In Germany, according to the Federal Institute for Drugs and Medical Devices (BfArM), as of December 21, 2016, there were exactly 900 cannabis patients with an “exception permission to purchase cannabis flowers.” The rest of the approximately 5,000 patients receive pharmaceutical marijuana products such as Sativex or Dronabinol.
The hurdles for the state document allowing the acquisition of whole plant cannabis are high for patients and doctors — the application process takes up to eight months — but this will change soon. On January 19, 2017, the German Parliament (Bundestag) will adopt a law that allows every doctor to simply prescribe cannabis beginning in March or April of 2017 with a so-called “narcotics prescription.”
Currently, Germany’s medical doctors can only recommend cannabis for a patient, and then assist the patient with the complicated application process.
One gram of cannabis currently costs an average of 15 euros, although the strain variety is very limited at seven. The oldest and most popular strain is “Bedrocan” by the Dutch company of the same name, deriving from Jack Herer (Sensi Seeds).
The state-supervised producer offers:
Bedrocan (Jack Herer, THC 22%, CBD <1%)
Bedrobinol (Jack Herer x Afghaan, THC 14.5%, CBD <1%)
Bedica (Afghani x Herijuana, THC 14%, CBD <1%)
Bediol (Strain unknown*, THC 6.5% CBD 8%)
Bedrolite (Strain unknown*, THC 1%, CBD 9%)
Since the end of August 2016, there are two Tweed varieties from Canada’s state cannabis program:
Argyle (Nordle, THC: 6.31% CBD: 8.92%)
Princeton(Ghost Train Haze, THC: 14.00%, CBD <1%)
Another two other Tweed varieties will follow soon:
Penelope (CBD Skunk Haze, THC: 10.2%, CBD: 7.42%)
Houndstooth (Super Lemon Haze, THC 13.5%, CBD 0.05%)
Within the next week, Ontario-based producer Peacenaturals will be selling the following strains via German pharmacies:
Pedanios 22/1 (Strain unknown*, THC 22%, CBD 1%)
Pedanios 14/1 (Strain unknown*, THC 14%, CBD 1%)
Because the varieties offered are more expensive than high-quality cannabis on the black market, many patients still buy illegally or grow their own despite their lack of permission. To make matters worse, the pharmaceutical products offered in pharmacies are still much more expensive than the herbal cannabis they also sell. For example, 1000mg of THC costs 456.80 euro as the mouth spoon Sativex, as Dronabinol drops 880 euro and 68.20 euro as herbal “Cannabis Flos.”
However, Sativex is paid by health insurance for patients with a Multiple Sclerosis diagnosis. Dronabinol or buds are only covered by insurance companies in very rare and exceptional cases, most German cannabis patients must pay for medicine out-of-pocket. But in Germany the reimbursement of almost all drugs is anchored by law, and the new law could make cannabis a prescription medicine covered by health insurance providers. A multi-year trial with voluntary patients will decide if cannabis will need to be covered by health insurance providers.
Germany Moves From Cannabis Importer to Producer
The Federal Republic will be letting companies grow medical cannabis on domestic soil in the near future. The new law provides for the establishment of a German Cannabis Agency which will issue state licenses for cultivation and monitor production and distribution channels. Although the agency has not yet been established, many companies have already applied for a license through the BfArM. Insiders consider German-Austrian company Bionorica as a serious potential player in the burgeoning market. The company already cultivates cannabis in Vienna for Dronabinol production together with the Austrian Agency for Health and Nutrition Safety (AGES). Bedrocan does not seem to have any interest in building up facilities in Germany, as the Dutch producer is currently busy on new projects in the Czech Republic and Italy.
The new agency’s rules will likely to be similar to those of the Netherlands, and therefore be very strict. For the production of medical cannabis, minimum requirements such as 100% sterility, accounting for every milligram handled, a financial concept, access to significant starting capital as well as the cooperation of pharmacologists, doctors, government laboratories and various other government authorities.
