5 Years of Legalization of Medical Cannabis in Germany: What Is the Result?

Germany has implemented limited medical cannabis availability for the last five years after the signing in of amendments to the Narcotics Law (BtMG) and the Narcotics Prescription Ordinance (BtMVV) in 2017. In that time, German medical cannabis patients have grown to over 100,000. However, access to cannabis is still extremely strict, and doctors must seek approval before starting treatments.

Five years ago, the Bundestag paved the way for prescription cannabis in Germany. Since then, doctors can prescribe medical cannabis to patients with serious diseases in the absence of any alternative therapy.

About 100,000 patients in Germany are currently treated with cannabis according to the latest estimates, 100 times more than before the legalization in Germany when 1,000 patients had an exemption from the Narcotics Act that allowed them to benefit from access to Dutch medical cannabis.

While the exact way things will develop from this point forward is still somewhat uncertain, one thing we do know is that as soon as news breaks, we will cover it here and in our free-to-download cannabis news app.

The Medical Cannabis System in Germany

With the March 2017 amendments to the Narcotics Law (BtMG) and the Narcotics Prescription Ordinance (BtMVV) in Germany, cannabis flowers and extracts, as well as pharmaceutical preparations such as dronabinol, can be prescribed on a dedicated narcotics prescription at the expense of health insurance.

Patients with serious illnesses are entitled to medical cannabis. Doctors must obtain the approval of the health insurance company before starting the treatment, which can only be refused in justified exceptional cases. Patients in Germany are entitled to a maximum of 100g of flowers for 30 days or 1g of pure THC in the extract.

The country is supplied almost exclusively from abroad, as national production licenses have taken their time to be granted. Cannabis imports in Germany have thus increased by 75% between 2020 and 2021 to about 30 tons per year, mixing flowers and extracts.

The Constraints to Be Solved

The market in Germany is now the largest European market for medical cannabis, pending France. On the supply side, in 5 years, the supply of medical cannabis has expanded: there are now about 150 varieties and 60 different extracts available on the German market. In addition to the difficulties of supply which rely on the importation of non-negligible quantities of narcotics, patients still have difficulties in accessing cannabis.

The treatment of medical cannabis by a doctor is not always simple. There is no single form of therapy for all patients, who require individual and increased follow-up. The training of health professionals plays an important role in the accessibility of medical cannabis. If German doctors have additional training in “special pain therapy” or are trained in “palliative medicine”, they can now more easily prescribe medical cannabis products to their patients after a 20-hour training session and continuous learning.

Medical cannabis also weighs heavily on health insurers in Germany. Imported, often sold to pharmacies by wholesalers who raise the final price of the drug, it is charged nearly 3 times the price of medical cannabis in the Netherlands, a significant financial burden for health insurance companies that reimburse patients for the drug.

Will the future legalization of cannabis for adults in Germany open up access to medical cannabis or will it instead cause a shortage of available cannabis? See you in Germany in 5 years for the answer.

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(Photo by Maheshkumar Painam on Unsplash)

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