Briefing

New Bioactive Compounds from Natural Product Chemistry 

An example of cutting-edge basic research comes from Jung et al. (Pharmaceuticals 2025;18(4):521). The authors were the first to isolate two previously unknown cannabinoids – including cannabielsoxa – as well as chlorin-type metabolites from the flowers of Cannabis sativa. While classic cannabinoids demonstrated strong antitumor effects against neuroblastoma cells in cell culture, the chlorin derivatives open up an entirely new therapeutic avenue: their light-activated properties could be used in photodynamic treatments to selectively destroy tumor cells. For cancer patients whose standard therapies have reached their limits, these newly discovered compounds may become a valuable addition in the future. 

Long-Term Real-World Data from Australia 

The QUEST initiative provides impressive real-world evidence. In a prospective cohort of 2,353 patients treated with medical cannabis oil, quality of life and symptoms such as pain and fatigue improved within a few weeks and remained stable over twelve months. Remarkably, 70% of participants who had previously relied on opioids were able to reduce or completely discontinue their opioid dosage. Such practice-oriented observations are essential for demonstrating that medical cannabis should not be reserved as a last resort but integrated as a core part of modern pain therapy. 

Cannabis for Chemotherapy-Induced Nausea 

Grimison et al. investigated in a large Phase II/III study whether THC:CBD capsules could relieve nausea and vomiting in patients experiencing severe symptoms despite standard antiemetic prophylaxis. Participants took 2.5 mg THC plus 2.5 mg CBD or placebo three times daily. The result: With the cannabis extract, the rate of complete response (no vomiting, no rescue medications) rose from 8% to 24% – a statistically significant increase of 16% (95% CI 4–28; p = 0.01). Episodes of significant nausea, daily vomiting occurrences, and quality-of-life scores also improved. Side effects were mostly mild (sedation, dizziness, transient anxiety), with no serious adverse events. Even moderate doses thus proved to be an effective complement to antiemetic therapy. 

Conclusion & Outlook 

The studies presented here are just a snapshot, but they expand our understanding of new therapeutic opportunities – from innovative antitumor approaches to alleviating treatment-related side effects. They also highlight where research priorities should lie: closing the gap between clinical trials and real-world practice so that medical cannabis gains further precision and trustworthiness, and finds more frequent integration into everyday prescribing. 

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Switzerland: From Pilot Projects to a National Cannabis Law 

For over a year now, pilot projects have been running in several Swiss cities to test regulated cannabis distribution. Initial results, recently published by the Federal Office of Public Health (FOPH), provide insights into user behavior and how the projects are being implemented (link to results). Now, Switzerland is taking the next step: In February, the National Council’s Committee for Social Security and Health (SGK-N) presented a draft bill for the comprehensive regulation of cannabis, with a strong focus on public health and youth protection. 

Under the proposal, adults would be allowed to legally consume, grow, and purchase cannabis under clearly defined conditions. Sales would be strictly state-controlled and non-profit, with neutral packaging, health warnings, and a THC-based regulatory tax. The cantons would be responsible for oversight and prevention programs. The next step: a detailed explanatory report will be published in summer, followed by a public consultation with stakeholders and associations. This would pave the way for formal legislative proceedings. 

The Netherlands: A Legal Supply Chain to Replace the Grey Zone 

At the same time, all eyes are on the Netherlands, where the final phase of the “Experiment gesloten coffeeshopketen” (closed coffee shop supply chain experiment) began on April 7, 2025. In participating municipalities, coffee shops are now allowed to sell only regulated, legally produced cannabis. Until now, cannabis sales have been tolerated, but its production remained illegal — a contradiction the experiment aims to resolve. The goal is to establish a fully closed, government-monitored supply chain that ensures product safety and weakens the black market. 

To help ensure a stable supply, especially of hashish, a temporary grace period has been introduced: for the first two months, authorities will not penalize shops that still rely on unregulated hash. By June, only legally regulated products will be allowed. The entire project is accompanied by an independent scientific study evaluating its impact on public health, crime, safety, and public order. 

