Most German primary care physicians expected cannabis use and disorders to increase after legalization, yet few screened patients for cannabis use or wanted additional training.
Healthcare professionals, medical educators, and policymakers interested in physician readiness for cannabis legalization.
40.3% of physicians prescribed medical cannabis, but few routinely screened for recreational use
What the researchers found
Among 239 responding physicians, most anticipated increased cannabis consumption and disorders post-legalization. Doctors with personal cannabis experience (37.9%) were more optimistic about policy goals like quality control. Despite 40.3% prescribing medical cannabis, screening for recreational use was rare.
Why it matters
Primary care physicians are often the first point of contact for patients experiencing cannabis-related health issues, making their preparedness and attitudes relevant to post-legalization healthcare.
The numbers in context
25.3% response rate (239 of 946). 37.9% of respondents had personal cannabis experience. 40.3% prescribed medical cannabis. Most anticipated increased consumption and cannabis use disorders after legalization.
How the study worked
Exploratory cross-sectional survey of GPs and practice-based anesthesiologists in three German states, conducted from September 2023 to March 2024 (pre-legalization). 946 surveys delivered, 239 responded (25.3% response rate).
What this study cannot tell us
Low response rate (25.3%) introduces selection bias. Only three of sixteen German states surveyed. Pre-legalization timing means attitudes may shift with actual experience. Self-selected respondents may differ systematically from non-respondents.
How to read the evidence
Low response rate (25.3%) in a limited geographic area, pre-legalization timing, and exploratory design limit generalizability.
When this study was published
2025 publication with data collected September 2023 to March 2024, before Germany legalized recreational cannabis.
The bigger picture
The gap between prescribing medical cannabis (40.3%) and actively screening for recreational use reflects a broader pattern seen internationally, where healthcare systems have been slow to integrate cannabis screening into routine care even as legalization expands.
Questions still open
- Will physician attitudes shift after experiencing the post-legalization reality?
- Would structured cannabis screening tools increase detection of problematic use in primary care?
Read the original research
Attitudes and expectations of primary care physicians regarding recreational cannabis legalization in Germany: a pre-implementation survey.
Journal of cannabis research, 7(1), 101
Citation
Hochheim, Uta; Müller, Frank; Noack, Eva Maria. (2025). Attitudes and expectations of primary care physicians regarding recreational cannabis legalization in Germany: a pre-implementation survey.. Journal of cannabis research, 7(1), 101. https://doi.org/10.1186/s42238-025-00367-8