Legal Development: Cannabis as Medicine in Germany
The legal landscape around medical cannabis in Germany has changed fundamentally in recent years. Since March 2017, doctors can order cannabis on prescription if conventional therapies are not sufficiently effective or are not tolerated.
With the entry into force of the Cannabis Act (CanG) in April 2024, cannabis was removed from the BtMG. Medical cannabis has since been prescribed on a normal recipe, no longer on a drug formulation. This significantly simplifies the prescription process.
For patients this means: access to medical cannabis has become easier, but the medical prescription remains linked to medical conditions. Cannabis is not a lifestyle product, but a medicine that is used therapeutically for certain complaints.
What complaints does medical cannabis come into question?
Medical cannabis is used for various complaints, especially if conventional therapies were not sufficiently effective or were not tolerated:
Chronic pain: This is the most common indication. Especially in neuropathic pain, fibromyalgia and chronic pain conditions that do not respond sufficiently to standard therapies, cannabis can be an option.
Spastics in multiple sclerosis: Cannabis-based medicines can reduce spasticity and improve quality of life. There are also approved prefabricated medicinal products.
Nausea and vomiting in chemotherapy: If conventional anti-emetics do not work enough, medical cannabis can be a complementary option.
Loss of appetite and weight loss: In severe diseases such as HIV/AIDS or cancer, cannabis can promote appetite and counteract weight loss.
Sleep disorders: In case of chronic sleep disorders that do not respond to other therapies, cannabis is used in some cases as an alternative.
Important: The suitability is always assessed individually and in individual cases by the attending physician. There is no automatic commitment to a specific diagnosis.
Forms of cannabis drugs
Medical cannabis is available in various forms of administration:
Cannabis flowers: Dried flowers of various varieties inhaled by vaporizer (evaporator). The effect occurs within minutes, which allows precise dosing. Different varieties have different THC and CBD levels.
Cannabis extracts: Standardized extracts taken orally, for example as drops. They offer a more uniform dosage than flowers and a longer duration of action.
Finishing products: Approved drugs based on cannabis, such as dronabinol (synthetic THC) or nabiximols (mouth spray). These have the advantage of a standardized dosage and clinically tested efficacy.
CBD preparations: Cannabidiol (CBD) is not psychoactive and is used in epilepsy, anxiety disorders and inflammation. Epidyolex is indicated for certain epilepsy forms.
The choice of suitable form depends on the indication, patient preferences and medical assessment.
The path to cannabis recipe
The medical cannabis prescription process comprises several steps:
1. Documentation of previous therapies: Keep in mind which treatments you have tried so far and why these were not sufficient. The better the documentation, the easier the medical assessment.
Two. Medical consultation: A doctor assesses your medical history, current complaints and previous therapy attempts. This can also be done by telemedicine. The doctor decides whether cannabis is a medically sensible option in your case.
3. Recipe exhibition: In the case of a positive assessment, the doctor will issue a prescription. Since the change in law in 2024, no BtM recipe is required, but a normal cash register recipe or private recipe.
4. Redemption in the pharmacy: The recipe is dissolved in a pharmacy. Some pharmacies specialize in cannabis medicine and offer a broader selection and expert advice.
Payment by the sickness fund: Legal health insurance funds may take over the costs under certain conditions, in particular if there are serious illnesses and conventional therapies are exhausted. A prior approval of the sickness insurance fund is required in many cases. Private recipes are redeemed at their own expense.
Important notes on cannabis therapy
Speed: Under the influence of THC-containing cannabis drugs, driving is restricted. Legal limits apply, and the individual reaction may vary. Check the question of driving skills with your doctor and find out about the current legal situation.
Quantities and dosage: The dosage is individually adjusted and usually starts low. A slow dose increase helps to minimize side effects and find the optimal dose. Separate dose adjustments should be avoided.
Side effects: Possible side effects include dizziness, oral dryness, fatigue, concentration disorders and also psychological effects such as anxiety or paranoia in high THC doses. Most side effects are dose-dependent and can be minimized by careful dosage.
Interactions: Cannabis can interact with various drugs, in particular with tranquilizers, blood thinners and certain heart medications. A complete indication of all taken medicines to the doctor is therefore essential.
