Briefing

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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Best wishes from both of us,

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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Best wishes from both of us,

On Thursday, November 14, 2024, we hosted our exclusive event “Yes, we can Cannabizz” in Berlin—a gathering that brought together top leaders from the cannabis industry, medical professionals, patients, and pharmacists. With nearly 100 guests, the event provided a unique platform to explore the opportunities and challenges facing both the German and international cannabis markets.

For those who couldn’t attend, here’s a recap of the day’s highlights. Against the backdrop of political uncertainty and an impending government transition, the event underscored one clear message: collaboration across all stakeholders is essential to safeguard the progress made over the past months and actively shape the future of medicinal cannabis in Germany.

Event Highlights

Yes, we can Cannabizz: Berner, CEO of Cookies, and Transatlantic Perspectives

The event kicked off with a compelling business panel featuring Berner, founder and CEO of Cookies, alongside Jakob and Benedikt Sons from Cansativa Group. Moderated by Bijan Hezarkhani, the discussion offered attendees an exclusive look into the experiences of a global cannabis market leader. Since its founding in 2010, Cookies has operated across diverse international markets, navigating varying regulatory landscapes in both the medicinal and recreational sectors.

Berner emphasized the importance of quality, innovative genetics, and a patient- and consumer-focused approach as cornerstones of long-term success. His insights resonated deeply with Germany’s young and evolving cannabis industry, offering a roadmap for sustainable growth and stability. As the world’s most successful cannabis brand, Cookies set a benchmark for innovation and excellence.

Having Berner in Berlin to share his journey was a rare privilege and an inspiration for all in attendance. We thank him for joining us and providing invaluable insights that will guide the industry forward.

Yes, we can help: 200 Days of the New Cannabis Law – What’s Changed?

The second panel explored the medical landscape under the new legislation. Moderated by Bertan Türemis (Fette Pharma), the discussion brought together leading experts, including Prof. Dr. med. Kirsten R. Müller-Vahl (Medizinische Hochschule Hannover), Melanie Dolfen (Bezirksapotheke), Gero Kohlhaas (Selbsthilfenetzwerk Cannabismedizin), and Finn Age Hänsel (Sanity Group).

Since the introduction of the Medicinal Cannabis Law (MedCanG) in April 2024, several critical improvements have been made. Removing medicinal cannabis from the Controlled Substances Act has simplified prescribing processes, strengthened doctors’ autonomy, and significantly reduced administrative burdens. However, the panelists agreed that there’s still much work to be done.

The absence of Pillar II, which would establish commercial supply chains, continues to hinder the clear separation between medical and recreational cannabis use. Prof. Müller-Vahl highlighted this gap:

“Without Pillar II, the supply gap persists. Commercial structures are essential to combat the black market effectively and protect both patients and consumers.”

Adding to the industry’s concerns is the political uncertainty surrounding the upcoming government transition. The Union’s pledge to roll back parts of the cannabis legalization framework has caused widespread unease. Finn Age Hänsel voiced his worries:

“A coalition with the Union would be the worst outcome for us. They’ve already signaled their intent to stop legalization, and the SPD likely won’t push back enough.”

Yes, we can all benefit: Exploring Cannabis Quality Under the Microscope

The day concluded with an engaging workshop led by Yordanka Caglar from Tiergarten Apotheke Konstanz. Attendees had the opportunity to analyze various cultivars of medicinal cannabis under the microscope, examining quality indicators such as color, aroma, and terpene profiles. The workshop reinforced the importance of rigorous quality assurance in maintaining trust and meeting patient needs. High standards are essential for building confidence in medicinal cannabis as a therapeutic option.

The “Yes, we can Cannabizz” event demonstrated the power of collaboration and dialogue within this dynamic and growing industry. We thank all speakers and attendees for making this day a memorable one. Together, we are poised to navigate the challenges ahead and continue building a stronger, more resilient cannabis sector.

Explore more moments from ‘Yes, We Can Cannabizz’ in our picture gallery. View Gallery

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Clinical Studies for Improved Therapy

Clinical studies are crucial to understanding the effects of medical cannabis on conditions like chronic pain, epilepsy, and multiple sclerosis. These studies establish a scientific basis that can inform medical decisions and guide therapeutic approaches. A recent study on multiple sclerosis indicates improved quality of life with cannabis therapy, especially in physical and mental health. In palliative care, daily THC doses of 5 mg have shown potential to extend the quality and duration of life in seriously ill cancer patients.