For Germany’s illegal growers, it will be much more difficult to legalize their business than it was in the U.S. with small-scale medical dispensaries. The new rules are things underground botanist are not too familiar with yet, because transparency is just as new to German growers as new as the difference between Master Kush and Purple Haze is for an official in the German Cannabis Agency.
The Gold Mine in Strain Knowledge
Countries with established medical cannabis programs have made one thing clear: a medical cannabis program works a lot better with the help of growers. The Netherlands have cooperated with former illegal botanists since 1993 to set a medical cannabis program.
In Canada, it was obvious that the program would not work without the knowledge of patients and growers. For this reason, a few years ago, patients were asked to provide the producers with their home-bred strains. Those strains were then taken over by the cannabis companies and certified by Health Canada. For the development of new strains, the producers now have laboratories and personnel, which work according to scientific and medical standards. However, the Strain-Knowledge of the Canadian Medical Growers was the basis for a well-functioning program, creating competition by strain diversity.
Although Canadian patients are not too satisfied with the program, compared to Germany the variety is now robust, the prices are adequate and the quality is strictly controlled and excellent. While in Canada, patients can choose from more than 200 strains with different cannabinoid profiles, whereas a few EU countries with corresponding laws have just five; in Germany, currently seven strains are available.
The countries attempting to keep illegally acquired botanic knowledge out of their reach are currently not ready to put their own medical cannabis programs on their feet. Uruguay has had three years to get it right, but to this day, a legally-produced flower has not been delivered to patients. In the Czech Republic and Italy, production is lagging far behind the demand, with both states’ programs failing after being initialized. Now Bedrocan consults at least Italy and the Czech Republic.
Finland imports Bedrocan and has no intention of producing domestically for patients. The rest of the EU does not care at all. Even in cannabis-liberal Spain, where thousands of social clubs are tolerated, patients still move in a gray area due to the lack of a medical cannabis law.
The average German patient receives 1.8 grams of cannabis per day, which equates to an annual requirement of 591 kilograms for the current 900 patients. Once the new law comes into force and cannabis becomes prescriptive on a national level, observers expect a rapid increase in demand.
Maximilian Plenert, who is regularly invited by the German Bundestag as an expert in questions about medical cannabis, estimates with approximately 175,000 patients that, “The quantity of cannabis, which a patient has received on average per day, was four grams in 2014 (in Canada) is now 2.7 grams. The number of patients developed parallel to the quantity sold cannabis. In mid-2014 it was 7,914 people and the most recent value for mid-2016 was 75,166 patients. The proportion of patients in the population is slightly above 0.2%. In Germany, there are 0.001% of the inhabitants who have a medical license. As a first approximation, one can transfer absolute values to Germany. The number of inhabitants is higher (in Germany) by a factor of 2.3. This makes 175,000 patients in Germany soon, compared to Canadian circumstances.”
20 Legal Plants Are Already Flowering
Similar to “Urban Grower” Remo and other Canadian patients, two patients in Germany have fought successfully for their right to self-help. In addition to Michael F., Frank Ackermann has been able to continue his legal cannabis therapy with self-cultivated flowers since December 2016. But the conservative Federal Ministry of Health has not discovered his heart for distressed cannabis patients overnight, Ackermann has merely made the best of a 16-year-long series of defeats in the court: A new law that keeps patients from growing currently only allows two patients permission to grow; both won their lawsuits before the law was implemented. Three more might follow soon due to another pending lawsuit. .Just as during the Harper-area in Canada, despite the numerous defeats against self-supplying patients, homegrowing patients are still not part of the new German law. Therefore, all private licenses are limited in time and are expected to be withdrawn as soon as the law allows the reimbursement of the costs or provides patients with cannabis produced in Germany. Because of the history of its origin, the new law is called “cannabis cultivation prevention act” among patients.
Germany would do well to skim off the strain knowledge and needs of its growing patients as quickly as possible. Everything else leads to new lawsuits like those filed in Canada. In the end, German patients will be able to choose whether they want to alleviate their symptoms with self-cultivated flowers or Cannabis Flos, tinctures, extracts, and other pharmaceutical products available at the pharmacy. The main thing is, it helps.
Cover Image Courtesy of Max F. Schubring
* Business secret