What Europe Can Learn 

A clear pattern is emerging in both countries: a pragmatic approach to cannabis policy that acknowledges social realities while prioritizing control, prevention, and consumer safety. In the Netherlands, producers are given time to scale up, while Switzerland is building on the experience from its pilot programs to draft a sustainable national policy. 

What lessons can Germany draw from this? First, that regulation is feasible — when planned and implemented thoughtfully. Second, that Europe is slowly but surely moving away from blanket prohibition. Instead, real-world models are being developed to show how responsible cannabis regulation can work. Switzerland and the Netherlands are showing the way. It’s time for Germany to take a closer look — and stop delaying the next phase of its own cannabis policy. 

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Review of the Political Debate 

Over the past year, discussions have centered on both the opportunities and challenges of the new law. A key question remains: Have the reforms led to tangible benefits for society and public health? Critics point to gaps in prevention efforts, concerns about youth protection, and potential burdens on the justice system and schools. Supporters argue that no alarming trends have emerged so far and highlight the positive effects of decriminalization, particularly for those previously stigmatized. Beyond public health, the economic impact is also significant. The medical cannabis industry continues to grow, with many mid-sized businesses successfully adapting to the new regulatory landscape. 

Medical Cannabis: Stability or Uncertainty? 

Medical cannabis access has improved with more doctors prescribing it and fewer bureaucratic hurdles for patients. However, challenges remain. Will the CanG stay in place as it is, or will further adjustments be made? The answer is critical for patients, healthcare providers, and businesses alike. 

A full rollback of the law would have major consequences—disrupting treatment for patients, creating uncertainty for doctors and pharmacies, and adding unnecessary bureaucratic complexity. However, targeted adjustments, such as refining enforcement tools to combat the illegal market, could be implemented without undoing the core reforms. 

Scientific Findings and the Road Ahead 

Early research offers some insights: Data from Stuttgart, for example, suggests no significant rise in cannabis use since the law took effect. But a comprehensive evaluation will take time. More data is needed to guide future adjustments based on real-world evidence. 

What’s Next? 

One year later, Germany has not only adapted to cannabis reform—it has proven resilient. Removing cannabis from the Narcotics Act was a crucial step in improving medical access and reducing stigma. The next phase is critical: Thoughtful decisions must be made to ensure progress continues, without political reversals that could undermine the positive developments achieved so far. 

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Last week, the German Pain and Palliative Care Days 2025 took place in Frankfurt. Among the numerous lectures and workshops, the use of cannabinoids was a recurring theme throughout the event. Approximately 14 million people in Germany suffer from chronic pain – a serious public health issue that severely affects daily life and is often associated with psychological burdens. It is all the more important that the use of cannabinoids in pain medicine continues to gain significance. 

Cannabinoids in Pain Therapy 

Cannabinoids work through the body’s endocannabinoid system by reducing inflammation, dampening nerve irritations, and influencing pain processing in the brain. In palliative care, they also alleviate nausea and improve sleep. 

Cannabinoids exert their effects through two main receptors. CB1 receptors, primarily found in the central nervous system, inhibit neurotransmitter release and reduce the perception of pain. CB2 receptors, primarily located in immune cells, contribute to anti-inflammatory effects by decreasing the release of pro-inflammatory cytokines. 

Cannabinoids as an Alternative or Complement to Opioids 

Studies have shown that cannabinoids can be used both as a complement to and an alternative to opioids. A 2017 patient survey with 2,897 participants reveals impressive results. 78% of respondents reported better pain reduction compared to pure opioid therapy, 88% found the side effect profile more favorable, and 97% were able to reduce their opioid dosage. These numbers highlight the potential of cannabinoids, particularly in minimizing opioid-associated risks like addiction and side effects. 