Research also shows promising results in treating endometriosis symptoms. A European study with over 900 participants found that cannabis eased sleep disturbances, pelvic pain, and menstrual cramps. Notably, nearly 90% of patients could reduce traditional pain medication with cannabis, highlighting its potential as an alternative therapy. These clinical studies improve treatment options and help reduce biases within the medical field, promoting cannabis as a credible option in healthcare.

Preclinical Research for New Applications

Parallel to clinical studies, preclinical research is vital for exploring the biological mechanisms and potential new applications of cannabis. Compounds like CBD and THC are studied in laboratory settings to understand their interactions with the human body. This research lays the groundwork for expanding therapeutic uses and refining safety profiles. For example, a study by the University of Bonn showed in mice that low-dose THC administration might slow brain aging processes. An Australian study examined the effects of specific cannabinoids on inflammation and neuroprotective properties, particularly related to neurodegenerative diseases like Alzheimer’s. The findings suggest that cannabinoids can reduce inflammatory markers and prevent nerve cell damage in preclinical models. Such findings provide the foundation for new therapeutic approaches, though clinical trials in humans are needed to confirm these effects.

Studies on Destigmatization and Education As discussed in previous briefings, Switzerland has already launched several scientifically supervised pilot projects examining the impact of regulated cannabis sales on consumption behavior. These findings help differentiate the cannabis discourse and reduce societal prejudices. In Germany, the legal foundation for cannabis regulation has been established with the new Cannabis Act (CanG); only the responsible authority remains to be appointed.

Research in all its forms is key to advancing both medical and societal progress in cannabis. This diversity in research underscores the value of scientific insights for destigmatization, therapeutic application, and social acceptance. Through ongoing studies, cannabis’s potential can be optimally utilized, paving the way for evidence-based regulations.

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US-Regulation today

Currently, cannabis remains illegal under federal law as a Schedule I drug, but state-level policies vary. Twenty-four states and D.C.—covering 53% of the population—have legalized cannabis for recreational use, while 38 states permit medical use. This disparity creates a complex legal landscape, often leading to excessive tax burdens and limited access to banking services for cannabis retailers. However, the upcoming election may change policies beyond US borders.

What’s on the Line for Cannabis Regulation?

For the first time, both major presidential candidates have shown support for a significant change in federal cannabis policy. This bipartisan shift suggests that regardless of who wins, the US may be inching toward a more unified approach to cannabis regulation. Voters in Florida, North Dakota, South Dakota, and Nebraska will also have a direct say in cannabis legalization through ballot measures, signaling the growing momentum for reform across the country.

Kamala Harris’s Position

Kamala Harris has been a prominent advocate for cannabis reform. In 2019, as a senator, she was the lead sponsor of the Marijuana Opportunity Reinvestment and Expungement (MORE) Act, a bill aimed at descheduling cannabis that would remove cannabis entirely from the Controlled Substances Act (CSA). Although it did not pass the Senate, this showcases how Harris’s stance on cannabis has evolved significantly over time. In 2010, as California’s Attorney General, she opposed a state measure to legalize recreational cannabis. And ten years later, she was advocating for complete federal legalization. Currently, as Vice President, Harris leads discussions on criminal justice and cannabis reform within the Biden administration, focusing on rescheduling cannabis under a less strict section of the CSA.

Donald Trump’s Position

Donald Trump’s position on cannabis has been more inconsistent. He supports the idea that the legalization of recreational cannabis should be left up to individual states and recently stated he would vote for Florida’s ballot measure to legalize it. Trump has also endorsed the rescheduling of cannabis under the CSA, aligning this aspect of his stance with the Biden administration’s current efforts. However, Trump’s approach to medicinal cannabis has been somewhat ambiguous. While he stated in 2016 that he “likes” cannabis when used for medicinal purposes and believes its health benefits should be explored further, he has also expressed doubts about its effectiveness, claiming it might do “significant damage.” Moreover, during his presidency, his administration took several anti-cannabis actions, including rescinding an Obama-era policy that directed federal officials not to pursue cannabis-related prosecutions in states where the drug is legal.

