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The prevalence and incidence of medicinal cannabis on prescription in The Netherlands

  • Pharmacoepidemiology and Prescription
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A growing number of countries are providing pharmaceutical grade cannabis to chronically ill patients. However, little published data is known about the extent of medicinal cannabis use and the characteristics of patients using cannabis on doctor’s prescription. This study describes a retrospective database study of The Netherlands.


Complete dispensing histories were obtained of all patients with at least one medicinal cannabis prescription gathered at pharmacies in The Netherlands in the period 2003–2010. Data revealed prevalence and incidence of use of prescription cannabis as well as characteristics of patients using different cannabis varieties.


Five thousand five hundred forty patients were identified. After an initial incidence of about 6/100,000 inhabitants/year in 2003 and 2004, the incidence remained stable at 3/100,000/year in 2005–2010. The prevalence rate ranged from 5 to 8 per 100,000 inhabitants. Virtually all patients used some form of prescription medication in the 6 months preceding start of cannabis use, most particularly psycholeptics (45.5 %), analgesics (44.3 %), anti-ulcer agents (35.9 %) and NSAIDs (30.7 %). We found no significant association between use of medication of common indications for cannabis (pain, HIV/AIDS, cancer, nausea, glaucoma) and variety of cannabis used.


This is the first nationwide study into the extent of prescription of medicinal cannabis. Although the cannabis varieties studied are believed to possess different therapeutic effects based on their different content of tetrahydrocannabinol (THC) and cannabidiol (CBD), no differences in choice of variety was found associated with indication.

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AH is Head of R&D at Bedrocan BV, The Netherlands. The Dutch Association for Legal Cannabis and its Constituents as Medicine (NCSM foundation, Oegstgeest, The Netherlands) is gratefully acknowledged for providing the funds to collect data from the SFK database and providing the data to the authors. No additional funding was received for conducting this study.

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Correspondence to Arno Hazekamp.

Additional information


What is already known on this subject

• As clinical support for the therapeutic use of cannabis or its isolated components such as THC is mounting, several countries are now providing herbal cannabis of pharmaceutical grade to chronically ill patients.

• Many other patients obtain cannabis from illicit sources and experiment with self-medication, without the supervision of a medical professional.

• Other than surveys based on self-selected participation, not much is known about characteristics or preferences of medicinal cannabis users,

What this study adds

• This study is the first one using objective data to study national medicinal cannabis consumption patterns, providing accurate data on the incidence, prevalence and characteristics of users of prescribed medicinal cannabis in The Netherlands.

• Understanding the background and preferences of cannabis patients may help medical professionals to decide about the role of medicinal cannabis in their own practice.

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Hazekamp, A., Heerdink, E.R. The prevalence and incidence of medicinal cannabis on prescription in The Netherlands. Eur J Clin Pharmacol 69, 1575–1580 (2013).

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