COUNTRY REPORT | February 2019 Cannabis Regulation in Europe: Country Report Germany Heino Stöver, Ingo Ilja Michels, Bernd Werse, Tim Pfeiffer-Gerschel ideas into movement Legal framework1 The German Narcotic Drugs Act (Betäubungsmittelgesetz, BtMG), the country’s central legislative instrument, regulates sanctions. The German Code of Social Law (Sozialgesetzbuch, SGB) defines the conditions for financing treatment for drug dependence and drug-related illnesses. The BtMG provides for a variety of sanctions which, depending on the severity and type of offence, range from administrative fines to custodial sentences. In Germany, the consumption of narcotic drugs is not subject to sanctions. However, the purchase and possession that usually precede consumption are punishable, since they are associated with the risk of the drugs being supplied to others. The BtMG does not differentiate between different types of drugs, meaning that consumption-related offences involving all types of drugs may be dropped without going to court. However, in practice this option is mainly exercised in connection with cannabis cases (EMCDDA 2015). Further, the BtMG makes no legal differentiation regarding the ‘level of danger’ posed by individual drugs (for example, between cannabis and other drugs), leaving it to the courts to determine a hierarchy of drugs based on an empirically graded scale of ‘danger to public health’ (c.f. on this point EMCDDA 2002). The BtMG is primarily a regulatory and administrative law to regulate the trade in narcotic drugs – for example, purchase, sale, import, export – and prescriptions. Section 31a of the BtMG provides the possibility not to prosecute narcotics offences under certain circumstances, such as when the offender has grown, produced, imported, exported, carried in transit, bought or otherwise obtained or possessed minor amounts of narcotic substances exclusively for personal use and when the guilt is deemed to be minor and prosecution serves no public interest. Almost all Laender have introduced threshold values for ‘minor amounts’ in relation to cannabis, set by guidelines from which public prosecutors and judges may deviate on a case-by-case basis. Despite the existence of these guidelines there is no legal right to insist that the possession of smaller amounts of drugs not be prosecuted. In considering how to proceed with drug offenders across the justice system, it should be noted that the police has no power to exercise discretion and thus all cases of suspected offenders must be reported to the public prosecutor. In some Laender, local prevention projects, such as the widespread programme ‘Early Intervention with Drug Users Coming to the Attention of Law Enforcement for the First Time – FreD’ (Frühintervention bei erstauffälligen Drogenkonsumenten), are used as a way to avoid court proceedings. They allow for intervention without immediately initiating criminal proceedings. The programme is aimed at 14–18-year-olds but also adults up to 25 years of age who have come to the attention of the law for the first time due to their use of illicit drugs (Görgen, Hartmann, and Karim 2010; LWL-Koordinationsstelle Sucht 2017). The FreD project, which emerged from a voluntary support service for drug users with no criminal record, was continued in many Laender after the conclusion of the pilot phase. Today, 15 years on, there are around 120 project locations nationwide. The project is broadly accepted by decision- makers and practitioners as well as the target group. The service, specifically aimed at younger users, comprises an ‘intake conversation’ and a range of courses, and aims to prevent dependence and slipping into criminality. Cannabis use in the general population2,3 Cannabis is the most commonly used illicit drug in Germany by a large margin. The proportion of people who have used cannabis at least once in their lives is 27.2% for adults aged between 18 and 64 (Gomes de Matos et al. 2016) and 9.7% for adolescents aged between 12 and 17 (Orth 2016; Table 1). In relation to the last 12 months, 6.1% of adults and 7.3% of adolescents have consumed cannabis, with the 30-day prevalence rates at 3.1% and 2.2% respectively. Particularly the rates for current use among adolescents are, however, probably massively underrated, since the only nationwide survey on these age groups uses telephone interviews (Werse 2016). In all age groups, the substance was consumed by significantly more men and boys than women and girls . Over the last 25 years, the (estimated) prevalence of cannabis use among 18 –59 year-olds has increased overall. From 1990 to 2015 it increased significantly among men, from 5.6% to 8.7%, and among 2 | Cannabis Regulation in Europe: Country Report Germany transnationalinstitute Table 1 