There are two types of cannabis in Germany and the rest of the European Union: legal and illegal, otherwise known as medical and recreational. Cannabis designated for medical use is more accepted nowadays and represents an entirely new industry in Germany. However, if cannabis is used recreationally, its possession is still prohibited and heavily punished. If you look at the attitude of the German lawmakers, and most state governments, addiction researchers, insurance companies and doctor’s or health associations, you might almost believe that there is good and bad cannabis.
Even the largest patient association in the country is reluctant to comment on the legalization debate and does not take a clear position, as not to be associated with recreational consumers.
Therefore, Germans often ask what is different about medical marijuana than in illegally grown plants. The answer is this is the same product, that all medicinal strains have origins that trace back to the black market.
Since the legal approval of medical cannabis in 2017, prohibitionists keep on saying that one has nothing to do with the other. When it comes to medical use, it’s about alleviating the symptoms of illness, while recreational use is just about being high. These are often the same politicians who opposed the introduction of medical cannabis only a few years ago.
This rather shortsighted attitude mirrors the United States, before California became the first state to legalize medical cannabis in 1996. But the resulting situation has created an ever-growing gray area over the last 20 years. The legal and economic imbalance has become increasingly ridiculous in the face of real circumstances and has ultimately led to the legalization of recreational cannabis.
Safe pain medication
On the one hand, an increasing number of applications for medical cannabis have been discovered throughout the past two decades. The number of qualifying conditions rose steadily in legalized states across the nation and, of course, the number of patients did simultaneously. Medical cannabis is proving to be one of the safest painkillers. In the U.S., many physicians now recommend it as an alternative to highly addictive and sometimes fatal opioids. In Germany, more than 2 million chronic pain patients have discovered the painkilling properties of Cannabis Flos, as the medicine is named in German pharmacies.
On the other hand, it has been an open secret in the US that dispensaries gained more customers over the years who did not need a recommendation, but sought a legal avenue for buying cannabis. Even before cannabis was legalized for recreational use in California, Oregon, or Colorado, it was not difficult for adults to get marijuana recommendations in one of the many medical dispensaries. The persecution, and prosecution, of recreational users prompted them to use dispensaries for other than their medicinal intent. No matter if one was in California, Colorado, Vancouver, or Berlin, recreational cannabis persecution increases the potential for abuse of the medical marijuana patient status.
For example in Bavaria testing positive for cannabis metabolites in a urine test can result in a home search. The possession of more than one gram is often not considered as personal use anymore. As long as one has to count on disproportionate consequences as in Bavaria, there will always be the danger of people who might abuse the system.
Meanwhile, there are also reports that medical cannabis has appeared on the black market in Germany. This is the case with all narcotics and, unlike Ritalin, Rohypnol and many other prescription drugs, there is no known lethal dosage and the problem could quickly and easily be resolved by the creation of a regulated cannabis market for recreational consumers.
Abuse of prescription drugs is much more common
Meanwhile, there has been abuse of prescription narcotics for decades, yet this has never been a reason to question the medicine’s effectiveness or marketability. A possible abuse of a few has never been a reason to deny access to the vast majority of patients in need, even when it comes potentially deadly prescription narcotics
Overlooked are patients’ abuse of legal prescription drugs, often enabled by a doctor. In Germany, it is currently easier to prescribe opiates, opioids or amphetamines, and even be reimbursed for them, than to receive a prescription for cannabis. Although cannabis is a substance with less potential for dependence than opiates, opioids, or amphetamines, and the risk of a fatal overdose is negligible, most physicians still prescribe those aforementioned substances.
Avoid the “Californization”
In California, 57 percent voted in favor of legalization in 2016 not only because it was often discussed that the medical cannabis program could only be protected against abuse by regulating the entire market. California also experienced a prosperous new industry that created thousands of jobs and a wellness principle which is not utilized within the US healthcare system. At the end of the last decade, medical cannabis was a top crop in terms of sales and had already aroused numerous economic desires in the most populous US-State.
Due to the classification as a Schedule I drug at the federal level, a market with many strange circumstances had developed. Federal and state laws are so far apart that you could only pay cash for a medical product in the country where credit cards were invented. Not too long ago, operators of medical dispensaries were living in fear of raids by the Drug Enforcement Administration (DEA), even though they never violated state law.
With the legalization, consumers can do without the expensive cannabis recommendation because they no longer need to be afraid of the police when it comes to a few buds in their pocket. Now you can call things by name and both cannabis consumer and entrepreneur also have state-level legality, even without the medical distinction. Perhaps the most important factor is research on the state level is now a little easier.
But even in the states with legal cannabis, the problem is not completely solved. Since the medical cannabis programs there have developed completely independently of the respective state’s health system, medical cannabis is sold in the same shops as recreational cannabis. However, those who provide a medical recommendation do not pay all state taxes, which can cost more than 20 percent of the purchase price, depending on the city and state. Reimbursement of medical cannabis such as in Germany, where the cannabis program is part of the state health care, is hardly discussed in the U.S.
The same house, two floors
Unlike in Germany, the long-term effects of an exclusively medical market in the U.S. and Canada have already been recognized. While Europe still fears abuse of the system by recreational consumers, MDs and patients overseas are more concerned about basic medical research into whether cannabis is effective for acute and chronic pain relief. That is why patient organizations there, unlike in Germany, have fewer fears of contact with legalization activists. In Germany, some medical activists who deal with cannabis from a scientific perspective explicitly distance themselves from recreational consumers. They do not want to burden the already difficult topic with stereotypical clichés.
Anyone who supports the use of cannabis as a medicine, but pretends that it does not concern the legalization of medical cannabis, should realize criminalization blocks the necessary basic research. As long as cannabis remains illegal in Germany, it is not only the youth or the health that are endangered by a uncontrolled black market but the medical cannabis program could suffer from what I call a “Californization.”
Germany needs a Hybrid Model
For Germany, a hybrid of the US and the European system would be optimal. In principle, such a hybrid model already exists in Germany for the production of legal medicinal herbs. When cultivating and selling medicinal herbs such as chamomile, sage, or mint, the products sold in pharmacies are subject to very strict cultivation regulations and limit values for herbal tea, which is available in supermarkets. Just as in California, other US states, and soon in Canada, recreational cannabis should also be grown and distributed in Germany through licensed and regulated shops. Medical cannabis should be distributed like any other prescription medicine through pharmacies in the German health system.
Currently, attempts are being made to prevent the feared abuse by a doctor’s obligation to provide documentation for each patient as well as the monthslong individual examination by health insurance companies. Without legalization, medical science and research will not be as effective as it could be.