What doctors should consider about cannabis and driving licences
Doctors who prescribe cannabis for medical purposes have a particular responsibility for their patients' fitness to drive. The prescription itself is clearly regulated, and only doctors may issue it. This article summarises what prescribing practices should pay attention to when it comes to driving licences. It does not replace specialist or legal advice in individual cases.
The legal framework for prescribing
Under the Medicinal Cannabis Act (MedCanG), cannabis for medical purposes may only be prescribed by doctors. Dentists and veterinarians are excluded by the law and may not prescribe it. Supply to end consumers takes place only through a pharmacy and on presentation of the prescription.
These rules form the framework in which the question of a driving licence arises at all. Anyone prescribing must therefore know that the prescription alone does not decide whether a patient may drive. Fitness to drive depends on effect, dosage and course of treatment.
The exemption in road traffic law
The Road Traffic Act (StVG) contains an exemption for cases in which an active substance comes from taking a medicine prescribed for a specific illness as intended. This exemption is tied to the medicine being taken as directed. It is not a general permission to drive under the influence of cannabis.
For practice, this means that the prescription creates a basis, but does not replace information. Patients should know that the exemption only applies when the medicine is taken as intended, and that deviations can change the situation.
| Point | Content | Note for the practice |
|---|---|---|
| Prescription | Only by doctors | Document indication and dosage |
| Dispensing | Only in a pharmacy on prescription | Pass on instructions for use |
| Road traffic | Exemption when taken as intended | Raise fitness to drive |
The table summarises the points that should be clear in every practice. It does not replace the specialist assessment in an individual case.
Informing patients about driving
The information should be concrete. Patients should know that effect and tolerability depend on the preparation and the dosage, and that they can change when the treatment is adjusted. The product information and the package leaflet contain the manufacturer's notes on fitness to drive.
- Pass on the notes on fitness to drive from the product information
- Point out that the situation can change when the dose is changed or new medicines are added
- Recommend not driving if in doubt
The information should be understandable and should not play anything down.
Documenting the conversation
A note of the conversation helps make the information traceable. Record which questions about fitness to drive were discussed and which advice was given. This protects the practice and the patient if questions come up later.
Whether a patient depends on a car for work or private reasons also belongs in the documentation. It affects which alternatives need to be discussed.
Fitness to drive under the Driving Licence Ordinance
Annex 4 FeV lists, under “long-term treatment with medicines” (item 9.6), the cases in which fitness under the annex is lacking: in the case of “poisoning” (item 9.6.1) and where performance is impaired “below the required level” (item 9.6.2). Whether this applies to a patient is assessed by the authority in each case, if necessary with an expert report. A general statement about individual preparations is not possible here.
When fitness to drive becomes doubtful
If there are signs of restricted fitness to drive, the practice should talk to the patient. The decision on the driving licence rests with the driving licence authority. Where facts give rise to doubts about fitness, it can order a medical report (§ 11 para. 2 FeV). The practice can document the course of events and refer to these points.
If the practice recommends giving up driving, this should be justified factually and recorded in writing.
What patients can do now
Anyone taking medical cannabis who drives a car should raise the question of fitness to drive openly in the practice. The product information and the package leaflet also contain notes.
Information for patients is available from the Arbeitsgemeinschaft Cannabis als Medizin (working group on cannabis as medicine). A notice from the driving licence office should never be ignored.
What you can do now
If you prescribe as a doctor, make the information a fixed part of the consultation. Also read the article on the exemption from the limit value for a prescription. If you are a patient affected by this, the article on the question of whether you can keep your driving licence gives an overview.
For the legal position on medical cannabis, also see the section Medicine. Questions about youth protection are answered in the youth protection section.
Frequently asked questions
Who may prescribe cannabis for medical purposes?
Only doctors may prescribe cannabis for medical purposes. Dentists and veterinarians are excluded by the law and may not prescribe it. Supply takes place only in a pharmacy on presentation of the prescription.
Does a prescription allow me to drive?
The prescription creates a basis, but it does not replace the check of fitness to drive. The exemption in road traffic law only applies when the prescribed medicine is taken as intended. Whether a journey is justifiable depends on effect, dosage and course of treatment.
What should the documentation contain?
Note which questions about fitness to drive were discussed, which advice was given and whether the patient depends on a car. Written documentation protects the practice and helps trace the course of treatment.