The supply of cannabis for medical use through cannabis social clubs in Belgium (2018)

Cannabis Social Clubs (CSCs) are nonprofit associations of adult cannabis users, which collectively organize the supply of cannabis among their members. As CSCs currently also serve members using cannabis for medical purposes, this article aims to detail the particular features of Belgian CSCs as suppliers of cannabis for medical use, and how those are perceived by CSC members. In this article, we draw on data gathered through interviews with the managing staff (n = 21) of seven currently active Belgian CSCs. In addition, we conducted interviews (n = 21) and an online survey (n = 80) with members of Belgian CSCs using cannabis for medical reasons. We present Belgian CSCs' practices building on an adapted version of the health services analytical framework proposed by Belle-Isle et al. This article thus provides a first overview of the features of Belgian CSCs as suppliers of cannabis for medical use as well as members' perceptions. Structural differences emerged as to how the Belgian CSCs have accommodated medical members' needs (in mixed CSCs where no formal distinction is made between recreational and medical members, in a separate CSC subunit or in a CSC admitting medical members only). Candidate medical members must fulfill specific criteria, particularly when applying for the medical units. The CSCs have adopted two different types of distribution methods, and the cannabis supplied is produced organically - systematic quality control is, however, lacking. We noted some flexibility in relation to frequency and quantity distributed to medical members. Affordability was positively appreciated by CSC members. Collaboration between CSCs and the health sector remains challenging. Some degree of diversity in practices among CSCs remains, as well as common issues which continue to affect the model in Belgium and are important in understanding the role and potential of CSCs as providers of cannabis for medical use.