Medical and recreational cannabis policy: both have their own right to exist, but they can strengthen each other

In 2019, my mother passed away due to a brain tumor. The prognosis was immediately grim. One of the first things I did was ensure we had access to cannabis oil. You hear such hopeful stories. Even though we knew that this type of cancer would likely only provide relief, I wanted her to at least have the chance. But she was afraid to try it. More than that, she didn’t want anyone to know she had it in the house—because it was ‘drugs.’ The stigma was so deeply ingrained, even in my own mother. Eventually, after six months of chemotherapy and fifty radiation treatments, the tumors returned just as quickly. Only then did she dare to try it. Although it was too late, I saw her improve. She slept better, she ate, and her quality of life increased. But to my great sorrow, she passed away a few weeks later.

This personal story is not unique. It illustrates a broader societal reality: misconceptions and fear surrounding cannabis hinder people in their right to effective care and safe consumption. This is not just a matter of regulation, but of social acceptance and constructive policy. Medical and recreational cannabis serve different purposes, have their own right to exist, and simply cannot replace one another.

Medical cannabis: a reliable medicine that suffers from the recreational stigma

Medical cannabis is used for serious medical conditions such as chronic pain, epilepsy, and multiple sclerosis. This requires a strict pharmaceutical approach in which control, reliability, and safety take priority (IGJ, 2022; KNMP, 2023).

Medical cannabis is not a lifestyle product, nor a recreational substance, and should not be treated as such. It is a medicine, or rather, a raw material for a medicine. Like other pharmaceutical products, its production must meet strict standards: standardized dosages, purity guarantees, and controlled production (Bedrocan, 2023). Yet, medical cannabis is still dragged into the broader debate on recreational cannabis use. The result? A persistent stigma that causes patients who could benefit from medical cannabis to avoid it out of fear of social judgment (PMC, 2024).

My own mother only dared to try medical cannabis when she had no other options left. Not due to a lack of knowledge or access, but because of the fear associated with the stigma surrounding it. This is a glaring example of how political hesitation and social prejudices directly reduce patients’ quality of life. This must stop. When patients can benefit from an effective treatment, they should not be hindered by irrational fears or a lack of political courage.

Even though I am not actively involved in medical cannabis developments, I often hear that there is significant hesitation. Due to reluctance in the medical sector, it appears that patients often have to seek solutions themselves rather than follow a clear medical trajectory. Physicians and pharmacists play a crucial role in ensuring the correct application and dosage, and in safeguarding patient safety. This prevents arbitrary self-medication and ensures responsible use within a broader treatment protocol (Lung Cancer Netherlands, 2021; KNMP, 2023).

Recreational cannabis: a solution for public order and public health

Recreational cannabis serves a different function: coffee shops or cannabis retail outlets are a solution to a public order issue in the interest of public health. The Dutch government had the right idea in 1976 but never fully implemented the policy. The tolerance policy was introduced to create a separation between soft and hard drugs and thus protect public health (Jellinek, 2023).

Although the policy was partially successful in reducing contact between soft drug users and the hard drug scene, the production and supply of cannabis to coffee shops remained unregulated, leading to the so-called 'backdoor problem' (The Grass Company, 2023). This has left the market vulnerable to illegal trade and uncertainty for both consumers and businesses (Dutch Government, 2023). The tolerance policy has proven its function and legitimacy, but without a comprehensive regulation, the market remains unnecessarily exposed to illegal trade and a lack of clarity for consumers and businesses.

As the chairman of the Cannabis Retailers Association, I advocate for finally completing this policy. The current policy frustrates both consumers and businesses with unnecessary and outdated restrictions. Next year, the tolerance policy will be 50 years old, but regulations have barely evolved with society. In 1976, there was no consideration of innovation, and since then, countless new, safer, and controlled consumption methods have been developed. By clinging to a half-baked solution, we continue to facilitate illegal trade and shortchange consumers.

It is telling that even in a conservative country like France, voices are calling for a fundamental review of cannabis policy. The recent call from Éric Piolle, mayor of Grenoble, to hold a referendum on the decriminalization of cannabis illustrates how awareness is growing that the current repressive policy is failing. Piolle advocates for state-controlled legalization, which he believes would eliminate 50% of the illegal market (Bernard, 2025).

