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HEALTH

EXPLAINED: How Germany’s future cannabis clubs could work

Germany's plans to legalise recreational cannabis will be welcomed by many weed smokers - but with legal routes for purchasing the drug restricted to highly regulated clubs, it's not quite the free-for-all that many imagined. Here's what you need to know.

Published: 8 May 2023 13:31 CEST
EXPLAINED: How Germany's future cannabis clubs could work
A man smokes a joint at a cannabis legislation protest in Berlin in May. Photo: picture alliance/dpa | Annette Riedl

For many Europeans, hearing the words ‘cannabis legalisation’ conjures up images of Amsterdam-style coffee shops: special licensed weed cafes where stoners and tourists while away hours in a cloud of smoke.

This was one of the ideas on the table as Germany’s coalition government set about planning its forthcoming legal cannabis market – alongside the sale of marijuana in pharmacies and other licensed shops.

But after experiencing legal hurdles – not least of all from the EU’s Narcotics Act – the Health Ministry last month put together a significantly watered down version of the plans. 

Significantly, growing a small amount of cannabis at home, consuming the drug or carrying a certain amount of it while out in public will no longer be criminalised. 

But people who want to purchase or sell marijuana through legal channels with have some significant hurdles to jump through.

According to a new draft law obtained by DPA, the government wants cannabis to be bought and sold at special licensed clubs that are subject to strict regulations – and there will also be stringent rules on when and where the drug can be consumed in public.

Here’s an overview of what’s in the draft so far – though it could be amended at a later date.

Members-only clubs

When the plans to legalise cannabis were described in the original coalition agreement, the SPD, Greens and FDP envisioned the sale of weed in “licensed shops” that you might encounter around the city.

Instead, the Health Ministry now wants to allow people to set up “cultivation associations” that grow and sell cannabis to members. This is very similar to a model established in Malta, where non-profit collectives set up their own mini weed farms and sell their products at a low price to members. 

In Germany, membership will be restricted to people over the age of 18 and no more than 500 members per club. There will also be rules stating that individuals cannot be members of more than one club at a time, and that the associations can only sell cannabis to members. 

If you gain membership of one of these clubs, though, you’ll still have some restrictions around purchasing cannabis. According to the draft, each member will be able to purchase a maximum of 50g of cannabis per month, which will be sold in plain packaging or no packaging at all.

A leaflet detailing the weight, harvest date, best before date, variety and active ingredient content (THC and CBD) should also be provided whenever the drug is sold. 

READ ALSO: EXPLAINED: What you need to know about Germany’s plan to legalise cannabis

No smoking on the premises 

Though the term ‘club’ may suggest a social environment, Germany’s members-only clubs are unlikely to turn into gathering spots for people who enjoy weed.

That’s because, according to the draft, people won’t be allowed to smoke on the premises – or within 250 metres of it.

According to the government, this membership system will be the first phase in a two-phase process of piloting the legalisation of weed. As a next phase, a small number of licensed shops could be set up in certain local districts in order to test how this could impact society and potentially help combat the black market. 

Cannabis legalisation demo Berlin

A protester smokes a joint during a cannabis legalisation demo in Berlin. Photo: picture alliance/dpa | Annette Riedl

Reporting to authorities

For owners of cannabis cultivation clubs, there’ll be a fair amount of paperwork to contend with. For example, the clubs will have to submit annual reports to the authorities revealing how much cannabis was produced, what quantity of active ingredients (i.e. compounds that produce a ‘high’), how much of their stock they dispensed with or destroyed in the past year and what their current stock levels are. 

In addition, according to the draft, the clubs must continuously document where they obtain seeds, how many plants they grow and seeds they store and the amount of cannabis purchased by individual members. 

They must also ensure that limits for pesticide and fertiliser residues are complied with.

Child protection laws

Clubs will also have to navigate strict rules designed to protect children and young adults. As well as restricting membership to over-18s, there will be a special category of membership for youths aged 18-21. 

This group will only be allowed to purchase up to 30g of cannabis per month, with a maximum THC content of 10 percent. THC is the active ingredient that produces psychedelic effects, while CBD is the ingredient that causes smokers to feel relaxed and mellow. 

Areas of the club where cannabis is stored and grown will need to be sealed off to the public, with heightened security measures to prevent break-ins and theft. According to reports by DPA, the draft also stipulates that minimum distances to places like schools and nurseries will have to be maintained.

