Accessing Medical Cannabis in Germany (Post-CanG)

To qualify for medical cannabis treatment in Germany, patients must have a qualifying medical condition and a prescription from a licensed physician. The Cannabis Act (CanG), which came into effect on April 1, 2024, has significantly altered the legal framework surrounding medical cannabis, removing it from the Narcotic Drugs Act (BtMG) and simplifying the prescription process. Here’s an overview of the current process:

Qualifying Medical Conditions:

While the CanG doesn’t provide an exhaustive list of conditions, medical cannabis can be considered when standard treatments are ineffective or insufficient for managing symptoms. This typically includes severe or chronic conditions that significantly impact quality of life. Examples of conditions where medical cannabis might be considered include (but are not limited to):

• Chronic pain syndromes (e.g., neuropathic pain, chronic non-cancer pain)
• Spasticity in multiple sclerosis
• Chemotherapy-induced nausea and vomiting (CINV)
• Anorexia and cachexia associated with cancer or HIV/AIDS
• Intractable epilepsy
• Tourette syndrome
• Inflammatory bowel diseases (e.g., Crohn’s disease, Colitis)
• Palliative care in advanced stages of terminal illnesses

It’s important to understand that this is not an exclusive list. Physicians can prescribe medical cannabis for other conditions if they deem it medically appropriate after a thorough assessment.

Medical Evaluation by a Licensed Physician:

Patients seeking medical cannabis treatment in Germany must undergo a comprehensive medical evaluation by a licensed physician. This evaluation includes:

• A thorough review of the patient’s medical history.
• Assessment of current symptoms.
• Evaluation of previous treatments and their effectiveness.

Prescription from Any Licensed Physician:

A significant change brought about by the CanG is that any licensed physician in Germany can now prescribe medical cannabis. The previous requirement for a special narcotics license is no longer in effect. This broadens access for patients, as they are no longer limited to specialists with specific certifications. However, physicians are still expected to adhere to professional guidelines and exercise due diligence when prescribing medical cannabis.

Benefit-Risk Assessment:

Physicians must still conduct a benefit-risk assessment before prescribing medical cannabis. This involves carefully weighing the potential benefits of treatment against the potential risks and side effects for the individual patient. The decision to prescribe is based on the patient’s specific circumstances and medical needs.