Prevalence of cannabis use in Germany Source1) Age Total Male Female Prevalence Prevalence Prevalence Lifetime ESA 2015 18 - 64 27.2% 31.8% 22.6% DAS 2015 12 - 17 9.7% 11.2% 8.2% 12-month ESA 2015 18 - 64 6.1% 7.4% 4.9% DAS 2015 12 - 17 7.3% 8.1% 6.3% 30-day ESA 2015 18 - 64 3.1% 4.0% 2.3% DAS 2015 12 - 17 2.2% 2.7% 1.6% 1) ESA Epidemiological Survey of Substance Abuse. DAS Drug Affinity Study. Table source: ESA Epidemiological Survey of Substance Use, Munich 2015 (in German) women, from 2.7% to 5.3%. A similar trend can be observed among 12–17-year-olds (Orth 2016). The highest 12-month prevalence rate in this age group was recorded in 2004 (10.1%). Following a drop to 4.6% in 2011, it once again reached 8.1% in 2014. Between 2014 and 2015, the proportion of users fell to 6.4%. Since the beginning of the 2000s, the trends for both sexes have been parallel, including among adolescents. Cannabis use in the Laender In all surveyed Laender, cannabis is the most widespread illicit drug (Piontek et al. 2016). When looking at differences between the Laender, we see that prevalence rates in big cities (“city states”) are substantially higher than in other Laender. Cannabis use in specific sub-populations The broad acceptance of cannabis can also be seen from the survey carried out in the Phar-Mon NPS project on visitors to electronic music events (Hannemann et al. 2017). With a 12-month prevalence of 80.7%, cannabis is significantly the most commonly used illicit substance. On average, it has been consumed by users on 12.2 of the last 30 days. The proportion of daily users is 23.7%. The same is true for partygoers in Frankfurt nightlife settings (Kamphausen et al. 2018). In 2018, a study carried out in the MoSyD investigated substance use in the open drug scene in Frankfurt (Werse et al. 2019), found that nearly all respondents had consumed cannabis (96%). The 12-month prevalence rate was 75%. As far as the 30-day prevalence is concerned, the starting value from 1995 is higher than in subsequent surveys, but prevalence has recently risen again to a similar value (69Cannabis use within the previous 24 hours has also increased to a new all-time high, at 35%. Patterns, treatment and problematic/high-risk use Patterns of cannabis use The Epidemiological Survey of Substance Abuse (ESA) 2015 provided information on patterns of use among adults aged 18–64. Of those who have consumed cannabis in the previous 12 months, 21.8% also consumed at least one other illegal substance in the same period (Piontek et al. 2016). The proportion was highest, at 13%, for amphetamine, followed by ecstasy (9.3%) and cocaine/crack (8.5%). The average 3 | Cannabis Regulation in Europe: Country Report Germany transnationalinstitute age of first use of cannabis was 19.2 years in the ESA 2015, of which men and younger age groups reported earlier commencement. The majority of 12-month users of cannabis used the drug on less than six occasions (52%), and 14.9% reported use of 100 or more occasions. In the Bavarian ESPAD survey, it was reported that cannabis use among pupils remained experimental in the vast majority of cases (Kraus et al. 2016); 6.9% reported frequent use of at least 20 occasions, boys more often than girls. The average age of first use of cannabis is at 14.8 years. Gender-based differences or differences between types of school have not been observed. Just over one third of adolescents surveyed (38.5%) reported that it was easy or very easy to obtain cannabis, more among boys than among girls. For pupils in Frankfurt, the proportion reporting intensive (daily) use has fallen to 1% from the previous year (3%) (Kamphausen et al. 2018). The proportion of frequent users – those that have taken cannabis at least ten times in the last 30 days – has also declined. The proportion of all 15–18-year-olds surveyed who had used it during school hours fell from 5% in the previous year to 2%. The average age of first use of cannabis in 2017 is at 15.3 years, higher than in every year since 2002. Overall, however, the changes in the intensity of cannabis use do not indicate a clear trend and are not statistically significant. Reducing the demand for cannabis Specialist counselling and treatment of the secondary harm from cannabis use in Germany is generally provided on an out-patient basis. In-patient admittance and treatment is provided only for severe health disorders or in cases with a high risk of relapse (Hoch et al. 2015). In Germany, according to a study of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), around 10% of cannabis users needing treatment (daily or almost daily use) receive it. In a comparison with all other European countries, Germany, together with Norway, has one of the highest percentage of people reached (Schettino et al.