{"id":1315,"date":"2025-04-10T06:12:57","date_gmt":"2025-04-10T04:12:57","guid":{"rendered":"https:\/\/materiadeutschland.de\/cannabis-therapie\/"},"modified":"2025-09-24T11:31:06","modified_gmt":"2025-09-24T09:31:06","slug":"cannabis-therapy","status":"publish","type":"page","link":"https:\/\/materiadeutschland.de\/en\/cannabis-therapy\/","title":{"rendered":"CANNABIS THERAPY"},"content":{"rendered":"\t\t
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CANNABIS THERAPY<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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Cannabis as a Medicinal Plant<\/b><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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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.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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It is a great achievement of modern society<\/strong> that cannabis as medicine is once again available to patients in Germany\u2014enhanced by the knowledge of modern research<\/strong> and entirely new quality standards<\/strong>.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Why is cannabis used for so many different illnesses?<\/b><\/h4>

Both in the past and today, cannabis is used to relieve a wide range of symptoms<\/strong> 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<\/strong> and can therefore support people with very different medical conditions.<\/p>

On the other hand, every human being has an endogenous cannabinoid system<\/strong>, 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.<\/p>

Recent research suggests that a deficiency of the body\u2019s own cannabinoids<\/strong> may be linked to chronic pain, migraines, fibromyalgia, depression, anxiety disorders, and many other illnesses (1\u20134). The plant-based cannabinoids THC<\/strong> and CBD<\/strong> can help counteract this deficiency and produce therapeutic effects (5\u20136).<\/p>

For which conditions is cannabis used in Germany?<\/strong><\/h4>

Because of its individual effects and wide range of therapeutic applications<\/strong>, cannabis is used in Germany to treat a variety of illnesses. Observational data collected by the Federal Institute for Drugs and Medical Devices (BfArM)<\/strong> clearly shows that cannabis is prescribed not only for pain<\/strong>, inflammation<\/strong>, and cancer<\/strong> but also for a wide range of neurological and affective disorders<\/strong> (7).<\/p>

Who is eligible to receive cannabis?<\/strong><\/h4>

Since 2017, patients with severe illnesses in Germany have been entitled to receive medicinal cannabis<\/strong> if conventional treatments have been ineffective or have caused severe side effects. In such cases, statutory health insurance<\/strong> covers the cost of therapy<\/strong>, provided there is a prospect of alleviating serious symptoms through cannabis flowers or extracts (8).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Since April 1, 2024<\/strong>, it has also been possible to obtain cannabis by prescription<\/strong> without first having to prove the ineffectiveness or severe side effects of other medications. However, in these cases where patients are not considered \u201cfully treated\u201d<\/strong> with other therapies, they must cover the costs themselves. Individuals with conditions not classified as severe<\/strong> can also access medicinal cannabis if there is a prospect of improvement. In these instances as well, the full cost of treatment<\/strong> must be borne by the patient.<\/p>

Which doctors are authorized to prescribe cannabis?<\/strong><\/h4>

In principle, any private or statutory health insurance physician<\/strong> (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<\/strong> can prescribe cannabis without prior approval<\/strong> from the insurance provider. In all other cases, an application including a physician\u2019s questionnaire is required.<\/p>

Sources:<\/i><\/p>

[1] S. C. Smith and M. S. Wagner, \u201cClinical endocannabinoid deficiency (CECD) revisited: can this concept explain the therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?\u201d Neuroendocrinology Letters, vol. 35, no. 3, pp. 198\u2013201, 2014.<\/em><\/p>

[2] Henson JD, Vitetta L, Quezada M, Hall S. \u201cEnhancing Endocannabinoid Control of Stress with Cannabidiol.\u201d Journal of Clinical Medicine. 2021 Dec 14;10(24):5852.<\/em><\/p>

[3] Russo EB. \u201cClinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.\u201d Cannabis and Cannabinoid Research. 2016 Jul 1;1(1):154-165.<\/em><\/p>