Regulatory Challenges and Future Outlook 

The motto of the congress was “Individualization instead of Standardization” – a reflection of how urgently we need to bridge the gap between scientific knowledge and the specific needs in pain therapy. Practical reports show that, despite growing acceptance of cannabinoid-based medications, doctors are often faced with strict regulations and complex procedures before they can issue prescriptions covered by statutory health insurance (GKV). 

Therefore, it is crucial to simplify the prescription processes and integrate cannabinoids more strongly into the established pain therapy guidelines. Only through targeted research and reducing regulatory barriers can we ensure that patients receive the best possible support they need. 

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What is the Endocannabinoid System?

The Endocannabinoid System (ECS) is a complex network of natural compounds, receptors, and enzymes present in the human body. It influences various physiological processes, including pain regulation, brain development, appetite, reproduction, and gut motility.[1] This system is found in nearly all living organisms—except insects—highlighting its essential importance for vital body functions. The ECS is named after the discovery that certain compounds from the cannabis plant, known as phytocannabinoids, can have effects similar to those of endogenous cannabinoids produced by the body. The primary psychoactive component of cannabis, Δ9-tetrahydrocannabinol (THC), binds to the same receptors as these natural substances.

Although the ECS was discovered in the 1960s, many of its functions remain incompletely understood. Its gender-specific effects, in particular, have not been adequately explored.

Why is the ECS Relevant for Women’s Health?

It is well established that the ECS is closely linked to hormonal processes. Studies show that it plays a role in regulating the menstrual cycle, fertility, and menopause.[2][3] The potential for treating female-specific conditions such as endometriosis, premenstrual syndrome (PMS), or chronic pain is particularly intriguing. The ECS could be a key to new therapeutic approaches; however, there are currently few targeted clinical studies examining medical cannabis for these indications.

A better understanding of the ECS is not only scientifically desirable but also urgently needed. Women are often overlooked in medical research, and many of their ailments remain underdiagnosed or inadequately treated. Medical cannabis could offer an alternative or complementary option, especially for patients who do not respond sufficiently to conventional therapies. Furthermore, women tend to experience chronic pain more frequently, which is one of the most common applications of medical cannabis. Therefore, it is even more important to investigate pain perception and the response to pain medication from a gender-specific perspective.[4]

Why We Need More Gender-Specific Research

On the occasion of this year’s International Women’s Day, it is time to bring this topic into sharper focus. A better understanding of the ECS could not only help to apply medical cannabis more effectively but also open new doors for personalized medicine. A gender-specific approach in cannabis research is long overdue.

[1] Fowler, C. J. (2010). Anandamide uptake explained? Trends in Pharmacological Sciences, 33(4), 181–185.
[2] Santoro, A., Mele, E., Marino, M., Viggiano, A., Nori, S. L., & Meccariello, R. (2021). The complex interplay between the endocannabinoid system and the estrogen system in the central nervous system and periphery. International Journal of Molecular Sciences, 22(2), 972. https://doi.org/10.3390/ijms22020972
[3] Di Blasio, A. M., Vignali, M., & Gentilini, D. (2013). The endocannabinoid pathway and the female reproductive organs. Journal of Molecular Endocrinology, 50(1), R1-9. https://doi.org/10.1530/JME-12-0182
[4] Schmerzgesellschaft. (n.d.). Schmerz bei Frauen und Männern. Abgerufen von https://www.schmerzgesellschaft.de/patienteninformationen/besonderheiten-bei-schmerz/schmerz-bei-frauen-und-maenner

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International Industry Meetings: Exchange at the Highest Level

Germany remains a key player in the European cannabis industry. The ICBC Berlin (April 29-30, 2025) is the leading international event for the German market, bringing together businesses, investors, and policymakers. Market developments are discussed here, partnerships are forged, and the next steps for the industry are shaped.

