Parts of the German federal government are dissatisfied with the current interpretation of the Cannabis Act (CanG), introduced by the previous traffic-light coalition, which marked a paradigm shift in cannabis policy.
Since then, adults have been permitted to cultivate up to three cannabis plants at home, carry up to 25 grams in public, and consume cannabis legally in compliance with social distancing rules.
Access to medical cannabis was also expanded: prescriptions no longer required a controlled substances form, patients did not have to exhaust other treatment options first, and telemedicine or virtual consultations were sufficient for adults to obtain prescriptions
Health Minister Nina Warken (CDU) has criticised this situation and drafted a bill to amend the CanG. The new Federal Drug Commissioner, Hendrik Streeck (CDU), has also raised concerns that cannabis can now be obtained too easily via legal online channels. Rising import volumes of medical cannabis, they argue, suggest that the law is being exploited.
Industry Pushback
Any tightening of the CanG, particularly restrictions on access to cannabis medicine through online pharmacies, would have major economic consequences for providers and patients alike. Several companies have conducted surveys among users, warning of negative effects.
Dr Julian Wichmann, managing director of Bloomwell GmbH, described the proposals as a setback in health policy and ‘medically nonsensical’. He cautioned that restricting telemedicine would jeopardise effective therapy.
A Bloomwell survey of 2,500 patients found that 40% of telemedicine users would return to the black market for untested cannabis if access were cut off. The remaining 60% would also lose access to treatment options, with consequences for public health and individual wellbeing.
Wichmann questioned why such measures would be considered before the planned evaluation of the CanG: ‘In medical care, we have pharmaceutically pure products, controlled dispensing, age verification, medical contacts – none of which exist on the black market,’ he told.
Patient Surveys Indicate Risks
MedCanOneStop (MCOS GmbH) surveyed 9,583 patients on the potential impact of stricter telemedicine rules. The findings suggest a strong risk of patients turning to illegal markets if restrictions are introduced. If telemedicine were curtailed, 92.6% feared a return to illicit supply channels, while 59.2% said directly that they would rely on the black market.
Only 5.3% indicated they would visit a local doctor to obtain medical cannabis, and just 23.8% considered home growing an alternative, despite the lack of quality control or medical oversight.
Overall, 96.7% of respondents expected access restrictions to fuel black market trade, with 82.8% describing the effect as ‘massive’. By contrast, 84.7% of telemedicine users said legal, medically supervised access had already weakened illicit markets significantly.
Cedric Lehmann, founder and CEO of MedCanOneStop, said the data showed that ‘low-threshold access’ kept patients within a safe, supervised system. According to Prnews24.com, 75.6% of users would accept a mandatory annual video consultation with their doctor, and 93.6% would be willing to pay extra for this, provided the cost was not excessive.
Misjudging Supply Reality
Critics of the CanG argue that rising cannabis imports prove patients are obtaining medical cannabis through telemedicine for recreational rather than medical reasons. But a position paper from Cansativa, a company working with 3,000 pharmacies, disputes this. It argues that higher imports relative to prescriptions covered by statutory health insurance do not necessarily indicate abuse.
Much of the imported cannabis, it notes, is not dispensed directly to patients but is processed, re-exported, or destroyed due to poor quality. Germany has increasingly become a hub for medical cannabis trade, meaning import statistics cannot reliably reflect consumption or abuse. The paper adds that new legal frameworks have enabled more patients to access treatment, even without reimbursement from their insurers.
Calls for Improvements, Not Restrictions
Industry representatives acknowledge that some telemedicine providers may not follow best practices, such as issuing prescriptions without proper medical histories. However, they argue that targeted improvements, rather than wholesale restrictions, are needed.
‘Measures that clearly distinguish between dubious business models and regular medical care’ would be more effective, they say, in safeguarding access for patients – particularly those in rural areas.
Proposals include binding quality standards for telemedicine, stronger cooperation with pharmacies, digital identity checks using official ID, and a mix of video and in-person consultations.
Companies warn that banning telemedical access would be unreasonable for seriously ill patients, some of whom have limited mobility. Since only a fraction of German pharmacies regularly stock medical cannabis, mail order has become an essential patient-oriented supply channel.
