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‘Pharmacy weed to expensive and of inferior quality’

Source: Haarlems Dagblad By: Monique Verkerk.

Haarlem 21-02-2004
The Mediweed that became available in the pharmacies, from September 2003, is too expensive and of an inferior quality. This is being stated by the Foundation for Patients Interests (PMM), coffeeshop owners and Mediweed users. The pharmacy weed is three times more expensive than in coffeeshops and is not refunded by the Health Insurance Companies, except for a few cases. Less than 4 percent of the total number of (medical) cannabis users has been to the pharmacy, since it has been legalised.

According to Ger de Zwaan, chairman of the PMM, the results of the pharmacy weed are less effective than with the use of Mediweed from coffeeshops. Patients have to start using more (Mediweed) to get the same effects. His clients (patients) have often tried the pharmacy weed, but they always came back to him after that. Coffeeshop owners Nol van Schaik from Haarlems Willie Wortel and Edo Landtman from Superfly in Hoofddorp acknowledge this. Nevertheless, says Bas Kuik, spokesperson of the Bureau for Medicinal Cannabis (BCM), the quality (of the cannabis) must be good. The pharmacy weed is tested in a laboratory for strength and it is up to the demands of the European standards for the medicine.
Patients which purchase their Mediweed in coffeeshops* get it for the buyers price: two to three euros (per gram. NvS). At the pharmacy, the clients pay nine to ten euros per gram. De Zwaan thinks this difference is too high, and says the patients are going back to the coffeeshop. According to Kuik, only a few people go to the pharmacy, because the Mediweed is only available since last September. “It is a new product and doctors have yet to get used to prescribing the medicine.” Hans Mulder, the chairman of the Haarlems Pharmacy Collective, also thinks the number of patients will not increase, but he blames the health insurance companies for that.
“There will be no increase in patients going to the pharmacy, as long as there is no refund for most people.”

Patients know more about Mediweed than pharmacists.
“Pharmacy weed does not relax my husband’s muscles and is very expensive as well. Besides that the pharmacist knew nothing about the new medicine.” Corrie Hoekstra, living in Haarlem, does not buy her husbands Mediweed at the pharmacy anymore.
Lex Hoekstra is suffering from Multiple Sclerosis and uses Mediweed for three years now. The weed relaxes his muscles, reducing the agony of spasms. He also uses the weed to stimulate his appetite. “He was so sick that he lost his appetite. Now he is back to eating well”, says Corrie. “Besides that, Lex has problems going to the toilet. The Mediweed relaxes his bladder, which makes it easier for him to urinate.”
The precinct nurse helps Lex to shower and get dressed every morning. After he is finished with that, he smokes shag tobacco mixed with weed. Lex always smokes Mediweed from the coffeeshop. When the weed became available from the pharmacy, last September, he wanted to try the pharmacy weed. The weed was legal now and his Health insurance covers it. He got the two different strengths offered by the pharmacies: Potent and a little less potent. Both strengths did not work for Lex. An extra disadvantage is: the weed tastes like old cloths.
Corrie is especially displeased about the bad (lack of) information from the pharmacy.
“The weed had a closed in description, but there was no explanation about the way how to use it whatsoever. The pharmacist himself did not know anything about it as well.”

Mediweed does not particularly have to be smoked, it can also be used in a tea, or it can be inhaled after vaporization. This was a big difference with the extensive information that Corrie got at her first visit in the coffeeshop.
Haarlems’ Tineke Montauban did not get any explanation on how to use Mediweed as well, when she ordered it from her pharmacy. “I did not need to know anything, because I used the Mediweed from the coffeeshop for several years already.” Tineke is an MS-patient as well, but she has cancer next to that. She uses the weed to be able to sleep better. The weed reduces her spasms and pain. “I do not use it during the day, it makes me too numb.”