Focusing on the medical sector, the Medical Cannabis Congress (June 12-13, 2025) in Berlin provides a dedicated platform for physicians, scientists, and pharmacists to discuss the latest advancements in cannabis therapy.
Similarly, the German Pain and Palliative Care Congress (March 12-16, 2025) in Frankfurt will explore the role of medical cannabis—especially in pain management, which has gained new momentum following regulatory changes last year.
The discussion on Europe’s cannabis market extends beyond national borders. In London, Cannabis Europa (June 24-25, 2025) will focus on regulatory developments, economic opportunities, and industry challenges across the continent. This event is particularly relevant for companies and investors looking to expand internationally.

Germany as a Hub for Cannabis Events

Germany continues to establish itself as a central hub for cannabis events. Mary Jane Berlin (June 19-22, 2025) remains one of Germany’s largest hemp fairs and is unique in covering all aspects of the industry: adult-use cannabis, CBD, industrial hemp, and medical cannabis. The event attracts tens of thousands of visitors annually—including consumers, activists, and businesses—making it a key meeting point for the entire industry.

For professionals in the pharmaceutical industry and the pharmacy sector, Expopharm in Düsseldorf (September 18-20, 2025) is an essential event. With a growing focus on medical cannabis, the role of pharmacies in patient care is becoming increasingly significant. This trade show serves as a key platform for stakeholders involved in the distribution, prescription, and application of medical cannabis.

Looking Beyond Borders: Global Highlights

For those looking to connect with the international cannabis industry, MJBizCon in Las Vegas (December 2-5, 2025) is an unmissable event. As the world’s largest cannabis trade show, it attracts tens of thousands of attendees from all sectors of the industry—from producers and brand developers to investors and policymakers.

The Future of Cannabis: What Lies Ahead in 2025

The cannabis industry remains in motion, and 2025 promises to be a year of exciting developments. The range of upcoming events highlights the industry’s dynamism and innovative potential—both in Germany and globally.

Whether it’s regulatory milestones, medical breakthroughs, or new business models, the coming months will be pivotal. We look forward to following these developments with you and engaging in discussions at one of these key events.

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Telemedicine: An Opportunity or a Challenge?

While medical cannabis is becoming increasingly destigmatized, some telemedicine services have recently come under scrutiny. In particular, concerns have been raised about the practice of issuing prescriptions based solely on an online questionnaire without direct doctor-patient interaction, raising fears of misuse. However, it is important to recognize that telemedicine has become an integral part of healthcare in many areas, offering enormous benefits to countless patients.

Telemedicine allows for quick and convenient medical consultations — especially in rural regions where specialist shortages are a pressing issue. For chronically ill patients who rely on continuous treatment, digital access to healthcare can be a major relief.

At the same time, concerns about compliance with existing regulations and quality assurance are valid. However, rather than questioning telemedicine as a whole, the discussion should focus on how to ensure proper enforcement of existing rules to safeguard both patient protection and the integrity of medical care.

A Balanced Perspective on the Debate

This debate highlights that a targeted regulatory response should not be limited to medical cannabis alone but should consider telemedicine as a healthcare model in general. There are already established legal frameworks, such as the EU Patient Mobility Directive and the Medicinal Products Advertising Act (Heilmittelwerbegesetz – HWG), which set standards for safe and regulated cross-border access to telemedical services.

The concerns surrounding telemedicine demonstrate that new digital healthcare models are not inherently problematic but require clear guidelines to ensure safe and high-quality applications. Medical cannabis is not the only field where telemedical services are playing an increasingly important role—this issue affects the entire healthcare sector.

Regulate Telemedicine Sensibly, Not Demonize It

The political debate should focus on how telemedicine can be responsibly utilized rather than portraying it as a problem in itself.

A rational, solution-oriented discussion is needed—one that involves patients, doctors, and policymakers alike.

Modern, digital healthcare solutions offer substantial benefits—not just for medical cannabis but for numerous other prescription medications.

The key challenge is to strengthen and enforce existing regulations while further developing policies that ensure quality and safety for all patients.