[4] Russo EB. \u201cClinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.\u201d Cannabis and Cannabinoid Research. 2016 Jul 1;1(1):154-165.<\/em><\/p>

[5] Di Marzo V. \u201cTargeting the endocannabinoid system: to enhance or reduce?\u201d Nature Reviews Drug Discovery. 2008 May;7(5):438-55. doi: 10.1038\/nrd2553. PMID: 18446159.<\/em><\/p>

[6] NIDA. 2021, April 13. \u201cHow does marijuana produce its effects?\u201d URL: https:\/\/nida.nih.gov\/publications\/research-reports\/marijuana\/how-does-marijuana-produce-its-effects<\/a> (Accessed: 28 April 2025).<\/em><\/p>

[7] BfArM (Federal Institute for Drugs and Medical Devices), July 6, 2022. Final Report of the Accompanying Survey pursuant to \u00a7 31 Section 6 of the Fifth Book of the Social Code on the Prescription and Use of Cannabis Medicines.
<\/em>
[8] Medical Service of the Federal Republic of Germany (2023\/2024). Assessment Guidelines: Social-Medical Evaluation of Cannabinoids according to \u00a7 31 Section 6 SGB V. Effective as of April 26, 2024. https:\/\/www.medizinischer-dienst.de<\/a><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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The Endogenous Cannabinoid System (ECS)<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Medicinal cannabis works through the endogenous cannabinoid system.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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The body’s own cannabinoid system, also known as the endocannabinoid system (ECS)<\/strong>, was discovered in 1988 and is deeply rooted in our evolution. As a signaling and control system distributed throughout the entire body, it is essential for maintaining homeostasis<\/strong> \u2014 the balance of important physical and mental functions (1).<\/p>

Functions of the Endocannabinoid System<\/strong><\/h4>

The ECS<\/strong> regulates, among other things, sleep<\/strong>, mood<\/strong>, appetite<\/strong>, and pain perception<\/strong>. In addition, it influences inflammation<\/strong>, cognition<\/strong>, motivation<\/strong>, memory<\/strong>, digestion<\/strong>, neuroprotection<\/strong>, and the immune system<\/strong> (2,3,4).<\/p>

This is made possible by endogenous cannabinoids<\/strong> such as 2-AG<\/strong> and anandamide (AEA)<\/strong>, as well as the cannabinoid receptors CB1 and CB2<\/strong>, which regulate, among other things, the release of important neurotransmitters<\/strong> such as dopamine<\/strong>, GABA<\/strong>, and endorphins<\/strong> (1, 5, 6).<\/p>

Clinical Endocannabinoid Deficiency and Possible Consequences<\/strong><\/h4>

A deficiency in endocannabinoids \u2014 known as clinical endocannabinoid deficiency<\/strong> \u2014 is being discussed in research as a possible trigger for conditions such as chronic pain<\/strong>, migraine<\/strong>, irritable bowel syndrome<\/strong>, depression<\/strong>, anxiety disorders<\/strong>, or fibromyalgia<\/strong> (7, 8, 9, 10).<\/p>

Influence of THC and CBD on the Endocannabinoid System<\/strong><\/h4>

The two most important plant-based cannabinoids, THC (tetrahydrocannabinol)<\/strong> and CBD (cannabidiol)<\/strong>, can help restore balance to the ECS. Like the body\u2019s own anandamide (AEA), THC binds to CB1 receptors<\/strong> and can mimic its effects. CBD, on the other hand, supports the body\u2019s own production of endocannabinoids<\/strong>, thereby increasing their levels (11).<\/p>

Perspectives for Individual ECS-Based Therapies<\/strong><\/h4>

Understanding the numerous functions of the endocannabinoid system<\/strong> is essential for recognizing the broad therapeutic potential of medical cannabis<\/strong>. A personalized cannabis therapy tailored to the patient’s individual endocannabinoid system could significantly enhance the efficacy and safety of cannabis-based medications<\/strong> in the future.<\/p>

