Cannabis has been used as a remedy for thousands of years and is deeply rooted in human history. Before synthetically produced active substances dominated the market, cannabis was also a respected medicine in Western conventional medicine.
It is a great achievement of modern society that cannabis as medicine is once again available to patients in Germany—enhanced by the knowledge of modern research and entirely new quality standards.
Why is cannabis used for so many different illnesses?
Both in the past and today, cannabis is used to relieve a wide range of symptoms and health complaints. This broad spectrum of effects is due, on the one hand, to the numerous compounds found in the cannabis plant, which produce various therapeutic effects and can therefore support people with very different medical conditions.
On the other hand, every human being has an endogenous cannabinoid system, known as the endocannabinoid system (ECS). This means that not only plants produce cannabinoids (phytocannabinoids such as THC and CBD), but the human body also produces its own cannabinoids, called endocannabinoids.
Recent research suggests that a deficiency of the body’s own cannabinoids may be linked to chronic pain, migraines, fibromyalgia, depression, anxiety disorders, and many other illnesses (1–4). The plant-based cannabinoids THC and CBD can help counteract this deficiency and produce therapeutic effects (5–6).
For which conditions is cannabis used in Germany?
Because of its individual effects and wide range of therapeutic applications, cannabis is used in Germany to treat a variety of illnesses. Observational data collected by the Federal Institute for Drugs and Medical Devices (BfArM) clearly shows that cannabis is prescribed not only for pain, inflammation, and cancer but also for a wide range of neurological and affective disorders (7).
Who is eligible to receive cannabis?
Since 2017, patients with severe illnesses in Germany have been entitled to receive medicinal cannabis if conventional treatments have been ineffective or have caused severe side effects. In such cases, statutory health insurance covers the cost of therapy, provided there is a prospect of alleviating serious symptoms through cannabis flowers or extracts (8).
Since April 1, 2024, it has also been possible to obtain cannabis by prescription without first having to prove the ineffectiveness or severe side effects of other medications. However, in these cases where patients are not considered “fully treated” with other therapies, they must cover the costs themselves. Individuals with conditions not classified as severe can also access medicinal cannabis if there is a prospect of improvement. In these instances as well, the full cost of treatment must be borne by the patient.
Which doctors are authorized to prescribe cannabis?
In principle, any private or statutory health insurance physician (except dentists and veterinarians) in Germany may prescribe cannabis extracts or flowers. If the prescription is intended to be covered by statutory health insurance (GKV), certain specialists can prescribe cannabis without prior approval from the insurance provider. In all other cases, an application including a physician’s questionnaire is required.
[1] S. C. Smith and M. S. Wagner, “Clinical endocannabinoid deficiency (CECD) revisited: can this concept explain the therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?” Neuroendocrinology Letters, vol. 35, no. 3, pp. 198–201, 2014.
[2] Henson JD, Vitetta L, Quezada M, Hall S. “Enhancing Endocannabinoid Control of Stress with Cannabidiol.” Journal of Clinical Medicine. 2021 Dec 14;10(24):5852.
[3] Russo EB. “Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.” Cannabis and Cannabinoid Research. 2016 Jul 1;1(1):154-165.
[4] Russo EB. “Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.” Cannabis and Cannabinoid Research. 2016 Jul 1;1(1):154-165.
[5] Di Marzo V. “Targeting the endocannabinoid system: to enhance or reduce?” Nature Reviews Drug Discovery. 2008 May;7(5):438-55. doi: 10.1038/nrd2553. PMID: 18446159.
[6] NIDA. 2021, April 13. “How does marijuana produce its effects?” URL: https://nida.nih.gov/publications/research-reports/marijuana/how-does-marijuana-produce-its-effects (Accessed: 28 April 2025).
[7] BfArM (Federal Institute for Drugs and Medical Devices), July 6, 2022. Final Report of the Accompanying Survey pursuant to § 31 Section 6 of the Fifth Book of the Social Code on the Prescription and Use of Cannabis Medicines.
[8] Medical Service of the Federal Republic of Germany (2023/2024). Assessment Guidelines: Social-Medical Evaluation of Cannabinoids according to § 31 Section 6 SGB V. Effective as of April 26, 2024. https://www.medizinischer-dienst.de
Medicinal cannabis works through the endogenous cannabinoid system.
The ECS is part of the nervous system and includes the cannabinoid receptors CB1 and CB2. The endogenous cannabinoid system is involved in many physiological functions, including immune defense, neurotoxicity, inflammation and injury of the nervous system, epilepsy, depression and stress, appetite, food intake and energy balance, cardiovascular regulation, reproduction, and bone remodeling. In principle, cannabis may be considered as a therapy for a wide range of illnesses.
The ECS regulates various processes in our body. When medicinal cannabis is consumed, the cannabinoids from the cannabis plant bind to these receptors, making it possible to positively influence disease symptoms—for example, by regulating pain through the CB1 receptors.
Each cannabis strain affects a variety of conditions differently, many of which are not yet fully understood. Therefore, it may be necessary for doctors and patients to try different cannabis flowers and cannabis extracts in order to achieve the desired medical effect. Physicians typically start with a gradual dosage increase until the therapeutic effect is reached. As with any other medication, cannabis requires a period of adjustment and consistent dosing. Once the patient is stabilized, potential side effects—usually associated with overdose or intolerance—are reduced.
Terpenes are plant compounds that occur widely in nature. Among other things, terpenes contribute to a plant’s taste and aroma.
Medical benefits: pain-relieving, antispasmodic, anti-inflammatory, alleviates insomnia, antioxidant
Effects: no known physical side effects
Aroma: pepper | woody | spicy
Found in: cannabis | basil | hops | clove | oregano | pepper
Medical benefits: anti-inflammatory, antimicrobial, pain-relieving
Effects: appetite suppressant
Aroma: woody | earthy
Found in: cannabis | hops | coriander
Medical benefits: antidepressant, anxiolytic, antifungal, regulates stomach acid
Effects: mood-lifting, stress-reducing
Aroma: orange | citrus | lemon
Found in: cannabis | peppermint | juniper | citrus peels
Medical benefits: alleviates insomnia, stress-reducing, antidepressant, anxiolytic, antispasmodic, pain-relieving
Effects: relaxing, sedative
Aroma: citrus | floral | spicy
Found in: birch | cannabis | lavender | bay leaf | rosewood | citrus fruits
Medical benefits: antifungal, antimicrobial, anti-inflammatory
Effects: enhances the psychoactive effects of THC, relaxing, sedative
Aroma: clove | musky | citrus | herbal
Found in: cannabis | bay leaves | mango | thyme | citrus fruits | lemongrass
Medical benefits: anti-inflammatory, antifungal, anticonvulsant, antibacterial
Effects: may cause increased coughing
Aroma: herbal | sweet | woody | fruity | slightly sour
Found in: cannabis | mango | mint | basil | orchids | parsley | pepper
Medical benefits: anti-inflammatory, bronchodilator
Effects: increases alertness and memory retention
Aroma: sweet | pungent | pine
Found in: cannabis | pine needles | conifers | sage
Medical benefits: antimicrobial, antioxidant, calming effects
Effects: promotes a relaxing body sensation
Aroma: herbal | pine | slightly sour | floral
Found in: valerian | cannabis | coriander | marjoram | nutmeg | parsley | pennyroyal | rosemary | celery | tea tree | juniper | Scots pine | grapevines