Tineke’s Mediweed is being paid by her Health Insurance, that’s why she stays client of the pharmacy. The Mediweed is being delivered at her house. Tineke, who has trouble walking, does not have to leave her house this way. Tineke does think the quality of the pharmacy weed is lower than at the coffeeshop. “The coffeeshop weed is more potent. I have to use more to get the same effect now”, according to Tineke.
The owner of coffeeshop Superfly in Hoofddorp, Edo Landtman, has a few dozen patients that purchase their Mediweed at his place. They tell him they are not so content with the pharmacy weed. “They consider it too expensive and less potent than the coffeeshop Mediweed. The patients do try it, but after one visit at the pharmacy, they are back on my doorstep.” The number of patients has remained the same, since September, in his case.

The same goes for Nol van Schaik, owner of coffeeshop Willie Wortel in Haarlem, who has lost no patients (to the pharmacy). His shop had about 80 patients purchasing their Mediweed there, before September 2003. He had expected that they would all switch to the pharmacy weed, but, so far, the number of patients has only increased. “The legalisation stimulated people to purchase Mediweed, but they were not adequately served at the pharmacies, so they came to me”, according to the coffeeshop owner.

Van Schaik is an advocate for Mediweed legalisation for many years now. At first, he was very happy about the fact that the weed was acknowledged as a legal medicine. “We thought we had reached our goal, but the legalisation is not been dealt with properly.” Van Schaik is disappointed that the pharmacists are not informed good enough. “Pharmacists usually know less about the Mediweed than the people that order for it. I also consider it an outrage that sick people are being overcharged at the pharmacy” Van Schaik himself supplies Mediweed for the buyer’s price. In Haarlems 15 pharmacies, so far only ten clients have been in for the Mediweed. Pharmacy Meerwijk BV has three regular clients. Pharmacist Marieke Kroese has learned a lot from these clients. Kroese: They are experienced users. They told me how to use the weed in what way. I was familiar with the effects of the weed, but that is all.”

Bas Kuik of the Bureau for Medicinal Cannabis reports that the information must be good.
Kuik: “The pharmacists and doctors have been informed extensively. We have sent all kind of brochures. Also. a lot about it has been written in pharmaceutical trade magazines. It is up to the pharmacist to read all that well.” Furthermore, Kuik reports that the weed comes with a closed in description about the effects. According to him, the different ways of ingestion can be found in a brochure that is available in the pharmacies.
Kuik is not negative about the future of Mediweed. He thinks that doctors will start prescribing Mediweed more often, so that the pharmacies will attract more patients.

Van Schaik hopes that the quality of the pharmacy weed improves, and for a better information to the patients. Van Schaik: “Until then I will just keep supplying my patients with Mediweed.”
* Unfortunately, only a few coffeeshops do so. Willie Wortel is the only Mediweed supplier in Haarlem since 1996, motivated by Wernard Bruining’s Mediwiet Project.

Translation: Sinsemilla Guerrilla
More about Mediweed and coffeeshops on www.hempcity.net

I have some comments, remarks and questions to add to this article.

Lex Hoekstra prefers to pay for Mediweed from Willie Wortel, rather than having to use the refunded weed from the pharmacy, which does not work for him, and tastes like somebody else’s laundry. That is good for the reputation of my coffeeshop, but it is sad for people like Alex, who have to pay for their own medication, out of a minimum wage, as a disabled person. It is not only sad; it is wrong, and not according to the Dutch National Health regulations.

In Holland, we are entitled to the medicine that works best for the needs of the individual patient or disabled person. The Government does advice, in case there are more medicines available, which work equally good, or better, to supply the patient the cheapest possible version/brand of that medicine, for economical reasons, of course. In Holland too, budgets for National Health are being cut, to save money.
This seems to be a clear example of that regulation, Lex uses the version/brand of the medicine that works best for him, cheaper than the (only) alternative, and at least as good, if not better, than that single alternative.

