cannabis in Netherlands. Most medical users still use non-prescribed sources. Key barriers: cost, product limitations, physician barriers, stigma.

How the study worked

Semi-structured qualitative interviews with 33 people using non-prescribed cannabis for medicinal purposes in the Netherlands.

What this study cannot tell us

Qualitative study with self-selected participants. Cannot determine prevalence of specific barriers. May overrepresent those with negative experiences. Dutch-specific regulatory context. Small sample.

How to read the evidence

Detailed qualitative analysis from a unique regulatory context, though small self-selected sample limits to moderate.

When this study was published

Recent qualitative study from the Netherlands.

The bigger picture

The Dutch experience demonstrates that legalizing medical cannabis is necessary but not sufficient for access. Program design, cost, product variety, and healthcare provider engagement all determine whether patients actually use formal channels.

Questions still open

Which barrier, if addressed, would most increase prescribed cannabis uptake?
Do other countries' medical cannabis programs face the same barriers?

Common questions

Why don't Dutch patients use prescribed cannabis?

High cost, limited product variety, doctors unfamiliar or unwilling to prescribe, and stigma associated with requesting cannabis were the main barriers identified.

Does this mean medical cannabis programs don't work?

It means that having a program is not enough. The program must be affordable, offer appropriate products, have physician buy-in, and be designed to reduce rather than create stigma.

Read the original research

Barriers to accessing prescribed medical cannabis: qualitative insights from people using non-prescribed cannabis for medicinal purposes in the Netherlands.

Harm reduction journal, 23(1), 13

View on PubMed ↗Publisher’s paper ↗

Citation

Strada, Lisa; van Gelder, Nadine; Martinelli, Thomas; Fraser, Alex; Hipple Walters, Bethany. (2025). Barriers to accessing prescribed medical cannabis: qualitative insights from people using non-prescribed cannabis for medicinal purposes in the Netherlands.. Harm reduction journal, 23(1), 13. https://doi.org/10.1186/s12954-025-01369-8