Rescheduling Uncertainty: Potential Ripple Effects on European Cannabis Policies

Rescheduling cannabis would be a significant reform but not equivalent to full descheduling. President Biden has acknowledged that rescheduling at the federal level is “not a done deal.” While the Justice Department proposed moving cannabis to Schedule III, the final decision lies with the DEA, with a public hearing scheduled for December 2. This uncertainty has weakened investor confidence. If rescheduling stalls, barriers to medical research and commercial activities will persist. Federal reclassification could also influence European policies, prompting countries to reconsider regulations and impacting trade, research, and legal frameworks, given the US’s role in the global cannabis market.

This election could mark a turning point for cannabis regulation, not just in the US but across the globe, as countries closely watch how the evolving American stance might shape the future of cannabis policy worldwide.

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1. What is Grashaus Projects, and who is behind it?

Grashaus Projects is a pilot initiative in the Swiss canton of Baselland, designed to study the legal distribution of cannabis and its impact on participants’ health and well-being. The project aims to determine whether legal cannabis distribution, combined with professional advice through our retail model, can promote safer use. We operate two dispensaries in Allschwil and Liestal, with space for up to 4,000 participants—about 1,000 have registered so far. The study, running for up to five years, has specific criteria for participation: participants must live in Baselland, be of legal age, meet certain health requirements, and already be regular cannabis users. The project is supported by the Sanity Group in collaboration with the Swiss Institute for Addiction and Health Research (ISGF) in Zurich, , which is responsible for the scientific part of the project. Importantly, the project is non-profit, with all proceeds reinvested in cannabis research or addiction prevention or donated.

2. What are the goals of the project?

The Grashaus Project, like the other Swiss pilot projects, seeks to explore whether and how legalization in Switzerland can create value. The goal is to test different models of legal cannabis distribution, scientifically monitor participants’ consumption data, and prioritize consumer protection and harm reduction. Additionally, we aim to promote safer use and destigmatize cannabis, moving it out of the “taboo” category and integrating it as a normal part of society. We hope to support a responsible and value-driven approach to legalization.

3. What challenges did you encounter during implementation?

The biggest challenge was working with the authorities, particularly the Federal Office of Public Health (BAG), as our key stakeholders. The approval process was lengthy and required a lot of patience due to numerous questions and adjustments. This can be a significant hurdle, especially for smaller organizations with limited resources. Gaining acceptance within the local community was also crucial, and we had to work hard to garner support. Additionally, reaching potential participants has been challenging, given the strict rules on how the study can be communicated.

Another aspect we’ve observed is that the pricing of the products can be a challenge and is not always seen as an attractive alternative to the illegal market. Some consumers find the prices too high, especially compared to cheaper offers from dealers who often provide bulk discounts. Such pricing promotions are not possible in our studies, as they could encourage consumption. The higher prices are partly due to higher production costs and the fact that only a few domestic growers are licensed, limiting the selection. It’s also challenging to introduce new products into the study, which restricts product variety. Many cannabis enthusiasts enjoy trying new strains, and due to the pricing and limited selection, some participants may turn back to the illegal market.

4. What initial insights or trends have you observed?

After the first six months, we conducted an interim evaluation. We found that participants previously consumed cannabis from illegal sources on 20 days per month, but now it’s down to 10 days—a halving of illegal use, which we see as a positive trend. Interestingly, flower consumption is slightly declining, while the use of extracts has increased by 50%, which is positive as these products are not smoked and fall under safer use products. High-THC products remain the most popular, likely due to habits from the illegal market, where high THC levels are often advertised but rarely achieved.

5. What learnings could be valuable for Germany’s legalization efforts once model projects are allowed there?

What has been done well and what Germany should definitely adopt is the testing of various distribution models. In Germany, this could be done through social clubs, pharmacies, specialty stores, and possibly even consumption lounges, similar to coffee shops—something that is not possible in our pilot project. This approach would best identify which models most effectively promote education, safer use, and consumer protection.

I also hope that Germany, like Switzerland, allows not only the sale of flowers and hashish but also edibles, oral extracts, vape pens, and possibly products like rosin, which are currently not permitted in Switzerland. The demand is there: many people want to try alternative consumption methods, move away from tobacco, and use products that are gentler on their lungs.