Since Mediweed became legalised, we can consider it to be a regular medicine in our tiny, yet progressive country, but those who use that medicine, are being denied the right to a free choice out of a wide range of medicines. The Government and the Health Insurance companies could benefit from allowing the patients to purchase and use Mediweed from coffeeshops, for they would only have to refund a third of what they have to refund for pharmacy weed. The patients do not care where it comes from, as long as it works for them!

Maybe Corrie and Lex Hoekstra should think about finding a good Lawyer, which will have to be issued and paid for by the State, for people on a low income. They could start a test case over this, to see if Lex is entitled to refund from Mediweed issued by Willie Wortel, we will write them the necessary receipts!

Mr. Kuik says that the legally produced pharmacy weed is up to the European standards for this medicine.
European standards? Now I am curious, what are the European standards for medical grade cannabis, or Mediweed?
Did the other countries in our European Union, the countries that do not allow the medicinal use of cannabis, set those standards, with the Netherlands? What are those standards? Do patients in other European countries have the right to Mediweed, if it fits these EU standards? Can other countries have their own medical grade marihuana grown by selected companies, like the Netherlands?

Mr. Kuik also states that doctors have to get used to writing prescriptions for Mediweed, because it is a new product.
That is absolutely not so, our 110 patients (+30 since September 2003) all came up with a doctor’s prescription, we demand that to prevent abuse of the system, which is being set up to supply the patients for the buyers price, which is a 50 % discount on the price for regular clients.
Some of our patients were even directed to a second opinion doctor by us, in case their own doctor refused to comply, by supplying them with the phone numbers on the prescriptions we have, of doctors who do prescribe Mediweed.
A new product? Mr. Kuik, it may be new to you, but the therapeutical use of cannabis dates further back than any history book, and it is certainly not new to the many patients that are using Mediweed since 1996, when the distribution from coffeeshops was initiated, by starting the so-called “Mediwiet Project”.

Mr. Kuik states that both the quality of the available pharmaweed and the information about the use of the pharmaweed must be good, and he blames the pharmacists for the failure to inform.
Dear, ignorant Mr Kuik, both the pharmaweed and the information about this ‘new’ product are no good at all, denial does not make things better. Ask your boss, Mr. Willem Scholten, to have a talk with some patients, instead of allowing greedy pharmacists and pharmaweed producers to get a monopoly on a plant that grows for every one that plants a simple seed.

Willie Wortel does not only have raw cannabis available for its patients, because not all patients smoke. We also supply chocolate bars, which contain 0.6 gram if Ice-o-lator hash, which means that it is easy to dose, with one part containing 0.1 gram of active cannabis substance. We supply these bars to care home Nieuw Unicum for their patients, which make a big difference for the better, for both staff and patients, as I was told by Coby Mobron, the Care-Coordinator. She recommended the chocolate bars to all care homes she is in contact with. Nieuw Unicum pays by bank, for the chocolate bars, and for their monthly 90 pre-rolled joints, in two different strengths.

We published a book, ‘Cannabis as medicine in Practice’*, with and by our patients in 2000, about their experiences with the therapeutical use of cannabis, meant to be a support for other patients, who do not know about the medical properties of Mediweed. It is complemented with recipes for food with Mediweed, drinks with Mediweed, sauces with Mediweed, and all other possible ways to ingest cannabis. Maybe the pharmacists want to start selling them, it could save them a lot of work, and it would benefit the patients.

Well, nothing changes for us, the people from Willie Wortel’s which take care of the Mediweed patients in and around Haarlem. We’ll just keep informing them about the best way to ingest Mediweed, how to find out what doses to use, before we supply them with the weed or hash of their personal choice, for half the price, we do not wish to make money of the misery of others. We will just keep doing the work that is left undone by the Dutch authorities and Health organisations, just because we care.

We will only have reached our goal when good quality Mediweed is available with full refund for everyone, with a choice from a wide variety, like any other medicine, and with a free issued vaporizer, which are already on sale in Dutch pharmacies too, they do seem to know that Mediweed is business!


*Available in Dutch and English.

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