By Falk Altenhöfer
Carsten Linnemann used his first major appearance as Federal Health Minister at the German Pharmacists’ Congress (Deutscher Apothekertag) in Munich to make a clear statement. Medical cannabis, he said, is now getting “completely out of hand.” Flower imports could rise to around 300 tonnes in 2026, ten times the 2023 level. For him this is clearly abuse, consumption for intoxication, made possible through platforms mostly based abroad. You can watch the speeches from the opening on the ABDA website.
The direction is clear. The cabinet’s draft bill has been with the Bundestag since the end of last year. It provides that cannabis flowers may only be prescribed after direct contact with a doctor and dispensed only in pharmacies, no longer by mail order. The prescription by form is meant to go, personal contact is meant to come. That is Linnemann’s goal, and as a guardrail for quality it is even understandable.
But the amendment is not making progress. According to the Pharmazeutische Zeitung, the SPD does not want a reversal even under the new minister. Its health expert Matthias Mieves sees a need to act against questionable business models, but clearly puts patient care first. Even within the Union, doubts are growing. Health spokesperson Simone Borchardt admits that a legal route must be found that will stand up before European courts. Critics consider a complete ban on mail order simply incompatible with EU law.
This is where the core of the issue lies for me. We are in the EU, and European law applies in this debate as well. On the one hand, that means commercial specialist shops are not simply possible. Under the Schengen Implementing Convention and the 2004 EU Framework Decision, there is an obligation to prohibit commercial cannabis activities outside scientific or medical purposes. On the other hand, it equally means that patients have a right to medicines, across borders as well. And nobody in this debate should presume to decide from the outside who is a patient and who is not. That is decided by a licensed physician. That is exactly what they are there for.
Judith Heimbürger of gunnercooke also sees this as a task for politics: “Regulation needs a European dimension, not just a national one. But at the national level too, we need the most uniform application possible of the existing requirements. For a functioning market, comparable quality standards must apply, regardless of whether the product comes from Cologne or from another EU country.”
What bothers me most about Linnemann’s argument is how he reads the number. 300 tonnes in three years show above all one thing: there are people with a genuine and lasting interest in this product. The federal government now says so itself. In its answer of 22 September to a parliamentary inquiry from the Greens, it refers to the second EKOCAN interim report, according to which medical cannabis now covers 24 to 30 percent of the estimated demand for cannabis for non medical purposes.
The logical consequence would be to meet this demand where it belongs. That means scientifically supervised model projects with clean supply chains. But this is exactly what the government is blocking. The same answer shows that the BLE received applications for 82 research projects. Four were approved, and none of them provides for supply to consumers, as Krautinvest also reports. 20 projects with 44 applications were rejected because they were classified as model projects. 22 objections are pending. The justification is brief: the coalition agreement does not provide for regional model projects with commercial supply chains.
You cannot have it both ways. Whoever refuses the second pillar and at the same time narrows medical access does not create order, but pushes demand back into the black market. And it hits above all the patients who depend on a functioning supply.
By the way, as long as the draft has not been passed, the existing legal situation applies: a prescription is also possible after a telemedical anamnesis, provided the professional requirements are met. That is not a loophole, it is applicable law.
In parallel, the quality debate continues, and in my view it is far more relevant than the question of the screen between doctor and patient. In June, the Hessian State Office for Health and Care published a guidance note stating that critical steps such as drying, trimming and microbiological testing must be assessed in line with GMP. What matters are the requirements for placing products on the market in Germany, not the standards in the country of origin. Other federal states draw the line between EU GACP and EU GMP differently, and a uniform nationwide approach is missing. Keyword: EU GMP washing. This is where it will be decided which products will still reach German pharmacies at all.
Judith Heimbürger gets to the point: “The real problem is the differing interpretation and application of quality standards by the competent supervisory authorities. Hesse shows that German authorities are willing to enforce high requirements consistently. However, such enforcement decisions initially only take effect within their respective area of jurisdiction. The companies that truly want to succeed in the medical cannabis market invest in quality with patient health in mind. They want a reliable, credible medical cannabis market that clearly meets the standards intended for medicines. This patchwork of differing interpretations of the same quality requirements creates no additional safety gain, but leads to unequal competitive conditions for the companies that consistently implement the high quality requirements.”
My conclusion: Linnemann is right that there are black sheep. But the figures from his own government show that the real problem is the missing second pillar. The better answer is clear medical standards, genuine quality control across all countries and an honest opening for model projects.
We will explore exactly these questions on 7 October at 5 pm CEST in the DEEP DIVE with Judith Heimbürger.
