'Medical Cannabis' in a dutch context: a case history
Adriaan C.M. Jansen
Department of Economics and Econometrics (E-5.02), University of Amsterdam,
Roetersstraat 11, 1018 WB Amsterdam, The Netherlands
ln the second half of the l990s, attempts by Maripharm to introduce Medical Grade Marijuana met with the authorities resistance rather than approval (Khodabaks & Engelsma, 1998). Even medical experiments on the basis of MGM were discontinued. However, until now the provision of medical marijuana to patients by the Action Group Medical Cannabis and Maripharm is still tolerated.
Medical Cannabis' should be seen in the context of a Dutch 'toleration policy' toward recreational use. The so-called 'hash coffee shops' have been in existence for two decades now, and their number has increased from a score or so in the big cities in 1980, to around 1,500 all over the country today: the 1980s and the l990s have been showing a gradual diffusion of the coffee shops from the big cities to the smaller towns and even the villages. (Jansen, 199l; l996).
From the debate on who should determine the availability of 'drugs' in society, three distinct models of regulation can be construed: consumer sovereignty, occupational control, and bureaucratic regulation (Holloway, 1995). Dutch 'toleration policy' seems to provide arguments in favour of regulating cannabis by the principle of consumer sovereignty rather than by occupational control or bureaucratic regulation. Dutch 'toleration policy' has led to a wide (pseudo-legal) availability of cannabis for recreational purposes, but has not resulted in high prevalence figures in comparison with other countries (Korf, 1995). Moreover, cannabis use for recreational purposes seems to almost disappear in age cohorts of above 30 years of age (Langemeyer, Van Til & Cohen, 1998).
The principle of consumer sovereignty and the subsequent 'normalisation process' of cannabis in the Netherlands puts insights based on 'occupational control' and 'bureaucratic regulation' into perspective. Therapeutic insights of traditional healing systems in which cannabis is used "to relieve discomfort" (Clarke, 1998; Martin, 1997; Partridge, 1975) and the use of cannabis for "re-creation" show that borderlines between use and abuse are not always easy to draw. Even the mentioned limitations of the therapeutic usefulness of cannabis, such as the "many unpleasant side effects" and "the lack of specificity" (Adams & Martin, 1996: 1585) can be accommodated by the principle of consumer sovereignty or by traditional 'medical botany'. The Dutch 'real world' experiment of 'tolerated' consumer sovereignty in matters of cannabis seems to be at odds with the idea of 'bureaucratic regulation' on an international scale.