However, advancing cannabis research<\/strong> offers opportunities not only for personalized therapies but also for new approaches in prevention and treatment. This goes beyond the intake of cannabinoids<\/strong> such as THC and CBD. It is already known that moderate physical exercise in cases of severe depression has been shown to significantly increase serum levels of the body\u2019s own cannabinoids (12). Similarly, in patients undergoing electroconvulsive therapy<\/strong>, serum levels of the endogenous cannabinoids 2-AG<\/strong> and anandamide (AEA)<\/strong> also increased (12). This brings the ECS into focus for a holistic therapy approach that goes far beyond medication alone.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Sources:<\/em><\/p>

(1) Lowe H, Toyang N, Steele B, Bryant J, Ngwa W. The Endocannabinoid System: A Potential Target for the Treatment of Various Diseases. Int J Mol Sci. 2021 Aug 31;22(17):9472. doi: 10.3390\/ijms22179472.<\/em><\/p>

(2) Stampanoni Bassi M, Gilio L, Maffei P, Dolcetti E, Bruno A, Buttari F, Centonze D, Iezzi E. Exploiting the Multifaceted Effects of Cannabinoids on Mood to Boost Their Therapeutic Use Against Anxiety and Depression. Front Mol Neurosci. 2018 Nov 20;11:424. doi: 10.3389\/fnmol.2018.00424.<\/em><\/p>

(3) Wu J. Cannabis, cannabinoid receptors, and endocannabinoid system: yesterday, today, and tomorrow. Acta Pharmacol Sin. 2019 Mar;40(3):297-299. doi: 10.1038\/s41401-019-0210-3.<\/em><\/p>

(4) Preteroti M, Wilson ET, Eidelman DH, Baglole CJ. Modulation of pulmonary immune function by inhaled cannabis products and consequences for lung disease. Respir Res. 2023 Mar 28;24(1):95.<\/em><\/p>

(5) Low ZXB, Lee XR, Soga T, Goh BH, Alex D, Kumari Y. Cannabinoids: Emerging sleep modulator. Biomed Pharmacother. 2023 Sep;165:115102. doi: 10.1016\/j.biopha.2023.115102.<\/em><\/p>

(6) Lowe H, Toyang N, Steele B, Bryant J, Ngwa W. The Endocannabinoid System: A Potential Target for the Treatment of Various Diseases. Int J Mol Sci. 2021 Aug 31;22(17):9472. doi: 10.3390\/ijms22179472.<\/em><\/p>

(7) Russo EB. Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes. Cannabis Cannabinoid Res. 2016 Jul 1;1(1):154-165. doi: 10.1089\/can.2016.0009.<\/em><\/p>

(8) Aran A, Eylon M, Harel M, Polianski L, Nemirovski A, Tepper S, et al. Lower circulating endocannabinoid levels in children with autism spectrum disorder. Mol Autism. 2019;10:1-11.<\/em><\/p>

(9) Giuffrida A, Leweke FM, Gerth CW, Schreiber D, Koethe D, Faulhaber J, Klosterk\u00f6tter J, Piomelli D. Cerebrospinal anandamide levels are elevated in acute schizophrenia and are inversely correlated with psychotic symptoms. Neuropsychopharmacology. 2004 Nov;29(11):2108-14. doi: 10.1038\/sj.npp.1300558.<\/em><\/p>

(10) Bourke SL, Schlag AK, O’Sullivan SE, Nutt DJ, Finn DP. Cannabinoids and the endocannabinoid system in fibromyalgia: A review of preclinical and clinical research. Pharmacol Ther. 2022 Dec;240:108216. doi: 10.1016\/j.pharmthera.2022.108216. Epub 2022 May 21.<\/em><\/p>

(11) Di Marzo V. Targeting the endocannabinoid system: to enhance or reduce? Nat Rev Drug Discov. 2008 May;7(5):438-55. doi: 10.1038\/nrd2553.<\/em><\/p>

