When should you talk to your GP about cannabis?

You should speak to your GP about cannabis if physical or mental complaints arise, if you take medication, or if you are unsure whether your use is still within reasonable limits. Doctors are bound by medical confidentiality. Even a short appointment can help to clarify the causes.

Why a conversation with the doctor makes sense

Doctors know your medical history and can see how complaints are connected. They can check whether sleep problems, restlessness or mood swings have other causes as well. This matters because cannabis does not have to be the only explanation for such complaints.

Your doctor can also judge whether cannabis and your medication affect each other. For this reason, a list of your medication is helpful at the appointment, including over-the-counter preparations.

Warning signs that call for an appointment

Not every irregularity is an emergency. Even so, there are signs that justify a medical check-up. These include the following points.

• Racing heartbeat, dizziness or circulatory problems after use that keep recurring.
• Persistent sleep problems or strong inner restlessness.
• Fear, low mood or lack of drive lasting longer than a few days.
• Thoughts that feel alien or threatening to you, or the feeling of being followed.
• Use together with alcohol or with medication you take regularly.
• Early conflicts at work, at school or in the family that keep piling up.

Psychosis is particularly important here. According to BIÖG, people who use cannabis develop psychosis more often than people who do not. The link is statistical; according to BIÖG, it does not prove that cannabis causes psychosis. According to the DHS, cannabis can increase heart rate, and existing heart problems may worsen in individual cases. If you hear voices or feel constantly watched, seek medical help straight away.

How to prepare for the conversation

A short preparation makes the conversation considerably more productive. Write down how often you use, roughly how much you use, at what times and in what mood. If you have made notes for a week, you can simply bring them along. The article Does a use diary help when quitting cannabis? shows what such a log can look like.

Also note all medication, dietary supplements and other substances you take. Think of two or three questions that matter most to you. Speak openly about your use, even if it is uncomfortable. Honest information is the basis for a good assessment.

What the doctor can do

The doctor starts with a conversation and can arrange a physical examination. If needed, blood values are checked or complaints are examined more closely. At the same time, it is checked whether other illnesses play a role that should also be treated.

If use suggests dependence, the practice can refer you to an addiction counselling service or a specialist service. Medical support is important when withdrawal symptoms are severe. The article When should a doctor accompany cannabis withdrawal? lists the key warning signs.

Medicinal cannabis is a separate topic

Anyone who uses cannabis as a medicine only gets it prescribed by a doctor, under current law. Patients receive it only from a pharmacy, on presentation of the prescription. This is a different route from the use that many people talk about when they are unsure.

If cannabis is prescribed to you as medicine, discuss dosage and effects with the prescribing doctor. More on the legal framework is in the area medicinal cannabis (Medizinalcannabis).

Confidentiality and fear of consequences

Many people hesitate because they fear consequences. Doctors are bound by confidentiality, and their aim is to assess your health. Passing judgement is not their role. If you worry that the conversation may have consequences for you, raise this openly. The practice can then explain what it documents and what it does not.

It also helps to know that you do not have to solve everything at once. One conversation is a first step. Further steps can be planned afterwards, for example with a counselling service.

Using your GP practice and a counselling service together

GP practices and counselling services do not rule each other out. Many people use both. The practice looks after physical questions, medication and diagnoses. The counselling service deals with use, everyday life and your goals. If both are to talk to each other, you need explicit consent to pass on information.

This consent is known as a release from confidentiality (Entbindung von der Schweigepflicht). You decide which information is passed on and to whom. You can also limit the consent to individual points. Ask both services how they handle this.

A referral from the GP practice to a counselling service is possible. You can, however, also contact a counselling service yourself, for example through the DHS Suchthilfeverzeichnis (addiction help directory). If you are unsure, ask your doctor for a recommendation. The conversation in the practice is then a good starting point for the next step.

What you can do now

1. Note your complaints, your use and your medication.
2. Make an appointment and briefly state the reason when you call.
3. Bring your questions and speak openly about your use.
4. Ask for a recommendation for a counselling service if you would like one.

A conversation with the GP practice can be a way into help. With acute complaints, do not wait for the next appointment. Then contact the emergency number 112 straight away. More orientation is available in the area Help and counselling.