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With the first issue of the new year, we spotlight a forward-looking topic: research projects on recreational cannabis. While such studies have been underway in Switzerland for about a year (see the Cansativa Experts’ Dialogue), Germany opened the door for research applications on December 11. Despite positive experiences in Switzerland, this endeavor remains new territory in Germany, leaving many questions unanswered.   

The Role of Research in the Cannabis Act 

The Cannabis Act (CanG), effective since April 2024, provides the legal framework for scientific investigations into recreational cannabis use. The goal is to gather data-driven insights to better understand its impact on consumers, markets, and society. This represents a rather conservative approach designed to ensure evidence-based policymaking before implementing extensive regulatory changes.   

Diversity as the Key to Insight 

No single model can fully capture the complexities of cannabis consumption and markets. This is why research projects focus on diverse approaches and distribution models. Different regions and cities will test measures aimed at protecting youth, safeguarding health, and reducing the illegal market. This diversity is crucial to gaining insights into societal, health, and economic impacts. Particularly, analyzing market potentials and demand structures can shed light on how regulated distribution channels affect the illicit market.   

A Starting Point for Research 

The release of the new Cannabis Research Regulation in mid-December marks the beginning of a new phase (more details in the BMEL press release). Municipalities, scientific institutions, and other stakeholders can now submit their proposals. The responsible authority will determine which projects move forward. Cities such as Hanover, two Berlin districts, and Frankfurt have already expressed interest, highlighting the strong demand for robust data. Cansativa, too, is planning a model project in the Groß-Gerau district, focusing on pharmacy-based distribution (see the press release for more details).   

More Than an Experiment – A Foundation for Future Decisions 

Cannabis research projects are far more than mere experiments. They provide a foundation for regulation that considers both health and societal aspects. By testing and analyzing diverse approaches, reliable data emerges to inform responsible policymaking.   

It is now up to all stakeholders—society, researchers, and policymakers—to seize this opportunity. Together, we can lay the groundwork for informed and forward-looking cannabis regulation.   

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The year 2024 has been a milestone for the cannabis industry in Germany. The removal of medical cannabis from the Narcotics Act and the launch of Pillar I have enabled significant progress. More recently, the release of the decree on cannabis research has opened new perspectives and provided greater planning certainty for scientific endeavors. However, the political landscape ahead of the federal election in February 2025 is causing nervousness within the industry. In this briefing, we look back at the past year and take a glimpse into the future: How will the election shape the future of cannabis regulation? 

What’s at Stake? 

The federal election is a pivotal moment for the industry. The Union party has repeatedly announced plans to roll back the Cannabis Act that has been in effect since April, often without drawing a clear distinction between recreational and medical cannabis. Such a rollback could not only halt legal recreational use but also jeopardize advancements in the medical cannabis sector – such as the simplifications in prescriptions for doctors and patients. 

At the same time, the Union has historically emphasized the need for secure access to medical cannabis. It remains critical to ensure and expand the achievements that have been steadily made since the legalization of medical cannabis in 2017. 

Scenarios for 2025: Progress or Regression? 

A conservative-led government could undo previous progress. This would not only destabilize the industry but also present new challenges for patients and consumers. A clear commitment to stable and reliable regulatory conditions would provide the industry with the planning security it needs. This could lead to increased investment, secure jobs, and Germany’s continued growth as an innovation hub for medical cannabis. 

A Look Abroad 

International developments demonstrate that the acceptance of cannabis as medicine continues to grow, with regulatory frameworks being adjusted in many countries. Denmark, for example, has been running a successful pilot program for medical cannabis since 2018. Initially planned as a temporary project, the Danish government recently decided to make the program permanent. The Czech Republic is also taking a significant step forward: From 2025, general practitioners will be allowed to prescribe medical cannabis for the first time. This decision is part of a broader plan aimed at improving access to medical cannabis and enhancing patient care. This approach could pave the way for broader societal acceptance and expand therapeutic opportunities. 