In addition, club owners will need to draw up a youth and health protection concept and appoint a fully trained addiction prevention officer. 

READ ALSO: UPDATE: German ministers present draft law on cannabis legislation

Hemp plant at cannabis legalisation demo

A hemp plant made out of plastic is displayed as part of a demonstration calling for the legislation of cannabis. Photo: picture alliance/dpa | Annette Riedl

Restrictions on smoking in public

Alongside strict rules around purchasing and selling cannabis at the members’ clubs, the draft also sets out some restrictions on smoking weed in public.

People wanting to smoke outdoors will need to think carefully about where they do it, as they’ll need to keep a distance of at least 250 metres from schools, day-care centres, playgrounds, youth facilities or sports facilities.

Smoking in “pedestrian zones” will also be banned between 7am and 8pm, so people who want to light up a joint in these areas will need restrict their smoking time to the evenings. 

Growing and carrying cannabis

Despite the tough rules around buying (and consuming) marijuana, the legislation still marks a sea change in the legal system’s approach to the drug.

If the law passes without significant changes, people will in future be able to grow up to three of their own cannabis plants for personal use and won’t get in trouble with the police if they’re found carrying up to 25g in public. 

What are the next steps? 

Health Minister Karl Lauterbach (SPD) apparently circulated his draft law around various government ministries at the end of April.

Once this review process is done and the draft has been finalised, a consultation process begins in which the government talks to relevant experts and stakeholders. This is expected to happen this month.  

After this – likely in June – the draft will voted on by the cabinet ministers. Once this hurdle is cleared, the plans can go to the Bundestag for a debate. However, the Health Ministry says it will not be required to be put to a vote. 

At some point in summer, Germany’s Constitution Court is also expected to make a decision on whether the law complies with the country’s Basic Law. Depending on the outcome, the law may have to be amended again.

Currently, the government is hoping to kick off the licensing process by the end of the year, with clubs potentially opening their doors in 2024. 

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OPINION AND ANALYSIS

OPINION: Why it’s becoming harder to get a doctor’s appointment in Germany

Germany's health service is known as one of the best in the world but securing a timely appointment with a doctor is getting harder. A creaking system and the culture around excessive doctor visits are part of the problem, argues Brian Melican.

Published: 17 May 2024 11:54 CEST
OPINION: Why it's becoming harder to get a doctor's appointment in Germany

Germans have always been known for being health-conscious – some would even say hypochondriacs. That has its down-sides (see Covid…), but also some notable advantages. One is the ability to go to any doctor’s practice and request treatment, skipping general practitioners, referrals, and all of the attendant bother.

As a result, in any well-to-do area of a major German city, you’ll have a bewildering array of medical practitioners within walking distance, from general physicians (Allgemeinmedizin) and orthopaedic practices (Orthopädie) to ones that will have you Googling (HNO stands for Hals-Nase-Ohren – ears, nose, and throat – by the way. You’re welcome.)

The strength of this patient-choice system is that it allows people to manage their own care. So if one doctor can’t see you, you go and find another. And if you’ve moved towns or fall ill away from home, you can still access care. In theory, this spreads demand and keeps people with non-urgent complaints out of casualty wards. Yet in practice, the system is now creaking audibly. 

In recent months, I’ve tried to get appointments for several routine procedures with doctors’ offices I have been visiting for years – and the earliest I could get anything was, to my surprise, now several months off. Both dentists and dermatologists are currently, it would seem, planning their schedules for September and October. And when a rather unpleasant case of shoulder pain struck earlier this year (fittingly, just ahead of my 39th birthday…), the earliest appointment I could get at any of the three(!) local orthopaedic practices was at least a month off.

This isn’t just me getting unlucky here. In a recent representative survey, only 25 percent of respondents reported having no trouble getting a doctor’s appointment. The rest are having to wait anything between two weeks and two months – and I’m clearly now one of the 15 percent who report even longer delays. 

I’m not alone in thinking – knowing – that it didn’t used to be this way. So what has gone wrong? 

READ ALSO: Seven things to know about visiting a doctor in Germany

Structural changes in medical practice: fewer doctors working fewer hours

First off, there are changes afoot among Germany’s niedergelassene Ärzte – literally ‘settled doctors’ with surgeries, called so in order to distinguish them from hospital medics. For one, these doctors are getting old and retiring – just like the population they serve (or rather: have served). And as younger cohorts are less numerous, physicians looking to pass on their practices are having difficulty finding takers – especially in disadvantaged urban areas or out in the sticks.

