OBJECTIVES: In the Netherlands, cannabis has been available for medicinal purposes in pharmacies upon prescription by a medical doctor since September 2003. This research was done to study the characteristics of patients that start to use cannabis from pharmacies. METHODS: A national enquiry was started to identify all patients who were prescribed medicinal cannabis. Patients were contacted by their pharmacist to fill out a questionnaire. The questionnaire contained items about characteristics of patients; complaints and morbidity; use of cannabis; experiences with other cannabis products. Furthermore, history of drug use was collected. RESULTS: In total, 200 patients returned a questionnaire whereas drug history was available for 175 of these patients. Sixty-seven percent (67%) of respondents were female, and 60% of all respondents had used cannabis before. The main indications for cannabis use were chronic pain (72.5%) and muscle cramp/stiffness (53.0%). Among the cannabis users, 42.0% suffered from multiple sclerosis and 11.0% were diagnosed with rheumatic diseases. The history of drug use showed a relatively frequent use of analgesics (36.6%) and psycholeptics (34.9%). Experiences with previous use of other cannabis products indicated that concomitant drug use could be decreased in 40.4% of the patients, remained the same in 48.6% and increased in 0.9%; in total 10.1% did not use any concomitant drugs. Most reported side effects of previous cannabis products were lethargy (42.5%) and dry mouth (38.1%). CONCLUSIONS: The main indications for prescription of medicinal cannabis were chronic pain and muscle cramp/stiffness; multiple sclerosis was the most frequently reported disease. The majority of patients had used other cannabis products before, resulting in a decrease in concomitant drug use in a substantial number of patients. Legalization did not cause an excessive increase of cannabis used, most likely to be explained by the more expensive drugs in the pharmacy compared to coffee shops.