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Patricia Atkins is a Senior Applications Scientist with SPEX CertiPrep and a member of both the AOAC and ASTM committees for cannabis.

On April 1, 2024, the Cannabis Act (CanG) passed in Germany and reclassified cannabis as a non-narcotic. These legislative actions eased administrative barriers for patients and prescribing doctors, sparking significant growth in the market. Since then, the medical cannabis industry has seen a substantial increase in both patient numbers and supply.

As of April 2024, there are an estimated 300,000 patients who use medical cannabis with 17 tons of supply. Yet the passage of CanG has only started to ignite momentum in the market. According to calculations based on findings in Bloomwell Group’s recent report titled “

The Cannabis Barometer: Motives, Concerns and Preferences of Cannabis Consumers in Germany

,” the German medical cannabis company found that the market has the potential to reach more than 20 million patients and a supply of 60,000 tons. With this in mind, Germany is poised to become one of the largest and most promising medical cannabis markets in the world, offering a bright future for investors, policymakers, and healthcare professionals (1).

Majority of German Consumers Cite Health Reasons for Cannabis Use

Bloomwell Group’s 2024 report revealed that 94% of respondents who consumed cannabis did so for at least one medical or health reason. The most common reason cited by respondents for consuming cannabis was for stress relief (about 60%), followed by sleeping disorders (50.4%) and pain relief (35%) (1).

The report also revealed that while the majority of cannabis users in Germany use the plant for medical or health reasons, within the past year, only 10% of the survey participants obtained cannabis exclusively from licensed pharmacies. Almost 60% of consumers continue to obtain their cannabis illegally, often despite their concerns about poor quality and associated health damage. Over a quarter of respondents (26%) said they had already purchased contaminated cannabis, while around 31% had obtained poor quality on the illegal market in the past (1).

Improving Patient Access Through Medical Training and Guidance from Experts

One of the key barriers to consumers being able to access medical cannabis through a pharmacy is the lack of doctors who are willing and experienced in prescribing cannabis as a medical treatment. Despite the improved legal framework, over 90% of those surveyed struggle to find a doctor who is open to cannabis therapy and has the necessary expertise. This highlights the urgent need for more doctors to be trained and open to prescribing medical cannabis, a crucial step in improving patient access and care.

Physicians who specialize in medical cannabis should lead conversations, spread awareness, and help educate other doctors in the field about cannabis as a medical treatment and its health potential. In addition, it’s important for medical professionals to provide evidence-based factual information to the public that can help ease outdated stigmas and myths surrounding cannabis. They should also take a firm hand in helping to guide regulatory leaders and professionals within the scientific and medical communities as they seek to ease regulations surrounding the research of cannabis for patients.

Technology to Drive Patient Access and Ease of Use

Within the last few years, telemedicine has increased worldwide, partly due to the travel and social distancing limitations imposed by the COVID-19 pandemic. According to McKinsey & Company, by the second quarter of 2022, 96 percent of outpatient practitioners in Germany were linked to the telematics infrastructure, up from 90 percent in 2020. As of the second quarter of 2022, 99 percent of pharmacies in Germany were connected to the telematics infrastructure, a significant increase from 75 percent in 2021, according to McKinsey & Company (2).

Telemedicine allows patients to access medical care consultations without having to travel to a physician's physical office. Using video chat, patients can speak with healthcare providers about their medical conditions, and doctors can prescribe medical cannabis based on the patient’s symptoms. Not only does this provide convenience and accessibility for patients, but it also helps reduce healthcare costs associated with in-person visits and cuts waiting times. This is especially useful to medical cannabis patients who are in remote parts of Germany and may not be in an area that has a doctor who specializes in cannabis therapy. Such advancements also allow pharmacies to receive digital prescriptions from prescribing physicians and fulfill them on-site.

Cannabis patients have reported to prefer to receive prescribed cannabis products through a digital application and have them delivered directly to them from the pharmacy. According to the Bloomwell report, 92% of those surveyed would like cannabis treatment through an app with delivery from the pharmacy (1).

Stakeholders have opportunities to build upon the areas of the industry that are already fueling growth, like telemedicine, and also provide strategies to help transition German consumers from the illicit market to the legal medical market.

To do this, it is important for key players within the industry to help fuel conversations about medical cannabis therapy and the patient process. Providing clear and accurate information about the benefits and regulations of the legalized medical cannabis market can help patients understand the benefits of securing cannabis through licensed pharmacies rather than risk contaminated products from the illicit market.