A patient undergoes a consultation with his doctor.

A patient undergoes a consultation with his doctor. Photo: picture alliance/dpa/AbbVie Deutschland GmbH & Co. KG | AbbVie Deutschland GmbH & Co. KG

Even where there is no shortage of potential successors, ever fewer of them actually want to set up in business for themselves. For most young medics’ taste, there’s too much paperwork, too much commercial risk, and far too much work involved in running their own surgery. Instead, they prefer to merge with others or sell on to management companies who will, in turn, employ them (often part-time, with no annoying evenings or weekends on call). 

The results of all of this are as follows. Within the space of just one year, between 2022 and 2023, the number of surgeries fell by 1,987 – a drop of over two percent. Meanwhile, in 2023, for the first time ever, more than one third of Germany’s 150,000 non-hospital doctors were employees, not self-employed. That’s twice the number in 2013. Moreover, over the same period, the number of medics opting to go part-time has gone up by 235 percent to 60,000. This means that, if your local surgeries haven’t closed, the likelihood is that the doctors there are now working fewer hours – and so there are fewer appointments left to go round.

READ ALSO: Do doctors in Germany have too little time for their patients?

This would be bad news for any society, but it hits particularly hard in Germany. As a rapidly-ageing society with a relatively unhealthy population (high rates of smoking and obesity), our demand for medical services – often for complex chronic illnesses – is rising just as provision is declining.

Cultural differences in consulting doctors

Another problem is that Germans are accustomed to a historically high number of available doctors – and as serial worriers (and passionate sick-note seekers) make excessive use of them. Your average German racks up almost 10 consultations a year – not including visits to the dentists! The OECD average is closer to six. And the stoic Swedes, strong silent types that they are, go the doctor’s just 2.3 times a year.

Even if I wanted (or needed) to, I simply couldn’t to get to the quack’s almost once a month: I don’t have the time and they don’t have the appointments. But in conversation, I notice that others clearly do manage to find both. Increasingly, I’m wondering how many of them, unlike me, have private health insurance. 

This brings us to the third major issue facing non-hospital care in Germany. When the figures in the representative survey I quoted above are broken down, it transpires that almost 60 percent of people who are insured in the state system (gesetzlich versichert) are now waiting longer than two weeks for an appointment; among those who are privately insured (privat versichert), that figure is only 37 percent.

Doctors ‘keen on private patients’ 

Doctors are keen on private patients because their insurers pay more for the same procedures and will also cover all sorts of supplementary stuff – from the clinically-proven through to the just plain wacky. As such, practices reserve as many appointments as possible for private patients and try to keep the rest of us at bay.

Given that around four in five people in Germany are in the state system, however, this leaves the majority of patients competing for the minority of slots. If you want to see how the other fifth live, try “accidentally” clicking privat on surgeries’ online booking tools: you will now see a range of appointments available within days while the rest of us are being fobbed off for weeks or even months.

Not only is this, as my grandmother used to say, enough to make you want to join the Communist Party – it’s wildly inefficient. By restricting the hoi-polloi to slots often months off, doctors are creating their own appointment-management problems: sometimes, the complaint in question will have disappeared by the time the consultation rolls around; more often, it will have actually been dealt with – not infrequently by the same physician – if the patient presents as an acute case earlier.

As such, slots weeks away are booked, only to be cancelled later by conscientious patients (and left blocked by others), while those same patients crowd into waiting rooms begging to be seen urgently at an open surgery. (That’s how I got my shoulder looked at.)

A German health insurance card.

A German health insurance card. Photo: picture alliance/dpa | Jens Kalaene

The cynic in me says that, in the long run, this might not be such a bad thing. If the increasing scarcity of doctor’s appointments gets Germans thinking about whether they really, really need to be seen for yet another case of the common cold (“No, Christian, it isn’t pneumonia this time, either!”) or various nebulous self-diagnosed ills (Kreislaufbeschwerden (circulatory problems) is the day-off-work-one I love to hate), maybe it’s not a bad thing.

Swedes don’t die unnecessarily because they avoid the doctor’s: in fact, they live a good year longer than us on average. The German in me, though, says: “My shoulder hurts. Maybe I’ve got early-onset arthritis. I should probably go and get it checked out…” And even though I don’t go too often, I’ve got used to being able to see a specialist when I need one. It’s a shame that this is becoming markedly more difficult.

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