Another point is the sourcing of products. In Switzerland, all products come from licensed domestic growers, which limits the selection since imports are not allowed. To create a viable alternative to the illegal market, Germany should allow more flexibility, whether through the import of cannabis from international producers or by making it easier for smaller growers to obtain licenses. This would increase product variety and enhance the attractiveness of legal offerings.

Another positive aspect is the enrollment process for the study. I believe it’s very important to establish and verify participation criteria because, at the end of the day, it’s about protecting and prioritizing the health of the participants.

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Czech Republic’s Progressive Cannabis Reforms

The Czech Republic is advancing cannabis reforms under the “Cannabis Management Act,” with plans for personal cultivation, licensed dispensaries, and a seed-to-sale tracking system. A leaked draft of the bill revealed that it goes further than Germany’s model by proposing a fully regulated cannabis market. However, the recent resignation of Jindřich Vobořil, the reform architect, has raised concerns about its implementation. Despite this, the bill is still seen as a major development in EU cannabis regulation.

The Netherlands’ Experiment with Legal Cultivation

The Netherlands, known for its tolerance of cannabis, still has limited legal production and distribution systems. In late 2023, the Controlled Cannabis Supply Chain Experiment began to assess whether the production, distribution, and sale of quality-controlled cannabis could be regulated. The experiment aims to study the impact on crime, safety, and public health. Despite challenges like supply shortages, the experiment expanded to eight additional cities this summer. The “Wietexperiment” is expected to continue until 2028.

Malta’s Cannabis Associations

Malta’s cannabis reform came into effect in 2021, and the first nonprofit cannabis clubs began providing products to members earlier this year. While cannabis possession (up to 7 grams and 4 plants) is decriminalized, full legalization has not been enacted. Cannabis can only be accessed through regulated, nonprofit associations, with strict limits on purchase amounts. Each club can serve up to 250 members and must adhere to guidelines overseen by the Authority for the Responsible Use of Cannabis (ARUC). New amendments were introduced emphasizing product safety, including requirements for indoor or greenhouse cultivation, quality control for water sources, and enhancing community involvement through nonprofit associations. There are currently eight clubs operating.

Switzerland’s Pilot Programs

Switzerland’s cannabis laws remain strict, but recent pilot programs are exploring regulated access. These pilot trials, launched in 2022, allow a limited number of participants to legally buy and consume cannabis under strict regulations, aimed at studying the effects of legal cannabis on public health and crime. The findings are meant to inform future cannabis policies, focusing on harm reduction and controlled safer consumption methods. By now six pilot projects are operating in different cities with diverse approaches and can already present initial findings.

Challenges and Opportunities

Across Europe, cannabis reform is a topic of increasing public and political debate. While Germany and Malta have made concrete legislative changes, others, such as Switzerland and the Netherlands, are in the experimental stages. Regulatory challenges persist, especially regarding supply chain management, product quality control, and ensuring that legal markets can outcompete the black market. The ongoing shifts in European cannabis policy signal that the continent is moving towards a more progressive and regulated future, though each country’s approach is unique.

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Background of the decision

For those who might not recall: In July 2023, the German Bundestag passed the Engpassgesetz (ALBVVG1), which, among other things, defined that certain specialist doctors should be excempted from the so-called Genehmigungsvorbehalt. This prior approval requirement meant that health insurance companies had to approve the prescription for reimbursement beforehand. The G-BA was tasked with defining specialist groups and the necessary medical qualifications , that would no longer require prior approval (Genehmigungsvorbehalt) from health insurance for prescribing medical cannabis.

In November, the G-BA published a draft and consulted various stakeholders for feedback. Several associations called for completely abolishing the Genehmigungsvorbehalt or at least including general practitioners, who are the second largest group of prescribers. They play a crucial role in the current patient care landscape with cannabis medicines, especially in rural areas, and considering the growing shortage of specialists.

Implementation and Impact

While the Committee took their time, the decision was more positive than originally anticipated. Doctors from 16 specialties, including general medicine, anesthesiology, internal medicine, neurology, and psychiatry, can now prescribe medical cannabis without prior health insurance approval at GKV expenses. Five additional qualifications, such as geriatrics, palliative medicine, and specialized pain therapy, are also included. The G-BA ensured that the feedback from the consultation period was considered and selected those specialists who can best assess the requirements for a cannabis prescription.

