Early trends in outpatient addiction care for cannabis use disorder following cannabis legalization in Germany: Evidence from National Monitoring Data.

Authors

Carlotta Riemerschmid, Larissa Schwarzkopf, Eva Hoch

Published in

Addiction (Abingdon, England). Jul 07, 2026. Epub Jul 07, 2026.

Abstract

With the introduction of the German Cannabis Act (CanG) in April 2024, cannabis use was partially legalized in Germany. This study investigated immediate trends following this policy shift in treatment-seeking for cannabis use disorders (CUD) in the German outpatient addiction care system.
Data were obtained from the German Addiction Statistical Service (DSHS), Germany's national monitoring system for addiction-related treatment demand. We analyzed meta-aggregated datasets for two pre-legalization years (2022, 20 223) and one post- legalization year (April-December 2024), focusing on care episodes with a primary CUD diagnosis (International Classification of Diseases 10th Revision codes F12.1/F12.2). Annual facility-level rates were calculated for admissions and key treatment characteristics. Year-to-year differences were assessed using rate ratios (RR) with 95% confidence intervals (CI), adjusting for multiple testing.
CUD-related admissions per facility increased from 29.0 cases in 2022 to 30.0 cases in 2023 (RR = 1.03, 95% CI: 1.02-1.05) followed by a decline to 25.6 cases in 2024 (RR = 0.85, 95% CI: 0.84-0.87). The number of female clients remained stable (≈5.5 cases per facility), whereas male admissions declined from 23.9 in 2023 to 19.8 in 2024 (RR = 0.83, 95% CI: 0.81-0.84). Admissions among clients aged under 25 years decreased from 15.1 to 11.4 per facility between 2023 and 2024 (RR = 0.76, 95% CI: 0.0.74-0.78). Similar downward trends were observed for first-time admissions, referrals through the legal system and legal obligations to admissions.
First nation-wide monitoring data in Germany demonstrate a decline in cannabis use disorder-related outpatient addiction care seeking following the introduction of the German Cannabis Act, which may indicate that established ways of reaching young at-risk populations is no longer functioning effectively.

PMID:
42411383
Bibliographic data and abstract were imported from PubMed on 07 Jul 2026.

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