Hospital.Help

Berlin The Federal Ministry of Health (BMG) is missing the opportunity to urgently strengthen addiction prevention with its draft amendment to the Cannabis Act. Medical and psychotherapeutic associations as well as addiction support associations unanimously criticized this today at the hearing of the draft law in the Federal Health Committee.

The new draft law emerged from the protocol note with which the federal government attempted to respond to objections from the state governments in the run-up to the vote on the Cannabis Act in the Bundesrat.

In essence, the draft primarily provides for changes in the regulation of so-called cultivation associations. This will give the states more flexibility in dealing with these and allow them to adapt the granting of permits for cultivation associations to local or regional peculiarities.

In addition, the already planned evaluation of the effects of legalising cannabis is to be expanded in order to obtain initial findings as early as possible, and the Federal Centre for Health Education (BZgA) is to provide further training for addiction prevention specialists in order to support the countries’ efforts to strengthen addiction prevention.

We see it as positive that prevention is now being thought about and addressed more, explained Miranda Lee of the German Medical Association (BK). What we see, however, is that the BZgA’s offering is valuable, but is mainly online. But we need prevention on site.

More real-life prevention by professionals is needed, which takes place in schools, clubs and the like. And we don’t think that is adequately addressed in the amendment law, she complained.

For this, she received approval from the Federal Association of Pediatricians and Adolescent Doctors (BVKJ) and from the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN).

The BZgA’s offer is already helpful, explained BVKJ speaker Simon Hilber: What we would also like to suggest is that peer education could be strengthened through the BZgA’s offers. The additional preventive measure through the BZgA’s planned training program is to be viewed positively, admitted DGPPN board member Euphrosyne Gouzoulis-Mayfrank, but in our view this is not enough.

Roll out concepts nationwide

The BZgA does not need to reinvent the wheel, stressed Maximilian Plenert from the Federal Association for Accepting Drug Work and Humane Drug Policy (akzept). There are already very good concepts in the professional world, but they are not being rolled out nationwide, he said. We need work that focuses on harm reduction, because there is a big gap in this area with cannabis.

In addition, the controlled legalization of cannabis is expected to lead to an increase in consumption, especially among minors, stressed Hilber. It is unrealistic to believe that 18-year-olds would refrain from legally consuming cannabis because 17-year-olds or even younger are present.

We have to acknowledge that a normalization of cannabis consumption in public will have an impact, he stressed. However, the Federal Government’s communications are also partly to blame for this normalization when it advertises its plans in youth language with slogans such as “Bubatz legal”.

In this respect, major preventive efforts are necessary, he said. However, this was already the case before the Cannabis Act, and the BVKJ is in favor of expanding prevention to include alcohol and tobacco.

BK and DGPPN also expect an increase. If you expand the market and thereby increase the availability of a psychoactive substance, this will of course lead to more consumption, noted Lee.

This will come at a time when the medical profession is already under increasing pressure due to the consequences of risky cannabis consumption. We know from health insurance data that the need for treatment has increased significantly between 2012 and 2022. We expect there to be a further increase in consumption, she explained. More capacity is already needed, especially in the rehabilitation sector.

We also know from other countries that have legalized cannabis as a recreational drug in recent years that legalization is accompanied by an increase in consumption and therefore the need for treatment, even if the results from different countries are inconsistent.

She believes that the four-year period planned for the evaluation is too short to prove serious effects. In addition, the evaluation must not be ineffective. If it proves serious consequences, immediate action must be taken. Here, too, there was agreement with the BVKJ and the DGPPN.

Experts and associations from the cannabis industry saw a possible indirect health risk from the stricter requirements for cultivation associations. The draft law is intended to prevent associations from using joint cultivation areas or even the same building, and to restrict services related to cultivation.

The aim is to prevent commercial business models based on large-scale cultivation with package services for cultivation associations, the draft law states. The regulations should ensure that the cultivation associations’ non-commercial self-cultivation character is for the members’ own consumption.

However, this could be counterproductive, stressed economist Justus Haucap. This is because merging and scaling would help to make production more straightforward and cheaper. I have a great fear that this will ultimately fuel the black market by making it very difficult to obtain cannabis legally, he said. The easier it is to obtain cannabis legally, the smaller the black market becomes.

The new regulations would make it even more difficult and expensive for cultivation associations to find premises, particularly in large cities and metropolitan areas, explained Jürgen Neumeyer, Managing Director of the Cannabis Industry Association (BVCw). Added to this would be investments in technology: For larger cultivation associations, the costs can quickly reach six figures and I don’t know of any bank that would provide a cultivation association with a loan for this.

Models by the Federal Association of Cannabis Cultivation Associations (BCAv) have concluded that the new regulations could lead to a 50 percent reduction in legal cannabis quantities, explained BCAv deputy coordinator Peter Reinhardt. This will also lead to fewer opportunities for intervention in prevention programs. © lau/aerzteblatt.de