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Introduction
01
Dealing with medical cannabis in daily life: what should be considered?
When using Cannabis as a medicine, some important aspects should be considered in daily life. Apart from the fact that these are legally narcotics, the proper storage of the preparation as well as the environment in which medical cannabis is best used or taken must be considered. Having the most recent prescription for medical cannabis issued by your physician on hand, participating in road traffic and the availability of necessary certificates when traveling are points to consider in the daily handling of medical cannabis.
Medical cannabis in public places
02
Inhalation or ingestion of medical cannabis in public places
The legislator has not made any specifications as to where or in which environment a cannabis-based medicine may be inhaled or ingested. But actually it is clear to everyone: for outsiders it is not recognisable whether the use of cannabis is for legal, medical reasons or not. Therefore, it is advisable to refrain from using it in public spaces.1
Storage of medical cannabis
03
Storage of medical cannabis
In general, all medicines – including medical cannabis should always be stored in a “child-safe” manner, namely in a special place inaccessible to children. If children or people for whom the medical cannabis has not been prescribed accidentally take it, it can lead to dangerous health problems. Certain cannabis medicines should be stored in the refrigerator and should not be accessible to children and other people there.1
Traveling with medical cannabis
04
Traveling with medical cannabis
Whether and how much medical cannabis you can carry with you depends on the destination. Within the Schengen area, patients are allowed to carry medical cannabis on their person as travel necessities for up to 30 days – in the amount prescribed for the period.4
The Schengen area includes the following European countries: Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Sweden, Switzerland, Slovakia, Slovenia, and Spain.
Additionally, a “Certificate for the carrying by travellers under treatment of medical preparations containing narcotic drugs and/or psychotropic substances” is required in accordance with Article 75 of the Schengen Implementation Agreement. This certificate must be completed by the treating physicians and authenticated by the supreme state health authority. A separate certificate is required for each preparation.4
For travel outside the Schengen area, there are unfortunately no uniform international regulations regarding the carrying of narcotics. In some countries the carrying of Cannabis is strictly forbidden and subject to drastic penalties. Therefore, you should check the respective entry and exit regulations of the country you are travelling to and, if necessary, contact the diplomatic representation of the country you are travelling to inquire about the possibility of a local prescription. When travelling by air, it is advisable to keep the medicinal cannabis in your hand luggage, together with all the necessary aids for consumption. The same applies to the necessary papers such as a copy of the prescription and the certificate to carry your medicine.
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Participation in road traffic
05
Participation in road traffic
Patients treated with medical cannabis are legally treated in the same way as other patients taking a medicine that affects their ability to participate in road traffic or operate a machine. It is best for patients to consult with the treating physician about whether they can participate in road traffic.5
During the one to two week dosing or stabilisation phase of the therapy, driving vehicles (e.g. motor vehicles, bicycles, ships) should generally be avoided. This also applies to increasing the dose and changing the type of drug. After completion of the acclimatisation phase, regular participation in road traffic is possible if medical cannabis is taken as prescribed. However, it is the responsibility of the attending physician to assess this.5,6
The prerequisites for this are:
- the patients are in stable condition
- taking the narcotic does not negatively affect the general condition of the patients
- the patients critically assess their ability to drive and consult with the treating physicians concerning this
In principle, the same requirements for driving ability and the same legal situation apply as for the use of opioids in pain therapy.7 When driving motor vehicles, cannabis patients have an alcohol limit of 0.0 per mille. The consumption of alcohol and other psychoactive substances by cannabis patients before driving results in the loss of the driver's license. In the event of a violation, there is a risk of criminal liability in accordance with § 316 of the Criminal Code (StGB).5
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Please note
"Although cannabis patients are not threatened with a sanction pursuant to § 24a paragraph 2 StVG merely for taking cannabis, if it is a prescribed drug being taken properly for a specific illness, it is nevertheless the responsibility of the patient and that of the treating physicians to determine whether the ability to drive is impaired.”5
References
Status: 2021
BfArM: Bundesopiumstelle. Hinweise für Patienten https://www.bfarm.de/DE/Bundesopiumstelle/Cannabis-als-Medizin/Hinweise-fuer-Patienten/_node.html (last visited on 06 Aug 2021)
Laub L. Cannabismedikation und Medikamentenprivileg des § 24 a StVG. DPolG – Deutsche Polizeigewerkschaft Polizeispiegel 2017; 51(7/8). https://www.dpolg.de/fileadmin/user_upload/www_dpolg_de/pdf/polizeispiegel/polizeispiegel_17_08.pdf (last visited on 06 Aug 2021)
Arbeitsgemeinschaft Cannabis als Medizin e.V. Cannabis-Ausweis der ACM https://www.arbeitsgemeinschaft-cannabis-medizin.de/2018/09/09/cannabis-ausweis-der-acm/?highlight=Cannabisausweis (last visited on 06 Aug 2021).
Schengener Übereinkommen. https://www.auswaertiges-amt.de/de/service/visa-und-aufenthalt/schengen/207786#content_2aufenthalt/schengen/207786#content_2 (last visited on 21 July 2021).
Deutscher Bundestag. (2017, März 27). Drucksache 18/11701: Cannabismedizin und Straßenverkehr. https://dip21.bundestag.de/dip21/btd/18/117/1811701.pdf (last visited on 01 Aug 2021)
Ärzteblatt. Cannabispatienten dürfen Auto fahren https://www.aerzteblatt.de/nachrichten/74004/Cannabispatienten-duerfen-Auto-fahren (last visited on 01 Aug 2021)
Grotenhermen F, Häußermann K. Cannabis. Verordnungshilfe für Ärzte. Wissenschaftliche Verlagsgesellschaft Stuttgart 2019.