Prescription cannabis in Germany: requirements, procedure and which doctor is responsible

Anyone considering cannabis therapy will quickly come across conflicting information about who is authorised to prescribe it and what is required. This article explains the process: what the legal requirements are, what is assessed medically, and what happens after a prescription has been issued.

Key points at a glance

• Medical cannabis can be prescribed by doctors in Germany. Since 1 April 2024, the Medical Cannabis Act has applied to this, replacing the previous classification as a controlled substance. Since then, it has been prescribed on a standard prescription, usually as an e-prescription.
• Whether a medicine may be prescribed and whether statutory health insurance covers it are two separate issues with different requirements.
• The prescription is subject to a medical assessment. There is no entitlement to one, and there is no automatic route from a request to a prescription.
• Treatment is generally provided by registered doctors. The appropriate specialism depends on the underlying condition.

Can medical cannabis be prescribed in Germany?

Yes. Medicinal cannabis products are prescription-only medicines and may be prescribed following an appropriate medical assessment. The legal framework has changed: since 1 April 2024, medicinal cannabis is no longer regulated by the Narcotics Act, but by the Medicinal Cannabis Act. In practical terms, this means that a narcotics prescription is no longer required; a standard prescription is sufficient. An exception is the synthetic active ingredient nabilone, which remains subject to narcotics legislation. Older guidance documents and descriptions of the procedure often no longer reflect this current situation.

It is important to make a distinction that clarifies many questions in advance. A prescription initially only states that a doctor considers a particular medicine to be medically justified. Whether statutory health insurance covers the costs is governed by its own rules. Since 30 July 2026, dried cannabis flowers can no longer be prescribed at the expense of statutory health insurance. Since then, the statutory entitlement has covered cannabis extracts of standardised quality, as well as medicines containing the active ingredients dronabinol or nabilone. If the issue of cost is a priority for you, it is worth taking a closer look at this.

Which medical requirements are assessed

The first step is not to decide on a particular medicine, but to assess your situation. This initially involves determining what condition or set of symptoms you actually have and how certain this diagnosis is. A cannabis-based medicinal product is typically considered when symptoms have persisted for some time and established treatments have not been sufficiently effective, have not been well tolerated, or are not an option for medical reasons.

Any potential contraindications are also assessed. These include a history of mental health conditions, particularly psychoses in one’s own or family history, cardiovascular diseases, an existing or planned pregnancy, and interactions with other medicines. Your age, your occupation and whether you regularly drive a vehicle or operate machinery may also influence the assessment.

This overall assessment determines whether cannabis therapy appears medically appropriate. A specific diagnosis does not automatically lead to a prescription, and a consultation with a doctor is not a procedure with a predictable outcome.

Which doctor is in charge?

In principle, registered doctors may prescribe cannabis-based medicines. The Medicinal Cannabis Act does not stipulate that only specialists may prescribe such medicines, but it expressly excludes dentists and veterinary surgeons from the authority to prescribe and dispense them. There is no specific specialist designation for cannabis therapy.

In practice, therefore, responsibility depends on the condition to be treated. In the case of chronic pain, this often involves practices specialising in pain management; for neurological conditions such as spasticity, it is neurology; and for conditions related to cancer, it is oncology or palliative care. The GP’s surgery is often the most sensible first point of contact, as the patient’s medical history and current medication are already on file there.

There is also a practical point to consider: as a rule, prior authorisation from the health insurance fund is required for a prescription to be covered by statutory health insurance. Since October 2024, certain specialist, sub-specialist and additional qualifications have been exempt from this requirement; these are set out in a list drawn up by the Joint Federal Committee, including, amongst others, general practice, anaesthesiology, neurology, several specialisations in internal medicine, and the supplementary designations palliative medicine and specialised pain management. In the case of specialised outpatient palliative care, the authorisation requirement does not apply in any event.

Experience and willingness also vary considerably from practice to practice. It therefore makes sense to search specifically for practices that regularly deal with this issue, rather than booking appointments at random. Find doctors with experience in cannabis-based therapy in your area

What information is relevant to the consultation

To carry out a medical assessment, the practice needs as complete a picture as possible. It is therefore helpful if you can provide the following documents and information:

• Doctors’ letters, test results and diagnoses relating to the condition in question
• a list of all medicines, dietary supplements and over-the-counter products that you are currently taking
• an overview of which treatments you have already tried, for how long and with what results
• Information on previous medical conditions, including mental health conditions, and a family history of illness

It is just as important to provide an honest description of your symptoms in everyday life: when they occur, how severe they are and what you are no longer able to do. Some practices ask you to keep a record of this over a period of several weeks. This provides a basis for comparison when assessing later on whether a treatment is having an effect.

What happens next following the regulation

Cannabis-based medicines are dispensed through pharmacies. Depending on the product, a pharmacy may first need to order or prepare it, meaning there may be a delay of several days between the prescription being issued and the medicine being dispensed.

The actual core of the treatment begins afterwards. It is common practice to start cautiously and to have regular follow-up appointments, during which the effectiveness, tolerability and the agreed treatment goal are reviewed. If the hoped-for benefits fail to materialise or if the side effects outweigh the benefits, discontinuing the treatment is also a possible outcome. For the same reason, you should always discuss any changes, side effects or adjustments you have made yourself with the practice providing your treatment.

It is worth taking a sober look at telemedicine. Video consultations are a standard part of healthcare provision, but they are not a shortcut to obtaining a prescription. A draft bill to amend the Medical Cannabis Act proposes linking the initial prescription of cannabis flowers to a face-to-face consultation with a doctor and prohibiting the postal dispatch of flowers. Following its first reading in December 2025 and the public consultation in January 2026, this draft had not been adopted at the time of this review. Until it comes into force, the current legal position remains in force, which is why this point may change at short notice.

Frequently Asked Questions

Will I definitely get a prescription from a cannabis doctor?

No. Whether a prescription is issued depends on the outcome of the medical examination, not on a patient’s request for a specific medicine. Practices that promise a prescription in advance are not reputable.

Do I need a referral?

Not usually. You can contact a suitable practice directly. However, existing test results and doctors’ reports make the assessment considerably easier.

Do I have to have tried all other treatments first?

This is not strictly necessary for a prescription as such; however, separate conditions apply for coverage by statutory health insurance. In addition to a serious illness and the absence of an applicable standard treatment, the law has stipulated since 30 July 2026 that a six-month trial of treatment with an authorised ready-to-use medicinal product containing cannabis must first take place. Opinions currently differ amongst the parties involved as to how this requirement should be interpreted in individual cases. You should therefore clarify in practice what applies to your specific situation.

Classification

The path to cannabis-based treatment is not a mere formality, but a medical decision with an open-ended outcome. You will be best prepared if you can provide a complete account of your medical history, previous treatments and current medication, and if you consider the issue of costs separately from the question of the prescription.

If you’re looking for a suitable practice, it helps to take a close look at the location and the consultation hours on offer. View cannabis doctors by region