In addition, industry leaders and regulators alike should work together to ensure that legalized medical cannabis stays accessible and affordable for patients. The cost of medical cannabis must be competitive with that of the illicit market. To provide a steady supply, international imports of medical cannabis are needed and must continue to grow to meet consumer demand. Investors will need to continue fueling the German import market to ensure patients receive uninterrupted access to their prescribed treatment.

The Cannabis Barometer: Motives, Concerns and Preferences of Cannabis Consumers in Germany.

https://25378200.fs1.hubspotusercontent-eu1.net/hubfs/25378200/Report%20Motives%20Cannabis%202024%20E.pdf

Messal, H.; Niedermann, F.; Padmanabhan, P.; Müller, T.; Lösch, M.; Silberzahn, T.; Richter, L.

 Telemedicine in Germany: A Rapid Evolution Amid COVID-19. 

McKinsey & Company, Stuttgart, DE, 2022. 

https://www.mckinsey.com/industries/life-sciences/our-insights/german-e-health-offerings-expand-but-adoption-remains-uneven

Niklas Kouparanis is the CEO and Co-Founder of Bloomwell Group.

Kouparanis, N. Regulatory German Medical Cannabis Market Has Yet to Reach Its Full Potential. 

Germany’s Cannabis Act (CanG) is beginning to transform the country's medical cannabis market, with potential opportunities to expand telemedicine, improve physician training, and enhancing accessibility in this rapidly growing industry.

Topic

German Medical Cannabis Market Has Yet to Reach Its Full Potential

 first began in 1911 (1) and reminds us to soak in all the amazing achievements women have made to the nutraceutical space.

 is putting the spotlight on women by compiling women-related content, new and old. From research to interviews, women are such an important part of the cannabis science space that 

is dedicated to covering closely. Enjoy International Women’s Day 2025!

In this roundup article to honor of International Women's Day, 

 compiled a roundup of articles related to women's research.

Women Grow Launches New Nonprofit, Women Grow Foundation

Women Grow announced the creation of a 501(c)(3) nonprofit organization, the Women Grow Foundation, which is intended to offer access to education, funding, and advocacy for women-owned and -led businesses in the cannabis industry.

In this roundup article, we are excited to share with you our roundup of interviews with female leaders in the industry.

Trailblazing Women in Analytical Science Roundup

In this roundup article, we are excited to share with you our roundup of interviews from our December 2024 Women in Analytical Science Supplement.

Stay tuned for more International Women's Day-themed content! We will be updating this landing page throughout this week.

International Women’s Day. International Women’s day 2025 campaign theme: Accelerate action 

Check out our exciting 2025 International Women's Day coverage!

CST Celebrates International Women's Day 2025

This article has been updated to include additional commentary on interpreting the findings.

 (1), researchers examined the potential connections between cannabis legalization in Ontario, Canada and the prevalence of schizophrenia diagnoses. The study was conducted from January 1, 2006, to December 31, 2022, which covers both the legalization of medical cannabis, which started in 2001 and expanded until full legalization in 2015, and nonmedical cannabis legalization in 2018. The population-based cohort study, “Changes in Incident Schizophrenia Diagnoses Associated With Cannabis Use Disorder After Cannabis Legalization,” was published in February 2025 in 

(1). It was funded by Canadian Institutes of Health Research and by ICES (formerly known as the Institute for Clinical Evaluative Sciences).

The study noted prior research on associations of cannabis use, especially cannabis with high THC content, and the development or earlier onset of psychosis and schizophrenia, though evidence on cannabis legalization and psychosis is deficient. The goal in this study was to measure the population-attributable risk fraction (PARF) for cannabis use disorder (CUD) associated with schizophrenia, in other words, the number of cases of schizophrenia that could have been prevented if cannabis use severe enough to require emergency or hospital care was eliminated.

This study analyzed data from 13,588,681 people aged 14 to 65 years without a history of schizophrenia, noting diagnoses of CUD diagnoses in emergency rooms or hospital settings.

