Just a week after the first official data on the impact of Germany’s cannabis reforms was published, the Federal Cabinet approved proposals to restrict medical cannabis prescriptions across the country.
Though its approval was largely expected given the anti-cannabis CDU/CSU’s majority in the Cabinet (10 seats to the SPD’s seven), this marks a clear signal of intention from the government to push ahead with the controversial reforms, and lays the path for the bill to be debated in the Bundestag and Bundesrat.
The development has already seen fierce criticism from the industry, which has called claims of misuse ‘baseless’ and panned the ‘purely ideological approach by the conservative faction, which is breaking with the coalition agreement’.
With such reforms typically taking four to seven months to make it into law, alongside the increasingly divisive nature of the proposals, the industry’s battle to soften the blow of these reforms over the coming months is just beginning.
What happened?
On Wednesday, October 08, 2025, the Federal Cabinet announced that it had approved the proposed amendments to the MedCanG law, and has already submitted a corresponding draft bill to the EU for notification.
In an official statement, the government said that since the passage of CanG on April 01, 2024, there has been a ‘worrying trend’ regarding the consumption of cannabis flowers for medical purposes.
The widely reported increase in imports so far in 2025, which have now led to a temporary halt on import licences, is, according to the government, ‘not due to increased demand among seriously ill patients’
“Medical cannabis is a prescription drug and not a product for purely recreational purposes. The massive increase in cannabis imports and the practice of prescribing online without any personal medical contact require political action,” Federal Minister of Health Nina Warken said.
To recap: The draft, now at the Referentenentwurf stage, remains largely consistent with earlier versions but includes several clarifications and refinements.
Telemedicine prescriptions for cannabis flowers would be permitted only after an in-person doctor–patient consultation, conducted in practice or during a home visit. Repeat prescriptions could be issued remotely, but only if a personal consultation within the previous four quarters resulted in a cannabis prescription. The draft also clarifies that other doctors within the same practice may issue such follow-ups, provided the in-person requirement has been met.
The existing ban on mail-order dispensing remains, meaning prescriptions must be collected in person at a pharmacy, although pharmacy-run delivery services (Botendienst) would continue to be permitted. A new clause specifies that medical-scientific use of cannabis would be restricted to formal clinical trials, likely intended to prevent loopholes that could enable quasi-recreational or pilot schemes under the guise of research.
The draft still requires Cabinet approval, after which it will move to the Bundestag and Bundesrat for debate and potential amendment. While the legislative process could still reshape the proposal, the notification to the EC underscores the Health Ministry’s determination to advance tighter control over Germany’s medical cannabis framework.
Politicisation – Government Narrative vs EkoCAN Findings
The Cabinet’s decision comes just days after the preliminary findings of the EkoCan report were published, providing the first data points on the impact of reforms on cannabis use.
This report was focused more on the consumer side of the CanG bill (semi-legalisation and the launch of social clubs), rather than the removal of cannabis from the list of narcotic substances, which has driven the explosion of prescriptions.
However, it explicitly notes that a clear empirical separation between medical and recreational users is ‘not feasible’ and that medical prescriptions increasingly serve as an alternative legal access route for consumers who might otherwise use illicit channels.
Government’s Assertion of “System Misuse”
The Health Ministry argues that medical cannabis prescriptions are being misused, pointing to:
- A 170% surge in imports of medical cannabis flowers in late 2024 compared with a 9% rise in prescriptions.
- The spread of telemedicine platforms allegedly issuing prescriptions without genuine doctor–patient contact.
- A supposed blurring of medical and recreational use, with patients using private prescriptions as a legal workaround.
- This is presented as evidence of a “Fehlentwicklung” — a market distortion requiring urgent correction via stricter access rules.
What the EkoCAN Report Shows
The EkoCAN 2025 report, based on early empirical data, depicts a much more stable and controlled picture of cannabis use and access:
- Market composition: Only 9–13% of total cannabis demand was met by medical channels — a minor share of the total market, far below levels suggesting systemic abuse.
- Public health impact: No measurable increase in problematic or risky consumption among either youths or adults; health-related incidents remain stable, with no surge in hospitalisations or emergencies.
- Youth protection: Use among minors is declining, and child welfare referrals have fallen since legalisation.
