The rate of people in Germany seeking cannabis use disorder-related outpatient addiction care declined following the adoption of the historic German Cannabis Act (CanG) adult-use legalization measure in April 2024, according to a recent study. Researchers affiliated with various health and academic institutions in Germany conducted the cannabis use disorder (CUD) study with funding from the German Addiction Care Statistical Service. The study’s findings were published in the journal Addiction.
“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,” the researchers wrote about their methodology. “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.”
The cannabis addiction treatment industry is very lucrative, with market analysts from Future Market Insights estimating that “the cannabis use disorder treatment market was valued at USD 1.70 billion in 2025.” Unfortunately, not everyone who is subjected to cannabis addiction treatment does so voluntarily. Many people are forced into treatment for various reasons, including as part of a court-mandated penalty for being caught with cannabis.
“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.” the researchers in Germany found.
“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.” the researchers concluded.
The findings of this particular study build on a growing amount of research coming out of Germany in the post-legalization era. Another recent study conducted by researchers affiliated with the Federal Institute of Public Health examined twelve representative studies from 2008 to 2025 that tracked changes in the 12-month prevalence of cannabis use among adolescents (aged 12-17) and young adults (aged 18-25) in Germany. The results of the study were published this month in the Journal of Health Monitoring.
“One year after the partial legalisation of cannabis, no immediate, significant changes in the 12-month prevalence of cannabis use were observed among either female or male adolescents, or among young women, compared with 2023. In the longer term, a decline was observed among male adolescents compared with 2019.” the researchers found.
EKOCAN published its highly anticipated initial findings late last year. By many measures, the findings demonstrated that things are going well.
“First-time cannabis use among young people is declining for the first time since 2002, and consumption among young people has continued to decline since 2019.” stated the German Cannabis Business Association (translated from German to English) at the time. “The BvCW sees this as confirmation of the effectiveness of the increased educational and prevention programs.”
“The data show no significant increase in cannabis consumption among the general population. Consumers can now access safe products, which strengthens health protection. In addition, low-threshold services such as drug checking also contribute to harm reduction.” BvCW also stated.
The EKOCAN research project is funded by the Federal Ministry of Health (BMG). EKOCAN focuses on three areas of evaluation:
- Child and youth protection
- General health protection
- Cannabis-related crime
“Cannabis-related offenses were halved – over 100,000 cases were saved annually, freeing up police and judicial resources to combat organized crime.” BvCW wrote regarding the third area of EKOCAN’s evaluation.
“The data show the first positive effects of partial legalization. They confirm that education, prevention, and secure sources of supply are key factors in reducing risks and pushing back the black market. Next, we need to reduce the bureaucracy of cultivation associations and establish scientific model projects for regulated distribution.” Michael Greif, Managing Director of the BvCW, added.
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