(12) Scherma M, Muntoni AL, Riedel G, Fratta W, Fadda P. Cannabinoids and their therapeutic applications in mental disorders. Dialogues Clin Neurosci. 2020 Sep;22(3):271-279. doi: 10.31887\/DCNS.2020.22.3\/pfadda.<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Cannabis Today: What Applies Now and What Endures from the Past<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Cannabis as Medicine \u2013 From Tradition to Modern Medicine<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Cannabis has been used as a healing plant for thousands of years<\/strong>. In Germany too, medical cannabis was once a widely prescribed treatment. Historically, cannabis was valued as a therapeutic remedy for far longer than it was marginalized. Only from the 1930s onward did cannabis rapidly disappear from medicine and society<\/strong>. At that time, public opinion was heavily influenced, making a rational perspective on cannabis as a medicine nearly impossible. Sensationalist media reports spread alarming stories about cannabis use across all channels. One of the most influential examples was the 1938 film Reefer Madness<\/strong>, which became the very symbol of cannabis hysteria in Europe and the United States. In this climate, plant-based cannabis products were swiftly replaced by newly synthesized compounds.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Old Prejudices, New Evidence<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Many of the old prejudices surrounding cannabis persist even today. At the same time, the large body of scientific literature reflects the ongoing interest in the therapeutic potential of the cannabis plant:<\/p>

  • More than 30,000 scientific publications<\/strong> in the last ten years alone<\/li>
  • Over 45,000 publications<\/strong> on cannabis<\/strong> since 1840<\/li><\/ul>

    Thanks to this remarkable research effort and steadily growing evidence, cannabis is once again available to patients as a recognized medicine.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    Legal Milestones in 2017 and 2024<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    Since 2017, statutory health insurance providers (GKV)<\/strong> in Germany have covered the costs of cannabis therapy<\/strong> for eligible patients. In principle, approval must be obtained from the GKV before prescribing (1). However, since the amendment<\/strong> of the pharmaceutical directive<\/strong> in 2024, this approval requirement no longer applies to certain groups of medical specialists (2).<\/p>

    The requirements of \u00a7 31 SGB V<\/strong> remain binding for GKV prescriptions (3):<\/p>

    • The presence of a serious illness<\/strong><\/li>
    • Exhaustion of standard therapies<\/strong> (all available treatments have failed or are not applicable in the individual case)<\/li>
    • Scientific evidence<\/strong>, even if limited, suggesting that cannabis may offer therapeutic benefit in the specific case<\/li><\/ul>

      In 2024, access to private prescriptions<\/strong> for self-paying patients<\/strong> was also significantly simplified, as cannabis is no longer classified as a narcotic<\/strong> in Germany (1). Narcotics should only be prescribed when other therapies have failed, not for conditions with mild impairment. This change removed strict regulatory barriers and broadened access. As a result, plant-based cannabis extracts and cannabis flowers no longer require narcotic prescription forms (BtM-Rezept) (1).<\/p>

      A further strong signal for the renewed standing of cannabis in mainstream medicine<\/strong> came from various professional societies, which have now included cannabis in treatment guidelines<\/strong> for different pain conditions. Of particular note are the practice guidelines of the German Society for Pain Medicine (DGS)<\/strong>, as well as the current S2k guideline<\/strong> for the treatment of endometriosis, which recommends cannabis as a therapeutic option for pain alongside conventional medicines (4,5).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Conclusion<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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      Despite the challenges that remain, significant progress has already been made in Germany. The decisive task now is to use these opportunities responsibly. Beyond medical expertise, a crucial factor will be ensuring the highest quality and careful selection of cannabis products.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Sources:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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      (1) Bundesinstitut f\u00fcr Arzneimittel und Medizinprodukte (BfArM)<\/b> (01.04.2024): Medizinisches Cannabis \u2013 Hinweise f\u00fcr \u00c4rztinnen und \u00c4rzte. Online verf\u00fcgbar unter: https:\/\/www.bfarm.de\/DE\/ Bundesopiumstelle\/Medizinisches-Cannabis\/Hinweise-fuer-Aerzte\/_node.html, Stand: 01.04.2024. <\/em><\/p>

