In principle, you may drive with medical cannabis if it has been prescribed to you by a doctor for a specific medical condition and you take it as directed. The medication privilege (Medikamentenprivileg) under § 24a (4) StVG (Road Traffic Act) then applies, and the THC limit of 3.5 ng/ml does not count as an administrative offence for you. There is no protection if you are unfit to drive, i.e. if you show signs of impairment or cause an accident.
What is the medication privilege?
The medication privilege is an exception in § 24a (4) StVG. It states that the rules on THC and other intoxicating substances do not apply if the substance „results from taking, as directed, a medicinal product prescribed for a specific medical condition“.
For cannabis, this means: the offence under § 24a (1a) StVG – driving with 3.5 ng/ml or more THC in blood serum – does not apply if the THC comes from your medically prescribed therapy. The privilege applies not only to cannabis but to prescribed medicines in general.
This article provides professional guidance and is not legal advice. For specific legal questions, contact a specialist lawyer for traffic law (Fachanwalt für Verkehrsrecht).
Which conditions must be met?
The medication privilege only applies if two conditions are met together: a medical prescription for a specific medical condition and taking the medicine as directed. If one of them is missing, you are not protected.
| Condition | What this means in practice | Not protected is … |
|---|---|---|
| Medical prescription | A clear prescription for you and your specific medical condition | Cannabis without a prescription, even if you use it „medically“ |
| Taking it as directed | Taking it at the dosage set by your doctor | Overdosing or increasing the dose on your own initiative |
| No misuse | Only the prescribed product, as prescribed | Additional use from other sources |
| Fitness to drive | You drive without signs of impairment | Driving with signs of impairment or after an accident with indications of impairment |
What „as directed“ means
„As directed“ (bestimmungsgemäß) means that you take the medicine as it was prescribed. What counts is the dosage set by your doctor and the prescribed product. If you take more than intended or also use other cannabis, you leave the scope of protection.
When does the prescription not protect you?
The prescription does not protect you if you are unfit to drive. If you show signs of impairment or cause an accident because you are impaired, you face penalties and doubts about your fitness to drive despite the prescription.
The reason: the medication privilege only excludes the limit-based offence. It does not permit driving while impaired. So what always matters is how you actually feel and whether you can drive safely.
Mixed use
Mixed use is particularly critical. If you combine medical cannabis with alcohol or other substances, you risk your use no longer being considered as directed. In the guideline examples for other long-term medications, additional use and mixed use expressly count against fitness to drive.
Can medical cannabis still lead to an MPU?
Medical cannabis can indirectly lead to an assessment if doubts arise about your fitness to drive. This is possible after a drive with signs of impairment, after an accident or if there are indications of misuse.
In the case of illnesses and long-term medication, a medical MPU (medical-psychological assessment, Medizinisch-Psychologische Untersuchung) under § 11 FeV (Driving Licence Regulation, Fahrerlaubnis-Verordnung) can also be ordered. This is not about misconduct, but about whether the illness and therapy allow safe driving. The page Medical MPU explains more.
How assessment approaches medication in principle
Using other long-term medications as examples, the assessment guidelines (Begutachtungs-Leitlinien) show what matters: fitness to drive is possible if the therapy is stably adjusted and medically supervised, without additional use and without signs of impairment. A new adjustment or mixed use count against it. As a guide, this logic can also be applied to medical cannabis.
In such cases, proof is usually provided by a specialist medical report, generally no older than 3 months, with an explicit statement on fitness to drive.
What applies without a prescription?
Without a prescription, the medication privilege does not apply. You are then treated like any other cannabis user when driving: from 3.5 ng/ml THC in blood serum, there is an administrative offence under § 24a StVG. Repeated drives under the influence of cannabis can lead to an MPU under § 13a FeV.
The guide Cannabis legalisation and your driving licence explains exactly what the rules have been since legalisation. The page MPU for cannabis offers an overview of the cannabis MPU.
What should you do if you have already received an order?
If you have already received an order from the driving licence authority (Fahrerlaubnisbehörde), you should first request file inspection (Akteneinsicht). Only then do you know all the facts you are accused of and the exact question the expert report (Gutachten) is to answer.
If you still have your driving licence, you usually have to provide proof of fitness to drive within a set deadline; otherwise your licence may be withdrawn. A specialist lawyer for traffic law can check whether the order is lawful and which facts may be used. You are free to choose the assessment centre (Begutachtungsstelle) from among the officially recognised centres.
Which practical tips help in everyday life?
In everyday life, what helps above all is being able to document your therapy clearly and only driving when you feel safe. The following points are general recommendations and do not replace medical or legal advice.
- Keep proof to hand: it makes sense to carry proof of your prescription when driving, for example a copy of the prescription or a medical certificate. This way you can explain where the THC comes from if you are stopped.
- Stick exactly to the dosage: only take the prescribed product in the prescribed amount.
- Talk to your doctor about driving: clarify whether and when driving is justifiable in your phase of therapy, especially in the adjustment phase.
- No mixed use: avoid alcohol and other substances if you want to drive.
- Be honest with yourself: if you feel tired, dazed or unable to concentrate, leave the car at home.
What you can do now
- Check your prescription: is it clearly issued for you and your medical condition, with a clear dosage?
- Talk to your doctor about driving, especially when starting a new adjustment or changing the dose.
- Prepare proof of your prescription to carry with you.
- If you have already received an order from the driving licence authority, request file inspection and have the order checked by a specialist lawyer for traffic law.
- If an assessment is coming up: find suitable preparation.
Frequently asked questions
Does the limit of 3.5 ng/ml also apply to cannabis patients?
No, not as an administrative offence, as long as the THC comes from taking a prescribed medicine as directed. This is governed by the medication privilege in § 24a (4) StVG. However, it does not protect you if you show signs of impairment.
Is it enough to use cannabis for medical reasons without a prescription?
No. The medication privilege requires a medicine prescribed for a specific medical condition. Without a medical prescription, the normal cannabis rules apply.
What happens if I take more than prescribed?
Then you are no longer taking it as directed, and the privilege does not apply. You are then treated as in the case of ordinary cannabis use.
Can the authority doubt my fitness to drive despite a prescription?
Yes, for example after signs of impairment, an accident or indications of misuse. In the case of illness and long-term medication, a medical MPU under § 11 FeV is also possible.
