Medicinale cannabis

• The use of cannabis products for medical purposes is rapidly increasing in the Netherlands.
• Studies suggest that these products have positive effects in the treatment of chronic neuropathic pain, multiple-sclerosis-related spasticity, certain epilepsy syndromes and chemotherapy-related nausea and vomiting.
• The interpretation of these findings is impeded by methodological shortcomings, such as a small number of participants.
• Differences in product composition and dosage form mean that study results are often not directly comparable.
• Responsible prescribing requires that the patient be very well informed about the goal of treatment, alternative forms of treatment and the side effects.
• A history of psychosis, relevant cardiac co-morbidity, recurrent falls, addiction problems, pregnancy and breastfeeding are all contra-indications to the use of medical cannabis.

Conflict of interest and financial support: none declared.