A byline by Arnau Valdovinos
The German medical cannabis market has entered a decisive phase of maturity, becoming an established component of the country’s healthcare system. Persistent growth under the new government suggests that the reforms enacted with the CanG are not a temporary measure, but a structural shift in the country’s approach to cannabis, regardless of the policy-makers intention. With annualised imports of medical cannabis now exceeding 150 tonnes, the medical market is set to soon account for a significant share of the 800 tonnes of estimated annual demand by the German population. This medicalised access model has the potential to serve as a blueprint for other European countries seeking to build legal, safe, and scalable frameworks for cannabis distribution.
At the heart of Germany’s post-legalisation success lies the rapid expansion of telemedicine—a model that has enabled fast, affordable consultations, streamlined prescriptions, and convenient home delivery. This digital infrastructure has dramatically widened patient access, making medical cannabis available to hundreds of thousands under medical supervision. However, the very factors that enabled this accessibility are now drawing mounting criticism. The sharp rise in flower prescriptions—some issued by foreign-licensed physicians—and the aggressive marketing tactics of high-profile platforms have stirred public concern. As media narratives amplify these cases and conservative political voices grow louder, telemedicine is increasingly portrayed not as a solution, but as a loophole ripe for abuse.
This convergence of scrutiny and scepticism has pushed the debate into ideological territory, shaped more by stigma than evidence. With cannabis no longer classified as a narcotic and digital prescribing deeply embedded in the care model, the challenge is to preserve access without inviting overreach. If the sector fails to demonstrate responsibility and enforce internal standards, Germany risks sliding toward a regulatory overcorrection—one that mirrors the backlash seen in other countries, like Poland and Australia, where rapid growth went unchecked. The question now is whether Germany will respond with measured, intelligent oversight, or allow political pressure to roll back one of the most successful innovations in cannabis healthcare to date.
Poland: Growth without Guardrails Leads to Backlash
Poland’s medical cannabis market grew extraordinarily fast after allowing access in 2018, quickly becoming the third largest in Europe. The country’s broad prescription guidelines, similar to Germany’s, allowed cannabis to be used for a range of conditions, particularly chronic pain. Between 2020 and 2024, imports quadrupled to around 8 tonnes, and tens of thousands of patients gained access to treatment. But by 2024, public scrutiny had intensified around so-called “receptomat” platforms—automated online clinics offering low-cost prescriptions based on self-reported surveys, similar to telemedicine platforms in Germany. Despite the fact that 40% of Poles live in rural areas with limited access to prescribing physicians, media and political discourse fixated on the perceived abuse.
The backlash was swift: in November 2024, Polish authorities imposed a near-total ban on telemedicine prescriptions, mandating in-person examinations in most cases. The consequences were a collapse of 55% in monthly prescriptions within just two months. The hardship this imposed on patients having to travel far away for prescriptions received little public attention. The lesson is stark—if industry actors fail to enforce basic standards, regulators will intervene, often with a heavy hand. Since then, Polish operators have rushed to open physical clinics and improve compliance, and prescriptions have started to rebound in early 2025, but trust has been damaged and it is still uncertain if prescription rates will fully recover. The cost of rebuilding it may prove steeper than the cost of responsible self-regulation would have been in the first place.
Australia: Regulatory Drift and Reputational Decay
Australia was once considered a pioneer in medical cannabis access, as it emerged as the world’s second-largest federally legal cannabis market, but the country now finds itself navigating a credibility crisis prompted by increased scrutiny from regulators such as the Therapeutic Goods Administration (TGA), which have taken increasingly aggressive steps to rein in telemedicine platforms. Initial concerns around advertising breaches—for instance, sponsorship deals with sports teams—have led to sweeping bans on most forms of public communication, even those as basic as product directories used by patients to choose their medication. The issue has been compounded by hostility from key medical associations voicing scepticism and even outright opposition to high-THC prescriptions.
These groups have raised concerns about conflicts of interest, alleging that some doctors employed by vertically integrated companies lack independence, and have criticised marketing practices that appear to circumvent advertising regulations. The erosion of trust among key opinion leaders and stakeholders—regulators, healthcare providers, and political actors—now threatens to undermine years of progress. Telemedicine, instead of being viewed as a legitimate, modern mode to streamline care, is increasingly seen as a loophole to be closed. That perception is difficult to reverse and offers a warning to German operators: structural gaps in oversight, if left unaddressed, invite long-term reputational damage and regulatory regression.
Germany’s Fork in the Road: Regress or Reform
Germany now stands at a crossroads. Since the April 2024 reforms, the country has experienced rapid market expansion and significant gains in patient access. But this progress has been accompanied by growing political scepticism as the political climate has shifted towards more conservative positions. Concerns over perceived abuse and inconsistent standards have sparked calls to restrict online access or even reverse the declassification of cannabis as a narcotic. In order to avoid a return to prohibitionist instincts, Germany needs a framework of credible self-regulation that preserves access while strengthening oversight.
In this context, the joint communiqué released ahead of the 2025 elections by leading industry players was a positive, proactive step. Rather than reacting defensively, the sector has acknowledged the need for higher standards and committed to shaping the rules that will govern its own future. The statement made clear that telemedicine must remain a central pillar of Germany’s medical cannabis model, especially for patients in underserved regions. It also recognised that quality assurance, physician independence, and compliance with German law—especially in advertising and clinical decision-making—must be non-negotiable. The willingness to embrace data transparency and digital tools to enhance therapy monitoring is a sign that the industry is ready to grow up. Allegations of misuse must be addressed not with blanket restrictions but with enforceable protocols and professional accountability.
German telemedicine operators are facing an urgent, collective challenge. If the country succeeds in establishing a robust self-regulatory model, it can set a European benchmark to be imitated by other countries, rising the standard of cannabis digital healthcare. If it fails, it risks sliding into the kind of regression seen in Poland. Industry actors must engage more proactively with regulators, policymakers, healthcare professionals, and the media. Free-riding and opportunism must be replaced with shared responsibility: short-term marketing gains are not worth the long-term costs of political backlash and public distrust.
At the same time, policymakers must act with proportionality and reject opportunistic attempts to score easy political points. The right outcome is not prohibition or a Wild West, but a balanced, rules-based model grounded in medical legitimacy, patient rights, and transparent processes. A self-regulatory charter, anchored in enforceable best practices, would not only protect access but also build lasting trust. It would allow Germany to lead not just in cannabis regulation, but in the broader field of digital health innovation. At stake is more than the future of telemedicine—it is the credibility of a modern, patient-centred approach to healthcare policy.
About the Author
As the founder and principal consultant of Cannamonitor, Arnau Valdovinos (Linkedin) connects the dots of the global supply chain through an independent view of the international cannabis markets. An advocate for evidence-based drug policy reform, since 2018 Arnau has provided intelligence and practical advice to medicinal, recreational and CBD companies across 5 continents and 20 countries.
Disclaimer: Guest contributions do not have to reflect the opinion of the editorial team.