This change empowers a large number of German medical practitioners to prescribe medical cannabis more freely and less bureaucratic. The decision eliminates the cumbersome approval process from health insurance companies, significantly reducing the administrative workload for doctors. As a result, patients can expect faster access to necessary treatments.

Documentation and Compliance Remain the Same.

It is important to note that while the process for doctors to prescribe medical cannabis at the expenses of the GKV has been simplified, the requirements for a cannabis prescription to be reimbursed by health insurance have not changed. Patients in Germany have a statutory right to medical cannabis if they have a life-threatening illness or a serious condition that significantly impairs their quality of life. Additionally, a series of conditions must be met. Therefore, doctors must still carefully document the prescription of medical cannabis, including the indication, treatment course, and achieved therapy results.

Patient Advocacy Pays Off

This decision is thanks to the long-standing efforts of stakeholders who have highlighted the issues faced by severely ill patients waiting for health insurance approval. Their persistent advocacy has been instrumental in driving this change. The decision marks a significant shift towards the normalization of medical cannabis in the healthcare system, potentially increasing its acceptance and integration into standard medical practice.

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Self-Medication Through Self-Cultivation? A Historical Perspective

The idea of self-medicating with home-grown cannabis is far from new. There was a time when this was the only option for many patients facing a lack of alternative therapies. Take, for instance, the landmark case of an MS patient who was acquitted of illegal possession and cultivation of cannabis because he had no other therapeutic options. This case played a pivotal role in paving the way for the legalization of “cannabis as medicine” in Germany, eventually in 2017.

Since then, Patients can obtain cannabis via prescription, ensuring product safety and quality, and significantly enhancing medical care. Furthermore, as of April 1, with the new Cannabis Law (CanG), medicinal cannabis saw additional regulatory relaxations, making it no longer classified as a narcotic and available through standard prescriptions.

Administrative Relief and Destigmatization

Pharmacies have experienced significant relief with the removal of cannabis from the Narcotics Act. Cannabis no longer needs to be stored in safes, and the cumbersome documentation requirements for narcotics have been lifted. These changes save time and reduce administrative burden. However, medical cannabis remains a prescription drug, that requires identity and plausibility checks in the pharmacy. Such controls are essential to ensure patients receive high-quality and safe medication. Cannabis flowers are also analytically tested by manufacturers to detect and prevent unwanted contamination.

The partial legalization has also helped to destigmatize the topic of cannabis in the public eye. Cannabis is increasingly seen as medicine and not just a recreational substance. This is an important step in reducing stigma and recognizing cannabis as a legitimate therapeutic option. The increased public attention has helped to improve understanding and acceptance of medicinal cannabis.

Challenges Ahead: Separating Medicinal and Recreational Cannabis

But with the partial legalization of recreational cannabis, some new challenges have emerged. Many healthcare practitioners worry that the medical significance of cannabis might be overshadowed by its recreational use. There is concern that patients might opt for self-medication through home or club cultivation, potentially compromising their treatment.

Self-therapy with cannabis without medical supervision can lead to inadequate treatment of symptoms or underlying conditions. Wrong dosages and usage frequencies can cause interactions and side effects, risking patient health. Additionally, medicinal cannabis is subject to the specifications in the EU monograph, which ensure the active ingredient content, purity, and absence of contaminants. These standards protect patients and guarantee therapeutic efficacy.

While homegrown or club-grown cannabis is likely safer than from the illicit market, it is not intended for medical treatment and can pose health risks such as microbial contamination, especially for immunocompromised individuals. Not only the product quality itself is essential but usage also differs significantly. Patients typically take cannabis daily for medicinal purposes, use various administration routes, and apply controlled, low doses to alleviate their symptoms. They often suffer from poor physical health, psychological well-being, and overall life quality. Their primary goal is symptom relief rather than getting high, which is the main difference from recreational users who use cannabis mainly for pleasure, relaxation, and social effects.

The Path Forward

As we navigate this new landscape, it is crucial to maintain a clear distinction between medicinal and recreational cannabis. Ensuring stringent quality controls and medical supervision for medicinal cannabis will protect patient health and uphold the therapeutic benefits of this versatile plant.

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We wish you a good read!

With legalising greetings,