      (2) Gemeinsamer Bundesausschuss (G-BA) <\/b>(18.07.2024): Arzneimittel-Richtlinie: Abschnitt N \u00a7 45 (Genehmigungsvorbehalt Cannabisarzneimittel), Beschluss. Beschlussdatum: 18.07.2024, Inkrafttreten: 17.10.2024, ver\u00f6ffentlicht im BAnz AT 16.10.2024 B3. Online verf\u00fcgbar unter: https:\/\/www.g-ba.de\/beschluesse\/6728\/, Stand: 27.08.2025.<\/em><\/p>

      (3) Medizinischer Dienst Bund <\/b>(26.04.2024): Begutachtungsanleitung \u2013 Richtlinie nach \u00a7 283 Absatz 2 Satz 1 Nr. 2 SGB V: Sozialmedizinische Begutachtung von Cannabinoiden nach \u00a7 31 Absatz 6 SGB V. Datum des Inkrafttretens: 26.04.2024. Online verf\u00fcgbar unter: https:\/\/md-bund.de\/aktuell\/aktuelle-meldungen\/richtlinie-zur-begutachtung-von-cannabinoiden-ueberarbeitet.html, Stand: 27.08.2025.<\/em><\/p>

      (4) Deutsche Gesellschaft f\u00fcr Schmerzmedizin (DGS)<\/b>: DGS-PraxisLeitlinie \u201eCannabis in der Schmerzmedizin\u201c. Version 2.0 f\u00fcr Fachkreise. Erscheinungsjahr 2024. Verantwortliche Leitlinienautoren: Dr. med. Johannes Horlemann, Norbert Sch\u00fcrmann. Online verf\u00fcgbar unter: https:\/\/dgs-praxisleitlinien.de\/cannabis\/,\u00a0<\/em>Stand: 27.08.2025<\/em><\/p>

      (5) Deutsche Gesellschaft f\u00fcr Gyn\u00e4kologie und Geburtshilfe e.V. (DGGG), \u00d6sterreichische Gesellschaft f\u00fcr Gyn\u00e4kologie und Geburtshilfe e.V. (OEGGG), Schweizerische Gesellschaft f\u00fcr Gyn\u00e4kologie und Geburtshilfe e.V. (SGGG). (2025). Diagnostik und Therapie der Endometriose (AWMF-Registernummer 015\/045). Leitlinienklasse S2k. Ver\u00f6ffentlicht am 16. Juni 2025, g\u00fcltig bis: 31. M\u00e4rz 2030. Online verf\u00fcgbar unter: https:\/\/www.awmf.org\/service\/awmf-aktuell\/diagnostik-und-therapie-der-endometriose , Stand: 27.08.2025<\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

      CANNABIS THERAPY Cannabis as a Medicinal Plant 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 […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-1315","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/materiadeutschland.de\/en\/wp-json\/wp\/v2\/pages\/1315","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/materiadeutschland.de\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/materiadeutschland.de\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/materiadeutschland.de\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/materiadeutschland.de\/en\/wp-json\/wp\/v2\/comments?post=1315"}],"version-history":[{"count":25,"href":"https:\/\/materiadeutschland.de\/en\/wp-json\/wp\/v2\/pages\/1315\/revisions"}],"predecessor-version":[{"id":2582,"href":"https:\/\/materiadeutschland.de\/en\/wp-json\/wp\/v2\/pages\/1315\/revisions\/2582"}],"wp:attachment":[{"href":"https:\/\/materiadeutschland.de\/en\/wp-json\/wp\/v2\/media?parent=1315"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}