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German Medical Legalization Would Curb Home Grows, Keep Cannabis in Pharmacies

BERLIN — Europe is opening the floodgates to a new era of herbal therapy.

Earlier today Germany's health minister, Hermann Gröhe, introduced a proposal to establish a state cannabis agency to supervise domestic cannabis cultivation, distribution, and sales in pharmacies.

Gröhe was quick to note that this isn’t full legalization. But it does mark a new era in European drug policy. Germany, Europe’s most populous state and an affluent country, will allow much wider access to medical cannabis use. The country’s health insurers are likely to foot the bill, provided patients participate in data-collection studies. 

Currently, Germany’s Federal Institute for Drugs and Medical Devices (BfArM) must approve every patient who seeks treatment with herbal cannabis. Patients must first exhaust all other options before applying for access to cannabis in a complicated procedure that takes up to nine months. As a result, Germany has only 647 patients receiving herbal cannabis today, according to BfArM numbers from April, the latest available. 

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The German government’s proposal comes after a recent court ruling forced its hand. That ruling allowed patients to grow medical cannabis at home. The new proposal is seen as a way to prevent a tsunami of home cultivation, instead keeping cannabis production and sale within an institutionalized system.

That court decision came after a 12-year battle by multiple sclerosis patient Michael F., who fought for the right to cultivate at home to ease his painful condition with herbal cannabis. Courts ruled in April that BfArM must issue him a license to grow his own medical supply due to his inability to pay for medical cannabis from a pharmacy.

Germany's proposed law explicitly excludes patients from growing their personal supply or even the individual strain needed. Gröhe, of the conservative Christian Democratic Union Party (CDU), said that “Private cannabis cultivation by patients is out of the question.” 

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Up until early 2016, the country’s health ministry had insisted there was no need for such an institution. Germany chose the special tool of “exceptional permission for the import of medical cannabis” from the Dutch Office for Medical Cannabis (OMC) after the first court defeats dating back to 2005. Since then, cannabis has been imported from the Netherlands — but the Dutch say they can’t meet skyrocketing European demand.

“At this moment there is enough medicinal cannabis in stock to cover Dutch demand and demand in other countries. We already export much more to Germany than last year but as you know the number of German patients is growing quickly and so is the demand.” the Dutch OMC said in March.

Registered cannabis patients in Germany complain about regular supply shortages, and many can’t afford the price of imported cannabis. 

The German bill aims to reduce out-of-pocket costs, control production, and create a database on the efficacy of cannabis as treatment.

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Perhaps the largest gap in the current system is a lack of sufficient cannabinoid profiles. The Dutch OMC sells only five strains, a drop in the bucket compared to the hundreds of medical cannabis varieties available in Canada, Israel, and the United States. Advocates note that such a small selection won’t satisfy patients’ needs and will force them to grow illegally or turn to the black market. 

Without question the new law is a milestone for German cannabis patients, but it still leaves out important details, ignoring the need for a wider range of medical strains and the general scheduling of the substance. 

Local advocates say that just as cannabis should be removed from Schedule I in the United States, it should be removed from Attachment 1 of the German Narcotic Drugs Act as well. The rescheduling was originally planned in the draft version of the bill from January 2016 but was removed on its way to the cabinet

Germany is not alone. Several other European Union states, such as Croatia, Italy, and the Czech Republic, are acting to get legal cannabis markets off the ground in hopes of improving patients’ quality of life while enabling scientific research.