German Cannabis Patients Use Much Higher THC Doses Than Expected

German medical cannabis patients using flowers consumed an average daily THC dose of 336 mg, nearly 20 times higher than patients using other cannabis-based medicines.

Hundertmark, Marica et al.·Forensic science international·2025·Moderate Evidencecross-sectional survey
RTHC-06697Cross Sectional surveyModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
cross-sectional survey
Evidence
Moderate Evidence
Sample
N=1,030

What This Study Found

Among 1,030 German medical cannabis patients, 89.9% used cannabis flowers. Average daily THC dose for flower patients was 336 mg compared to 17 mg or less for other cannabis-based medicines. 16.2% used combinations of different cannabis products. 28.4% smoked cannabis flowers despite medical guidance against smoking.

Key Numbers

1,030 respondents. 89.9% used cannabis flowers. Average daily THC dose: 336 mg (flowers) vs 17 mg or less (other preparations). 16.2% used complex combinations. 28.4% smoked flowers (not recommended medically).

How They Did This

Anonymous nationwide online survey of German medical cannabis patients in Q1 2022. Included both patients with health insurance prescriptions and self-payers for the first time. Analyzed application patterns with focus on the cannabis flower sub-collective.

Why This Research Matters

The large gap between THC doses from flowers versus other preparations has direct implications for driving safety assessments and medico-legal evaluations of cannabis patients in traffic incidents.

The Bigger Picture

As more countries legalize medical cannabis, understanding actual patient consumption patterns is critical for setting driving thresholds, assessing workplace impairment, and providing accurate forensic assessments.

What This Study Doesn't Tell Us

Self-reported data from an online survey. Self-selected participants may not represent all medical cannabis patients. No verification of actual THC intake. Q1 2022 data predates Germany recreational legalization.

Questions This Raises

  • ?How do these THC doses compare to what is typically prescribed versus what patients actually consume?
  • ?Should driving regulations differentiate between flower and non-flower cannabis patients?

Trust & Context

Key Stat:
Cannabis flower patients consumed an average 336 mg THC daily vs 17 mg or less for other preparations
Evidence Grade:
Large survey including self-payers for the first time, but self-report design and online recruitment limit reliability of dose estimates.
Study Age:
2025 publication with Q1 2022 survey data.
Original Title:
Individual application patterns of Cannabis-based Medicines in Germany - Descriptive evaluation of a patient survey and discussion from a forensic perspective.
Published In:
Forensic science international, 367, 112352 (2025)
Database ID:
RTHC-06697

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study
What do these levels mean? →

Read More on RethinkTHC

Cite This Study

RTHC-06697·https://rethinkthc.com/research/RTHC-06697

APA

Hundertmark, Marica; Ihlenfeld, André; Landschaft, Assaf; Röhrich, Jörg; Germerott, Tanja; Wunder, Cora. (2025). Individual application patterns of Cannabis-based Medicines in Germany - Descriptive evaluation of a patient survey and discussion from a forensic perspective.. Forensic science international, 367, 112352. https://doi.org/10.1016/j.forsciint.2024.112352

MLA

Hundertmark, Marica, et al. "Individual application patterns of Cannabis-based Medicines in Germany - Descriptive evaluation of a patient survey and discussion from a forensic perspective.." Forensic science international, 2025. https://doi.org/10.1016/j.forsciint.2024.112352

RethinkTHC

RethinkTHC Research Database. "Individual application patterns of Cannabis-based Medicines ..." RTHC-06697. Retrieved from https://rethinkthc.com/research/hundertmark-2025-individual-application-patterns-of

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.