Out of the total population, 118,650 individuals had CUD

91,106 developed schizophrenia (0.6% of the population without CUD and 8.9% of the population with CUD)

From the prelegalization period to the legalization period, the PARF for CUD associated with schizophrenia increased from 3.7% to 10.3%

Compared with the PARF for CUD associated with schizophrenia, which increased steadily even after cannabis policy changes, the PARF for CUD associated with psychosis not otherwise specified accelerated after the liberalization of medical cannabis policy

Limitations of the study were noted. These included a lack of access to confounders (including individual-level income, educational attainment, family history of mental health disorders, and genetics), which could affect the validity of the PARF estimators. Other limitations included the exposure definition of CUD and the impacts of COVID-19.

Ultimately, the researchers concluded: “the proportion of incident cases of schizophrenia associated with CUD almost tripled during a period encompassing ongoing liberalization of medical and nonmedical cannabis. Although the proportion of cases of schizophrenia associated with CUD increased fairly linearly over time, incident cases of psychosis NOS and the proportion associated with CUD accelerated after cannabis liberalization.”

More research was called for in order to understand cannabis legalization policy’s long-term associations with the occurrence of psychotic disorders. Additionally, it was suggested that the association between cannabis use disorders and schizophrenia be taken into consideration in the legalization of cannabis.

Invited Editorial Commentary on this Study

 (2) from Jodi M. Gilman, PhD, Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School. Dr. Gilman summarized the study and offers insight on the major findings, explaining that the first main finding provides more evidence for the association between cannabis use and an increased risk for psychosis, especially in young adults.

She comments on the second main finding: “The second finding of this study is that the PARF for CUD associated with psychosis NOS, but not schizophrenia, accelerated further with the legalization of cannabis for medical but not recreational purposes. These mixed findings should not make us doubt the association between cannabis use and psychosis; rather, they highlight the methodological challenges of linking the biological causality of a complex psychiatric illness, such as schizophrenia, with a cannabis policy change.”

Dr. Gilman also addresses three challenges of using large-scale electronic medical record studies when assessing mental health consequences of cannabis policy, specifically, establishing concrete time points of legalization, establishing the start of cannabis use and the onset of psychosis, and establishing data on THC potency in cannabis consumed. She concludes: “It is important not to misinterpret findings suggesting no significant acceleration in adverse outcomes after cannabis legalization as a statement that policy does not matter. Policy does matter; allowing unfettered commercial markets to exist exposes more individuals to a greater variety of readily available, high-potency cannabis products.”

Correlation vs Causation; Interpreting the Findings

 offers additional insights and commentary on interpreting the results of the study. First, she notes that the populations of CUD and schizophrenia are very small: of the people with schizophrenia, 11.6% had CUD, while 88.4% did not, and of the people with CUD, 8.9% had schizophrenia, while 0.6% did not. “There’s a nontrivial coincidence – this only establishes correlation, not causation,” she explains.

Fisher also comments on the increase in accessibility of cannabis from 2006 to 2022 and the incidence of schizophrenia, noting that the incidence rate of schizophrenia decreased between 2006 to 2022, and the incidence of schizophrenia stayed the same between pre- and post-legalization. “The researchers simply glossed over this fact without providing any explanation and simply shifted the focus to cases of schizophrenia with CUD,” Fisher states. “It seems utterly plausible to me that people with schizophrenia don’t feel well, so they try to medicate. If cannabis became easier to access over the period, then it makes sense they’d increasingly use cannabis to self-medicate.”

She also points out that the analysis does not account for any other factors happening in the sociopolitical environment during this period, such as changes in polices regarding diagnosis or treating people with substance use or mental health disorders.

Fisher concludes: “In short, the analysis presented looks at several different co-occurring factors – cannabis legalization, CUD diagnosis, schizophrenia diagnosis, psychosis – and tries to present correlations as if they’re causations, without accounting for other more plausible explanations for the patterns found. Notably, they fail to recognize that the incidence of CUD and schizophrenia are both extremely small, and they seem to gloss over the fact that the incidence of schizophrenia was stable, if not decreasing over the period while cannabis accessibility vastly increased. The authors also fail to recognize the tremendous harm reduction impact of cannabis on society – it’s possible that without the availability of cannabis, people would have fared even worse.”

Myran, DT.; Pugliese, M.; Harrison, LD.; Solmi, M.; Anderson, KK.; Fiedorowicz, JG.; Finkelstein, Y.; Manuel, D.; Taljaard, M.; Webber, C.; Tanuseputro, P. Changes in Incident Schizophrenia Diagnoses Associated With Cannabis Use Disorder After Cannabis Legalization. 