This demonstrates that the cannabis debate is shifting worldwide. While some countries, even conservative ones like France, are willing to critically reassess their policies, the Netherlands remains stuck in a half-hearted status quo.

Recreational legalization requires its own approach. An approach where the role of coffee shops and cannabis retail outlets is not overlooked and where they can always compete with the illegal market. Comprehensive regulation of recreational cannabis must include both sales and production. By monitoring product quality and distribution, we can prevent the market from falling into criminal hands. Moreover, regulation contributes to public health by eliminating harmful substances and contaminants in cannabis products (Dutch Government, 2023; Official Gazette, 2023).

They can strengthen each other

It is therefore essential that both the medical and recreational sectors are not only regulated but also recognized as independent and legitimate markets. Even though medical and recreational cannabis cater to different needs, they both suffer from the same deeply rooted stigma. Both markets have their own right to exist and must be recognized and regulated as such. This fundamental distinction is often insufficiently highlighted in policy discussions and summits, resulting in inadequate regulation and persistent misunderstandings. I find it deeply concerning that we increasingly see recreational brands operating under a medical label—not only is this misleading, but it also undermines the legitimacy of both markets. This blurring of boundaries reinforces the stigma and prevents both sectors from gaining the recognition and regulation they deserve. Anyone committed to serious regulation, both medical and recreational, should defend this distinction clearly and proactively.

A regulated recreational market and a well-established medical cannabis industry can strengthen each other rather than undermine one another. A strict policy distinction is necessary, but equally important is a clear separation in the discussion. I have experienced this firsthand. My own mother, who might have benefited from medical cannabis, did not dare to use it because of the stigma. This is precisely why we must clearly define the distinction between medical and recreational cannabis. Only when we acknowledge that both markets have their own role and legitimacy can we work towards mutual acceptance and breaking down stigmas.

Referenties

• Bedrocan. (2023). Standaardisatie: Onze methode. Geraadpleegd op [4 februari 2025], van https://bedrocan.com/nl/over-bedrocan/standaardisatie-onze-methode/

• Bernard, A. (2025). Eric Piolle roept op tot een referendum over de decriminalisering van cannabis. Newsweed. Geraadpleegd op [4 februari 2025], van https://www.newsweed.fr

• Inspectie Gezondheidszorg en Jeugd (IGJ). (2022). Beleid rond medicinale cannabis in Nederland. Geraadpleegd op [4 februari 2025], van https://www.igj.nl/onderwerpen/medicinale-cannabis

• Jellinek. (2023). Wat is de geschiedenis van cannabis?. Geraadpleegd op [4 februari 2025], van https://www.jellinek.nl/vraag-antwoord/wat-is-de-geschiedenis-van-cannabis/

• Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie (KNMP). (2023). Richtlijnen voor medicinale cannabis in de apotheek. Geraadpleegd op [4 februari 2025], van https://www.knmp.nl/medicinale-cannabis

• Longkanker Nederland. (2021). Brochure medicinale cannabis. Geraadpleegd op [4 februari 2025], van https://www.longkankernederland.nl/media/1/Downloads/Brochure-medicinale-cannabis.pdf

• PMC. (2024). Publicaties over medicinale cannabis en stigma. Geraadpleegd op [4 februari 2025], van https://pmc.ncbi.nlm.nih.gov/articles/PMC10811895/

• Rijksoverheid. (2023). Experiment gesloten coffeeshopketen: Aanleiding en opzet. Geraadpleegd op [4 februari 2025], van https://www.rijksoverheid.nl/onderwerpen/experiment-gesloten-coffeeshopketen-wietexperiment/aanleiding-en-opzet-experiment-gesloten-coffeeshopketen

• Zoek Officiële Bekendmakingen. (2023). Scheiding der markten en beleid ten aanzien van coffeeshops. Geraadpleegd op [4 februari 2025], van https://zoek.officielebekendmakingen.nl/kst-34165-7.html