Medicinal and recreational cannabis policy: both with their own legitimacy

In 2019, my mother passed away from the effects of a brain tumour. That personal loss was the catalyst for my work in this field.

In 2019, my mother passed away from the effects of a brain tumour. The prognosis was immediately poor. One of the first things I did was to ensure we had access to cannabis oil. You hear such hopeful stories. Despite knowing that this form of cancer would probably only offer relief, I wanted her to at least have the chance. But she didn't dare try it. In fact, she didn't want anyone to know she had it in the house, because it was 'drugs'. The stigma was so great, even with my own mother. Eventually, after six months of chemotherapy and fifty radiation treatments, the tumours returned just as quickly. Only then did she dare to try it. Although it was too late, I saw her improve. She slept, she ate, her quality of life increased. To my still 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's right to effective care and safe consumption. This is not just a matter of regulation, but of social acceptance and constructive policy. Medicinal and recreational cannabis serve different purposes, have their own legitimacy, and simply cannot replace each other.

Medicinal cannabis: a reliable medicine suffering from the recreational stigma

Medicinal cannabis is used for serious medical conditions such as chronic pain, epilepsy, and multiple sclerosis. This requires a strict pharmaceutical approach where control, reliability, and safety are paramount (IGJ (Health and Youth Care Inspectorate), 2022; KNMP (Royal Dutch Pharmacists Association), 2023).

Medicinal cannabis is not a lifestyle product, not a recreational drug, and should not be approached as such. It is a medicine, or rather: a raw material for a medicine. As with other pharmaceutical products, its production must meet strict standards: standardised dosages, purity guarantees, and controlled production (Bedrocan, 2023).

Yet, medicinal cannabis is still dragged into the broader debate about recreational cannabis use. The consequence? A persistent stigma that causes patients who could benefit from medicinal cannabis to refrain from using it out of fear of social condemnation (PMC, 2024).

My own mother only dared to try medicinal cannabis when she had no other options left. Not due to a lack of knowledge or access, but due to fear, partly because of the stigma attached to it. This is a poignant example of how political reluctance and societal prejudices literally reduce the quality of life for patients. This must stop. When patients can benefit from an effective remedy, they should not be hindered by irrational fear or a lack of political courage.

Although I am not actively involved in medicinal developments, I often hear that there is a certain reluctance. Due to the hesitation in the medical sector, it seems that patients often seek solutions themselves instead of being able to follow a clear medical trajectory. Doctors and pharmacists play a crucial role in the correct application and dosage, and in ensuring patient safety. This prevents arbitrary self-medication and guarantees responsible use within a broader treatment protocol (Longkanker Nederland (Lung Cancer Netherlands), 2021; KNMP, 2023).

Recreational cannabis: a solution for public order and public health

Recreational cannabis has a different function: coffeeshops or cannabis retail outlets are a public order solution in the interest of public health. The Dutch government thought this through well in 1976, but never completed the policy. The toleration policy (gedoogbeleid) was introduced to create a separation between soft and hard drugs and thus protect public health (Jellinek, 2023). Although the policy was partly successful in reducing contact between soft drug users and the hard drug scene, the production and supply of cannabis to coffeeshops remained unregulated, leading to the so-called 'back-door problem'. This has meant that the market remained vulnerable to illegal trade and confusion for consumers and businesses (Rijksoverheid (Dutch Central Government), 2023). The toleration policy has proven its function and legitimacy, but without comprehensive regulation, the market remains unnecessarily vulnerable to illegal trade and confusion for consumers and businesses.

As chairman of the Bond van Cannabis Detaillisten (BCD) (Association of Cannabis Retailers), I am committed to finally completing this policy. The current policy frustrates both consumers and businesses with unnecessary and outdated restrictions. Next year, the toleration policy will be 50 years old, but regulations have barely kept pace with society since then. In 1976, innovation was not considered, 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 short-change consumers.

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

This shows that the discussion about cannabis is globally in motion. While some countries, even conservative ones like France, are willing to critically review their policies, the Netherlands continues to cling to a half-hearted status quo. Recreational legalisation requires its own approach. An approach that does not forget the function of the coffeeshop or cannabis retail outlet, and in which they must always be able to compete with the illegal market. Comprehensive regulation of recreational cannabis must cover both sales and production. By supervising product quality and distribution, it can be prevented that the market remains in criminal hands. Moreover, regulation contributes to public health by eliminating harmful substances and impurities in cannabis products (Rijksoverheid, 2023; Zoek Officiële Bekendmakingen (Search Official Publications), 2023).

Yet they can strengthen each other

It is therefore essential that both the medicinal and recreational sectors are not only regulated, but also recognised as fully-fledged, independent markets. Although medicinal and recreational cannabis use serve two different markets, they both face the same persistent stigma. Both markets have their own legitimacy and must be recognised and regulated as such. This fundamental distinction is often insufficiently highlighted in policy discussions and summits, leading to inadequate regulation and persistent misunderstandings. I find it concerning that we are increasingly seeing recreational brands operating under a medicinal flag; I find it misleading, but it also undermines the legitimacy of both markets. This kind of blurring of boundaries actually fuels the stigma and prevents both sectors from receiving the recognition and regulation they need. Everyone committed to serious regulation, both medicinal and recreational, should clearly safeguard and actively defend this distinction.

A regulated recreational market and a strongly embedded medical cannabis industry can strengthen each other rather than undermine each other. A sharp policy separation is necessary, but at least as important is a clear separation in the discussion. I have experienced this firsthand. My own mother, who might have benefited from medicinal cannabis, did not dare to use it because of the stigma. This is precisely why we must make the distinction between medicinal and recreational cannabis clear. Only when we recognise that both markets have their own role and legitimacy can we work towards mutual acceptance and breaking down stigmas.