Gilman, Jodi. Association of Cannabis Legalization With Prevalence of Schizophrenia—Challenges of Attributing Biological Causality to Policy Change 

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829844

The seventeen-year study analyzed cases of schizophrenia over periods of cannabis policy liberalization and legalization in a Canadian province.

Study Examines Prevalence of Schizophrenia Cases Associated with Cannabis Use Disorder After Cannabis Legalization

As the cannabis industry continues its trajectory of growth and maturation, 2024 marked a pivotal year, particularly in regulatory and compliance landscapes. With global markets projected to reach $38.19 billion and new federal and state-level initiatives reshaping the industry’s operational framework, cannabis businesses faced a year filled with challenges and opportunities.

In this blog, we’ll unpack the key events and regulatory milestones of 2024, examining how they have redefined compliance requirements, and the strategies cannabis operators must adopt to thrive in an evolving landscape.

In May 2024, the Drug Enforcement Administration (DEA) proposed rescheduling marijuana from Schedule I to Schedule III under the Controlled Substances Act (CSA). This was a monumental step, signaling a federal shift in how cannabis is perceived and regulated.

The proposed rule, published in the Federal Register, launched a 60-day public comment period ending in July 2024. During this time, industry stakeholders, advocacy groups, and the public submitted extensive feedback. While the move to Schedule III could significantly reduce tax burdens under Section 280E of the IRS Code, it left hemp and synthetic tetrahydrocannabinol (THC) untouched, maintaining their unique classifications under the CSA. The new proposed hemp bill however would close many loopholes when it comes to derivative cannabinoids, but the bill has yet to be finalized. So far, the bill may redefine hemp to include "naturally occurring, naturally derived, and non-intoxicating cannabinoids." This change could remove many intoxicating derivative hemp-derived products like gummies, beverages, and edibles from store shelves nationwide.

Industry reactions were mixed. On one hand, the rescheduling offers potential relief and legitimacy. On the other, concerns linger about the pace of implementation and the implications for existing state-level regulatory frameworks.

If federal legalization does happen in 2025 this will be a major shift in the way cannabis companies are regulated. This will make compliance with Food and Drug Administration (FDA) and OSHA fundamental in the survival of cannabis businesses. As discussed many times in previous blogs, becoming compliant with FDA by becoming 

 in advance and becoming compliant with Occupational Safety and Health Administration (OSHA) standards will be key to increase the success of a business.

OSHA compliance became a hot-button issue for cannabis cultivation and manufacturing facilities in 2024. OSHA launched targeted audits emphasizing fire safety, personal protective equipment (PPE), and respiratory protection, especially in high-risk extraction facilities. Technically OSHA has always had jurisdiction over cannabis companies, but just weren’t enforcing unless there was an incident or a complaint. Now that is changing due to many incidents resulting from a lack of regulation.

For Class 1 Division 2 facilities engaged in volatile solvent extraction, ensuring adherence to Hazard Communication (HazCom) standards and implementing proper spark-proof systems became critical. Failure to comply resulted in steep fines, pushing operators to reassess their safety protocols and invest in robust employee training programs.

OSHA’s increased attention underscores the agency’s recognition of cannabis as a legitimate industry requiring the same rigorous safety standards as other manufacturing sectors. Becoming compliant with OSHA standards is not an easy task, it takes time and effort to create a safe work environment and have a company that is prepared for an audit. OSHA is the highest fining department in the federal government and can cost a company hundreds of thousands of dollars in one short visit if the correct protocols are not in place. I recommend getting into compliance with these standards as soon as possible, not only to protect your workers, but to save you from business-ending shutdowns and fines as well.

In March 2024, California unveiled a streamlined cannabis licensing process that consolidated environmental and safety compliance into a single application. This approach simplified the regulatory maze for businesses, reducing administrative burdens and expediting license approvals.

Other states took note, with similar initiatives introduced in Oregon and Massachusetts later in the year. These changes reflect a growing awareness among state regulators of the need for efficiency in fostering industry growth while maintaining public safety standards.

Access to banking services has long been a thorny issue for cannabis businesses. Despite legalization at the state level, federal restrictions left many operators reliant on cash, exposing them to security risks and complicating compliance efforts.

The SAFER Banking Act was passed by the Senate and this will provide protections for financial institutions. Hopefully these changes will help with the banking issues we have been dealing with from the beginning. 

