Dr. Julian Wichmann, MD, Co-Founder and CEO of Bloomwell GmbH
Germany has, without question, the most progressive regulation of medical cannabis in the EU. Yet, the current federal government’s Ministry of Health, led by the CDU, wants to significantly restrict telemedical access to medical cannabis and specifically flowers, citing abuse. On closer inspection, there is still no supporting data or evidence for this.
Critics of telemedicine always point solely to sharply rising import volumes. The Federal Ministry of Health (BMG) expects 300 tonnes of imported medical cannabis flower in 2026, up from 205 tonnes in 2025. In 2023, the last full year before medical cannabis was removed from the Narcotics Act, imports stood at just 31.4 tonnes. No other data point or clinical study has actually indicated abuse.
Therefore, the question is whether imports have really risen so much that abuse can be inferred from them. Since April 01, 2024, medical cannabis is no longer classified as a narcotic in Germany but as a ‘normal’ prescription medicine.
Legislators took this step quite pragmatically: the risk profile of medical cannabis gave no reason to classify it as a narcotic anymore. Ever since the Cannabis as Medicine Act came into force in March 2017, the Federal Institute for Drugs and Medical Devices (BfArM) has evaluated its effects in an accompanying survey.
What stood out was that patients reported either no side effects at all or only mild ones. Even compared with other prescription drugs that chronically ill people take regularly, medical cannabis flowers have a favourable side-effect profile.
The addiction and risk profile of narcotics such as opioids is many times greater than that of medical cannabis. Therefore, it is now regulated as a medicine requiring a prescription by a licensed medical doctor. There are no over-the-counter medical cannabis formulations in Germany, despite such demands by pharmacy lobbying groups.
This has elevated medical cannabis as a possible treatment solution for doctors in Germany with the potential to minimise side effects and risks of a treatment. For widespread conditions such as sleep disorders and chronic pain, there are no other medications that can be taken over several months without considerable risks.
This completely changes the context of the import figures. Medical cannabis is still largely underprescribed in Germany. In principle, an estimated 20 million people in Germany are eligible for treatment with medical cannabis based on the prevalence of treatable major diseases. From a health-protection perspective, import volumes have therefore not grown too quickly but too slowly.
Dr. Julian Wichmann, MD, Co-Founder and CEO of Bloomwell GmbH
There are in addition two major reasons why access to legal medical cannabis benefits health. First, in a survey, patients who gained access to medical cannabis therapy through Bloomwell reported that after starting treatment they were able to significantly reduce or entirely stop taking other prescription medications, including opioids. For the vast majority of respondents, this meant a significantly improved quality of life and work.
Second, switching from the illegal market to legal therapy is already a gain for prevention and health protection. For many years, however, restrictive medical care left many people with no realistic alternative. In autumn 2024, the Sanity Group found toxic pesticides in two-thirds of 300 laboratory samples of illegal cannabis, and around 65% contained traces of human faeces, bacteria or viruses.
A further survey in September 2026 of 7,900 patients who gained access to therapy via Bloomwell showed that nine out of ten respondents had experience with both pharmacy-supplied medical cannabis and the illegal market. Their preference is clear: medical cannabis stands out for transparent information on active ingredients, product safety, cleanliness, price, and availability or ease of dosing. For patients, buying on the illegal market is also a significant source of stress.
Even scientific reports indicate that more, not fewer users should access medical cannabis instead of depending on other, mostly illegal sources: A study (2026) based on surveys among 4,414 cannabis users in the UK found that only 12.9% had received a prescription for medical cannabis.
A further 35.9% reported medical use without a prescription. Scientific surveys in other countries support the theory that at least half of the cannabis users pursue medical motives. In Germany, in an online survey of almost 11,500 cannabis users, 53.7% referred to medical reasons.
But only 29.2% stated that medical cannabis from a pharmacy is their main source. In a representative online survey in 2024 commissioned by Bloomwell, cannabis users were asked about their motives for use. 94.4% named at least one health or medical-related motive. Self-medication is a serious issue from a public health perspective, as it lacks pharmaceutical-grade cannabis quality and professional oversight by healthcare providers.
Anyone invoking ‘abuse’ in health policy also cannot simply point to the quantities prescribed. In medical circles, medication abuse is clearly defined by recognised standards such as ICD-10 and DSM-5, which are based on medically diagnosed impairments to health and quality of life, as well as on dependence. These have not been reported in any scientific or official source in Germany. Logical outcomes of medical cannabis abuse would be increased hospitalisation rates of cannabis patients or involvement in traffic accidents. Neither has been reported thus far.
The debate’s emphasis shows how stigmatised the topic remains. While the BfArM survey also highlighted positive effects, the current debate driven by conservative political parties around the evaluation of the Consumer Cannabis Act (KCanG) and the MedCanG appears focused on negative factors.
Even the pushback of illicit structures identified in the second interim report is not sufficiently acknowledged in political and public discourse. To make balanced decisions, it would also be desirable for more independent scientific organisations to examine the effects of medical cannabis more closely and to distinguish findings from recreational or illicit cannabis use.
The debate in Europe should finally stop focusing on hypothetical abuse and turn to health protection and prevention. The German telemedical cannabis model already serves as a blueprint for Europe and could help avoid adverse health effects from widespread use and overprescription of opioids and other addiction-causing medications.