In view of the controlled release of cannabis from Easter Monday, experts are calling for significantly more prevention campaigns for teenagers and young adults.

“It seems a bit strange to me to believe that 18 years is a magical limit,” says psychiatrist Euphrosyne Gouzoulis-Mayfrank, future president of the German Society for Psychiatry and Psychotherapy (DGPPN). “Teenagers are now probably more likely to get cannabis than before, even if it remains officially banned for them.”

The medical director of the LVR Clinic in Cologne is worried that it will not be possible to set up further campaigns anytime soon – “neither in terms of time nor in terms of financing”. Other problem areas for them include cannabis in traffic and poisoning of small children who could accidentally eat intoxicants stored at home if they are careless. “There are already observations about this from other countries.”

On March 22nd, the Federal Council approved the traffic light coalition’s new cannabis law. This applies from Easter Monday (April 1st). After 40 years, cannabis has been removed from the list of banned substances in the Narcotics Act. Contact will then remain fundamentally prohibited in the future – but with precisely defined exceptions for adults. This applies to the possession of certain quantities such as 25 grams for personal consumption in public, the possession of three plants for private cultivation as well as the regulated cultivation and distribution of the drug in special clubs.

Medical professional associations such as the DGPPN had criticized the partial legalization until the law was finally passed, including what they considered to be an age limit of 18 that was too low, quantities dispensed too high and too little state control. The main reason: the brain matures by the age of 25. If too much cannabis is added from outside during this time, it can have lifelong consequences such as psychosis.

More awareness campaigns required

With the start of the law, many doctors are missing initiatives for more education and prevention about cannabis risks – similar to the large and successful campaigns on alcohol abuse and HIV transmission.

The homepage of the Federal Center for Health Education (BZgA) is certainly good for cannabis, but it is not enough, emphasized Gouzoulis-Mayfrank. The Federal Ministry of Health’s campaign is also good. “But that’s not much overall. We have to go to schools, including vocational schools. We have to train teachers. Playful and humorous prevention campaigns have to be placed on social media, i.e. posts that young people like to share.” The tenor should be: Yes, it is now legal, but it is not safe. “There are parallels to alcohol. It’s not forbidden, but it’s not harmless either,” the expert added. In addition to alcohol, it also has to be about cannabis while driving.

The 18-year-olds who are now allowed to smoke weed also have to learn a responsibility towards younger people – “that they don’t just pass cannabis on to siblings or friends,” said the doctor. According to the BZgA, cannabis consumption has increased in Germany, especially among young adults. According to surveys, half of 18 to 25-year-olds had already experienced cannabis consumption in 2021 – this is the highest value recorded by the BZgA since 1973.

“I think that it is mainly adults who already have experience with cannabis who become members of a cultivation club or grow the permitted three plants themselves – and there are also a lot of curious people,” speculates Gouzoulis-Mayfrank. “However, we don’t know how consumption will develop in Germany. That depends on so many factors that we may not even be clear about yet.”

Research into cannabis consumption should be intensified

From the expert’s point of view, the observation period in the law is not yet sufficient to study the effects of the partial legalization of cannabis in society. “We would appeal for the consequences and consequences to be researched for more than four years,” she added. There are already representative surveys on the extent of cannabis consumption in Germany. Most recently, for example, according to the Federal Ministry of Health in 2022, there were around 4.5 million adults who had tried cannabis at least once – most often between the ages of 18 and 24.

“These surveys should be continued much more closely,” suggested the DGPPN expert. “It shouldn’t just be about smoking weed itself, but also about problems you’ve experienced with it.” In the short term, these can include fear, feelings of panic, disorientation, depressive moods, racing heart, nausea and hallucinations. In the long term, however, the risks can look much more threatening, especially for adolescents who smoke weed frequently: up to and including psychosis and schizophrenia.

“It is fundamentally a possible scenario that people with chronic pain will now also obtain cannabis through membership in a cultivation club. We will see whether that is a significant number – and how they feel about it,” added the psychiatrist. Regular surveys on the frequency of certain illnesses such as psychoses, which can be related to cannabis consumption, are particularly important with the start of the law. “But all of this would have to start very quickly,” said Gouzoulis-Mayfrank.

Cannabis is a psychoactive substance from the hemp plant that can be addictive – whether packaged as a joint, hash cookie or otherwise. “Risky consumption cannot be identified across the board,” says Stephanie Eckhardt, an expert at the BZgA. There are factors that interact – including how often cannabis is used, how much of it and how high the THC content is, i.e. the concentration of the drug tetrahydrocannabinol.