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Europe

Dutch Prefer Cannabis Cafes to Pharmacies

With legal cannabis readily available at cafes, the Dutch government program for issuing medical marijuana through pharmacies is losing money.

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Expensive relief

Stocks of pot are piling up in Dutch pharmacies as patients seeking medical marijuana eschew it for cheaper -- and more pleasurable -- relief available at cafes. That is costing the Dutch government hundreds of thousands of euros.

Even though marijuana is legal and widely available in hundreds of Dutch cannabis cafes known as coffee shops, the Dutch government set up a program for medical marijuana in September 2003.

The idea was that patients would prefer a prescription from a pharmacy with a guaranteed strength and quality rather than take their chances in the commercial coffee shops. It didn't work out that way.

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Dutch Minister of Health Hans Hoogervorst reported last December that the program generated a loss of almost €400,000 ($520,000) in 2004.

Of the estimated 10,000 to 15,000 patients who use cannabis for medical reasons, only between 1,000 and 1,500 have taken part in the medical cannabis program. The health ministry scaled down its expected yearly sales from between 200 and 400 kilos of marijuana to just 70 kilos (154 lbs).

"It appears that doctors are not prescribing as much as we had estimated based on studies," said Bas Kuik, spokesman for the government regulated Bureau of Medical Cannabis (BMC).

The government will not yet term the program a failure but said it is being re-evaluated and a decision on it would be made later this year.

Relief from marijuana

Studies have shown that marijuana can reduce nausea and vomiting in patients undergoing chemotherapy and radiotherapy, alleviate tension in glaucoma patients and improve the appetites of people infected with HIV or suffering from AIDS.

The Dutch decriminalized the use of cannabis in the 1970s and currently allow the sale through authorized bars known as coffee shops. Sales are limited to five grams per person and growing marijuana is forbidden.

Comparative shopping

Most attribute the growing stockpiles to cost.

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"Problem number one is the price," said James Burton, one of two officially-recognized growers of medical marijuana until this year when the government ended its contract with him. "Medical marijuana is sold at some €9 a gram while in a normal coffee shop you can get a gram of cannabis at €4.50 to €5. There is a market out there, just not at this price."

The American has a long history with the drug. As a glaucoma patient, he uses marijuana to ease tension. He was jailed in the United States for growing the herb before he moved to the Netherlands in 1991.

Smoking more fun

Another problem for patients is that the Dutch national health service does not reimburse prescriptions and only a few private health insurers do.

At government prices, that means a prescription such as Burton needs -- 90 grams a month -- costs over €800.

This is simply too much for most patients.

Kuik insisted that the BMC does not make any money from medical marijuana and explained the mark-up was necessary because of tax, research, sterilization, packaging and logistics.

He added that there is another possible reason for the unpopularity of medical marijuana. "The medical cannabis is made to be inhaled in a steam treatment or infused and drunk like tea and not for smoking," he said. "Maybe that is a disappointment for people expecting to smoke it but of course the ministry of health cannot encourage smoking."

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