Citation

Fischer B, Hall W. Lancet Reg. Health Eur. 2022; 23: e100546.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.lanepe.2022.100546

PMID

36405403

PMCID

PMC9672943

Abstract

Germany's federal (centre-left coalition) government is moving to implement the legalization of the non-medical use and supply of cannabis. Since 2012, several jurisdictions have done so (e.g., Uruguay, 19 US states, Canada, Malta, Thailand) or proposed (e.g., New Zealand) this policy reform, commonly for public health and safety objectives.1,2 Germany will be the first G-20 nation and European Community member doing so, and therefore set important precedents. Basic parameters of Germany's regulation plans have been outlined by its Federal Ministry of Health in charge of the legislation.3 The blueprint allows for selected comments on main regulatory issues, specifically based on experiences with cannabis legalization under different regulatory models implemented--and, to some degree, evaluated--in other jurisdictions.1,2 Overall, Germany's legalization framework is public health-oriented in goals, while allowing commercial cannabis production and distribution. Thereby it starkly resembles the regulatory approaches adopted elsewhere (e.g., Canada), yet an essential question is to which degree proposed regulations will effectively serve to advance public health goals.

Germany initially proposed to impose a general (15%) THC-content cap on legally available cannabis products. This was motivated by concerns that high-THC products are associated with increased risks for a variety of adverse health outcomes, including cannabis dependence and/or mental health problems.4 The proposed limit has since been abandoned, yet it raises questions for practical feasibility and impacts for legalization-policy. THC-content of cannabis products consumed has increased considerably beyond 15%, with cannabis flower commonly containing 15-25% THC or more and cannabis extracts 40-90% THC. The proposed cap would have meant that many consumers of higher THC-level products, which disproportionately include higher-risk users, would likely not purchase their cannabis from the legal (quality-controlled) market.5 This, in turn, would help to maintain demand for illegal cannabis products and a continuation of illegal cannabis markets contrary to interests of public health and safety. Rather, regulators should focus on limiting THC-content per cannabis-unit sold and providing consumer-oriented education about ways to reduce the risks for adverse health associated with higher-THC product use...

Language: en