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.
Forensic toxicologists, traffic safety regulators, and medical cannabis prescribers.
Cannabis flower patients consumed an average 336 mg THC daily vs 17 mg or less for other preparations
What the researchers 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.
Why it 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 numbers in context
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 the study worked
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.
What this study cannot 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.
How to read the evidence
Large survey including self-payers for the first time, but self-report design and online recruitment limit reliability of dose estimates.
When this study was published
2025 publication with Q1 2022 survey data.
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.
Questions still open
- 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?
Read the original research
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
Citation
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
Explore the wider topic
- CBD Oil Quality Guide: How to Avoid Snake Oil
- Anxiety After Quitting Weed: When to Consider Medication
- Cannabis for Chemotherapy Nausea: What the Evidence Actually Shows
- Cannabis for Chronic Pain: What the Research Actually Supports
- Cannabis and Epilepsy: The Epidiolex Story and What It Means
- Does CBD Actually Work for Anxiety? What the Evidence Shows
- Does CBD Help with Weed Withdrawal? What Studies Show
- CBD vs THC: The Differences That Actually Matter
- The Proven Medical Benefits of Cannabis: What Research Supports
- Quitting Weed Before Surgery
- Weed and Medications: What Changes When You Quit
- Quitting Weed During Pregnancy: What You Need to Know
- Quitting Weed While Pregnant: What You Need to Know
- Cannabis and Older Adults: Risks Seniors Should Know
- Cannabis and Breastfeeding: THC in Breast Milk