With federal legalization on the horizon, hopefully these financial burdens will be alleviated eventually. Keep in mind, that being compliant with federal standards can also lower your cost of insurance and help local banks work with your company by mitigating their risk.

Advancements in cultivation and processing technologies played a pivotal role in compliance management. Automated tracking systems, for instance, enabled real-time monitoring of inventory, improving traceability and reducing the risk of regulatory breaches.

Similarly, innovations in laboratory testing enhanced the accuracy of potency and contaminant analyses, addressing long-standing issues like lab shopping and potency inflation. Standardized testing protocols became a focal point for regulators aiming to protect consumer safety.

Evey year more and more technology innovations change the landscape of this industry. I personally have seen an insane amount of change since I started in the industry in 2014. I am excited to see what changes in the next 10 years.

As we look toward 2025, several trends and questions emerge:

Will marijuana officially move to Schedule III, and how will this reshape the industry’s regulatory environment? We still aren’t sure if this will happen in 2025, but we do know it will happen eventually. The DEA and the FDA have publicly backed the decision to reschedule though, so there is a possibility it might happen sooner rather than later.

Can federal rescheduling efforts harmonize with diverse state-level laws, or will discrepancies persist? I believe that the cannabis industry will be regulated a lot like wholesale food manufacturers where they have to abide by local and state regulations and with federal regulations as well. You will especially be required to have an FDA registration in order to sell across state lines, and some states will still opt-out of having a cannabis program all together. cGMP and OSHA compliance will be key in the success of your company.

How will international markets respond to US regulatory shifts, and what opportunities will arise for export and collaboration? If federal legalization goes into effect, there will be international opportunities. Many of my clients are working towards cGMP Certification to the 211 pharmaceutical standard to better position themselves to be able to sell internationally when it becomes available. Depending on your desired future of your company, it might be good to keep this in mind.

With increasing scrutiny from OSHA and other agencies, proactive compliance—from documentation to employee training—will be essential for maintaining operational integrity. cGMP Certification and full OSHA compliance plans will be necessary for company survival. Better to be proactive rather than reactive when it comes to compliance.

The cannabis industry’s evolution in 2024 underscores the importance of adaptability and vigilance. Regulatory shifts, technological advancements, and a growing emphasis on safety and transparency have set the stage for a more mature and sustainable industry. For operators, embracing these changes is not just about avoiding penalties but also about building trust and credibility in a competitive market.

As 2025 progresses, the question is not whether the cannabis industry will continue to grow, but how well it will navigate the complexities of compliance to unlock its full potential. By staying informed and proactive, businesses can position themselves as leaders in a rapidly changing landscape.

 is the CEO and founder of Allay Consulting. Direct correspondence to: 

Here, we unpack key events and regulatory milestones of 2024, including rescheduling, OSHA compliance, banking, and innovations, plus we discuss the outlook for 2025.

Cannabis Compliance in 2024: A Transformative Year

With the increasing use of cannabis for both medical and recreational purposes (1), understanding 

 contamination has never been more critical. The expansion of cannabis legalization across various regions has introduced new challenges in ensuring the safety and quality of cannabis products. This comprehensive analysis explores the nature of 

, the conditions that promote its growth, the health implications of its presence in cannabis, and the advanced methods used to mitigate these risks.

 is a genus that includes over 300 species of mold, with many being pathogenic to humans and animals. Common species include 

, each with varying degrees of virulence and impact on human health. These molds are typically found in organic matter such as soil, plants, and decaying vegetation, making them a natural part of many agricultural environments, including cannabis cultivation.

 contamination can occur at multiple stages of the production process. From the initial cultivation to the drying, curing, and storage stages, various factors can contribute to the proliferation of 

. The mold's ability to produce a large number of spores, which can easily become airborne, further complicates its management in indoor and outdoor growing environments.

Aspergillosis remains the most common fungal infection in hematopoietic stem cell transplant (HSCT) recipients (2).

The Cannabis Cultivation Environment and 

Cannabis cultivation, whether done indoors or outdoors, presents several challenges in preventing 

Aspergillus, a genus of mold that is abundant in our environment, has become a significant concern in the cannabis industry, particularly due to the health risks it poses to consumers. This mold, which thrives in various environments, including soil, decaying vegetation, and even in the air, is not inherently dangerous to healthy individuals. However, its presence in cannabis flowers, whether during cultivation, processing, or storage, can lead to severe health risks, especially for immunocompromised individuals.

Patricia Atkins

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