Germany has the potential to benefit from these international developments. The growing demand for medical cannabis, combined with Germany’s strong position as an exporting nation, offers enormous opportunities. However, long-term and reliable regulatory conditions are essential to strengthen the industry and remain competitive on a global scale. 

A Shared Goal 

The past years have shown how important collaboration and exchange between patients, doctors, pharmacies, and businesses are. Only through united efforts can we ensure that the industry is not set back to pre-April 2024 levels. The federal election will set the course for the future. 

As the year comes to an end, we want to extend our heartfelt thanks to all readers of the Cannabis Briefing. 2024 was a year full of challenges and opportunities, during which we made important strides together as an industry. The upcoming elections will define 2025 – and we all have a role to play in ensuring that the progress of recent years is not lost. It’s up to us to continue advancing the cannabis industry with innovative ideas, strong community spirit, and tireless dedication. 

With this in mind, we wish you and your loved ones a joyful holiday season, a happy New Year, and many bright moments ahead. Let’s approach 2025 with confidence and determination! 

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Since the legalization of medical cannabis in Germany in 2017, the industry has seen rapid growth. Yet, while some describe the current phase as a “Green Rush,” reminiscent of developments in the United States, others wonder whether the market is already moving toward consolidation. This debate is becoming increasingly relevant against the backdrop of political uncertainties and regulatory changes.

Understanding the “Green Rush”

The term “Green Rush” originated in the United States in 2012 when Washington and Colorado became the first states to legalize cannabis. This economic surge attracted entrepreneurs and investors eager to seize new market opportunities, drawing comparisons to the historical Gold Rush. Similarly, in Germany, the cannabis industry experienced significant momentum, especially following the removal of medical cannabis from the Narcotics Act (BtMG) in April 2024. This reform not only simplified the prescribing process and reduced bureaucratic barriers but also fueled industry growth.

From Disillusionment to Renewed Momentum

When Germany’s coalition government announced plans for comprehensive cannabis legalization in its 2021 coalition agreement, it sparked enthusiasm and optimism across the industry. Many businesses began preparing for a rapidly expanding market that would encompass both medical and recreational cannabis.

However, by late 2022, it became increasingly evident that the proposed legalization would not materialize as initially envisioned. Industry expectations were tempered, leading to a sense of disillusionment. Some observers even predicted an impending consolidation.

These concerns were alleviated with the removal of medical cannabis from the Narcotics Act in April 2024, which opened up new growth opportunities. Yet, challenges remain: the implementation of commercial supply chains (Pillar II) is urgently needed to adequately support the now-legal recreational market while maintaining clear separation from medical use.

Regulatory Uncertainty and Political Challenges

Today, the German cannabis market remains dynamic and continues to grow. Insights shared at the Executive Summit in Berlin two weeks ago highlighted key challenges and opportunities. For instance, only 20% of the population currently knows that medical cannabis is available as a treatment option. Raising awareness and destigmatizing cannabis remains essential to unlock the market’s untapped potential. At this stage, collaboration between industry players is more important than competition. Joint efforts are needed to educate the public and foster market development.

The consensus among experts is clear: it is too early for consolidation. The market remains vibrant, with room for innovation, growth, and new entrants. However, the looming federal election has created uncertainty about the future of cannabis regulation. The past has demonstrated that stable regulatory frameworks are critical for sustained market growth. Germany’s medical cannabis sector is still young and requires long-term perspectives to provide much-needed planning security. The upcoming government transition raises the question of whether recent progress will be preserved or if the market risks being rolled back to its state before April 1, 2024—a scenario that would create significant challenges for both the industry and patients.

A look abroad reveals a noticeable global shift in attitudes toward cannabis. In many countries, cannabis is increasingly being recognized as a legitimate medical treatment, leading to a globally rising demand. Germany has the potential to remain a leader in Europe. The coming months will be crucial in shaping the path toward a stable and innovative future for the German cannabis industry.

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