- Crime data: Cannabis-related offences have dropped, primarily due to legalisation effects rather than enforcement gaps.
- Market dynamics: The black market is slowly shrinking, and the legal share is expanding, with no clear indication that the medical system is being used as a loophole for recreational supply.
This is also supported by the findings of a new survey by the Bloomwell Group and physician network DocCheck, which suggests that medical cannabis remains rarely prescribed by general practitioners in Germany, despite its reclassification as a non-narcotic in April 2024.
Among 500 physicians surveyed, 28% said they have never prescribed medical cannabis, and fewer than one in five reported they would consider it for chronic pain before trying opioid-based treatments such as Tilidine or fentanyl.
A parallel patient survey by Bloomwell found that 55% had discussed cannabis therapy with their doctor, but only 13% received a prescription. Nearly two-thirds rated their doctor’s knowledge of medical cannabis as ‘poor’ or ‘unsatisfactory’.
Despite these obstacles, patient data show medical cannabis has helped 62.8% discontinue at least one other medication and 28.1% reduce another, while 90% reported a significant improvement in quality of life. Since reclassification, Bloomwell’s monthly patient numbers have risen by over 1,700%, driven largely by self-paying patients using digital health platforms.
Bloomwell Co-founder and Co-CEO Dr Julian Wichmann said: “Our surveys clearly disprove the baseless claim of widespread medical cannabis abuse, which Germany’s Federal Ministry of Health has misguidedly cited to justify its call to restrict access to medical cannabis therapy. In reality, patients are exhausted from having to plead for treatment, only to be denied. “
Market reaction
The German Cannabis Industry Association (BvCW), in an updated position paper, warned that the proposed bans would ‘place a heavy burden on patients with mobility restrictions’, those unable to easily attend appointments in person, including disabled, elderly, or rurally situated patients, adding that ‘only the black market will benefit’ from the clampdown.
As such, it argues for the implementation of ‘scientific model projects’, as seen in Switzerland and already accounted for in Section 2, Paragraph 4 of the Cannabis Act (KCanG).
“The path taken by the federal government is wrong. We need telemedicine and delivery options for patients, as well as model projects to enable legal access for consumers ,” said BvCW President Dirk Heitepriem .
It points out that 60 applications, including 34 for model projects, have been submitted to the relevant authorities, but no approvals have yet been granted.
BvCW Managing Director Michael Greif commented: “We ask the federal government to pave the way for scientifically supported model projects. With these, we can test practical solutions that both protect consumers and curb illegal trade. They are the key to fact-based regulation.”
Bloomwell Group mirrored this sentiment, but went further, accusing the government of ignoring its largely pro-cannabis coalition partners (SPD), breaking its coalition agreement and using medical cannabis as a ‘bargaining chip’.
Key to this, is the fact that the CDU/CSU have routinely blocked applications for cannabis social clubs and model projects in controlled states, meaning, according to Bloomwell Group’s CEO Niklas Kouparanis, that ‘only reliable supply besides home cultivation is currently medical cannabis for patients from pharmacies.’
He continued: “I am also astonished by the Federal Ministry of Health’s hostility toward digitalization, which is pushing aside the real problems of the overburdened German healthcare system and instead jeopardizing the effective care of hundreds of thousands of cannabis patients. …
“We are witnessing a purely ideological approach by the conservative faction, which is breaking with the coalition agreement. Now, patients, pharmacies, and industry expect the Social Democrats to remain steadfast in the parliamentary process and stick to their word. Otherwise, the SPD will vanish into thin air. Medical cannabis is not a bargaining chip!”
Dr Constantin von der Groeben, managing director of the Saxony-based producer Demecan, told Apotheke Adhoc that the Cabinet’s draft amendment ‘draws attention to an important problem: the German market is being flooded with imports.
“In 2024, there were 72 tonnes, and in the first half of 2025, almost 81 tonnes of medical cannabis from abroad.”
He added that domestic production remains low at under 3 tonnes, even though German manufacturers ‘have long been competitive’, and warned that ‘the proposed measures miss the mark’.
Von der Groeben further criticised the proposed shipping ban as ‘outdated and threatens the security of supply’, arguing that ‘hundreds of thousands of patients will suffer, as access will be made more difficult. This must be tightened up in the parliamentary process.’
