Cannabis law reform in Germany: a rocky road to a partial legalisation

Background: Several European countries are in the process of reforming their drug laws regarding cannabis. The German government (elected in 2021) has promised to allow the licensed sale of cannabis to adults for recreational purposes. After consultation with the European Commission, the plans have been reduced to two elements in order to comply with international treaties: 1) legal possession of cannabis for personal use and 2) legal cultivation of cannabis in private homes or as part of non-profit organisations (cannabis clubs).

Methods: In this session, I will first outline the political process that led to the agreed bill. Importantly, I will highlight how the bill deviated from the original overarching policy goals of protecting health and fighting organized crime. Second, I will present trends in cannabis use, cannabis-related diagnoses (ICD-10 F12) in outpatient medical settings, and arrests for possession of cannabis for personal use. The data presented are based on general population surveys or from routine statistics.

Results: Between 2009 and 2021, the prevalence of past-year cannabis use doubled among adults (from around 5% to 10%) but remained broadly stable among minors (at around 7-8%). Over the same period, the age-standardised rate of cannabis-related diagnoses increased by more than 200% (from 1.1 to 3.7 per 1,000). Similarly, the rate of cannabis possession offences increased by 65% (from 1.8 to 3.1 per 1,000).

Conclusions: Given the upward trend in all cannabis-related indicators over the past decade, I expect this trend to continue in the short term, highlighting the need for increased availability of evidence-based harm reduction and treatment options. In the long term, I expect that the proposed law will contribute to the ongoing normalisation of cannabis use; however, it will not create incentives for initiation of use through a commercial distribution model, thus avoiding the mistakes identified in several North American jurisdictions.