Driving with a cannabis prescription. What you need to know.

01Fitness to drive today and fitness to hold a licence

German law uses two terms that are easily confused: Fahrtüchtigkeit and Fahreignung. Both concern you, but in very different ways.

You need both. Taking prescribed cannabis does not by itself call your fitness into question, as long as you stick to the prescription and your performance is not impaired. Whether you are fit to drive is still something you decide afresh every day.

02The 3.5 ng⁠/⁠ml THC limit and the exemption for patients

Since 22 August 2024 there has been a statutory THC limit on German roads. Anyone who drives a motor vehicle with 3.5 ng⁠/⁠ml or more THC in blood serum commits an administrative offence (§ 24a(1a) StVG). E-scooters count as motor vehicles too (§ 1 eKFV).

The law makes an exemption for patients: the limit does not apply if the THC comes from taking, as intended, a medicine prescribed for a specific medical condition (§ 24a(4) StVG). This is not a free pass but an exemption with conditions. They are explained in the next chapter.

Why the exemption exists: people who take THC regularly can still be above 3.5 ng⁠/⁠ml days after their last dose. With regular use, the blood level says little about whether you are impaired right now.

03“As intended”: what your prescription has to show

The exemption hinges on one word: bestimmungsgemäß, taking the medicine as intended. This means taking exactly the product, in the amount and form that your doctor prescribed. Extra use, cannabis from other sources, a dose you increased yourself or a different strain than prescribed are not covered.

Courts interpret the exemption narrowly. The Bavarian Supreme Court requires a proper, clear prescription with dosage instructions (decision of 12 June 2026). In that case the prescription stated a single and a daily dose, but not whether the daily dose was fixed or a maximum. That was not enough. The Higher Regional Court of Hamm also considers blanket prescriptions insufficient (decision of 28 April 2026).

So check your documents:

• Does your prescription or medication plan name the specific product or strain?
• Is the dosage clear: single dose, how many times a day, and whether a daily amount is fixed or a maximum?
• Does the prescribed quantity match the dosage and the time until your next prescription?
• Does the prescription show the date of issue and the quantity? Keep a copy.
• Do several practices prescribe psychoactive medicines for you? Then they should all know about each other.

If anything is unclear, ask your practice before you drive. The Bavarian Supreme Court expressly noted that a mistake about the dosage could have been avoided by simply asking.

At 420doc you will find your prescription, the medication plan with dosage and intake as a PDF, and the digital patient card in your account.

Courts have not yet settled whether a prescription issued after an online-only consultation is enough for the exemption. According to the Higher Regional Court of Hamm, a lack of personal contact does not prevent you from relying on the exemption in fine proceedings, the local court of Hamburg-Wandsbek took a different view in 2025, and the Bavarian Supreme Court left the question open in 2026. If you want to be completely sure, you can also book an in-person appointment with 420doc.

04Cannabis and alcohol: combined use behind the wheel

There is no patient exemption for alcohol. The 0.5 per mille limit applies to you as to everyone else (§ 24a(1) StVG), and during probation and under 21 there is a complete ban on alcohol (§ 24c StVG).

Since 2024 it has also been specifically prohibited to drive with 3.5 ng⁠/⁠ml THC or more while drinking alcohol or after setting off under the influence of alcohol (§ 24a(2a) StVG, standard penalty 1,000 euros and a one-month driving ban). The medicine exemption does cover this rule as well, but only as long as you take your medicine as intended, and courts interpret that narrowly.

Medically the picture is clearer: alcohol and THC can strengthen each other’s effects. The German Road Safety Council (DVR) advises avoiding alcohol and not drinking at all before driving. The same goes for other medicines that can make you drowsy, such as sleeping pills, certain painkillers, antihistamines or antidepressants. More on this under interactions.

05Probation and under 21: what applies to new drivers

During the probationary period and until your 21st birthday there is a strict ban behind the wheel: no alcohol and no THC, neither while driving nor when setting off under the influence (§ 24c(1) StVG). The law does not set a figure like 3.5 ng⁠/⁠ml here, so even a low reading can be enough.

For THC from a prescribed medicine, § 24c(3) StVG contains the same exemption as § 24a, if you take it as intended. There is no exemption for alcohol.

A violation usually costs 250 euros and one point. During probation it counts as a serious offence: the authority orders a remedial course and your probation is extended by two years (§ 2a StVG, Annex 12 FeV). The same applies to an offence under § 24a StVG during probation.

If you have little driving experience, be especially careful. Raise the topic of driving early with your doctor.

06Starting treatment and changing the dose: don’t drive for now

At the beginning you do not yet know how you react to your medicine. The German Road Safety Council sees particular risks when starting or switching treatment and considers close medical supervision necessary, especially at the start. A review on medical cannabis advises not driving, particularly at the start of treatment and in the hours after each dose (Arkell et al. 2021).

For context: a large analysis of studies estimates that most driving-related skills recover about five hours after inhaling 20 mg of THC, and almost all after about seven hours. Most participants were occasional users, and after oral intake it may take longer (McCartney et al. 2021). For use without a prescription, the ADAC recommends much longer gaps: at least 12 hours, 24 hours if the strength is unknown or the amount larger, and more than 24 hours after eating THC. None of this is a green light for you. Agree with your doctor which gap applies to your treatment.

What to consider when switching strains is explained in the article Switching strains (in German).

07Self-check: am I fit to drive today?

Before every journey you check yourself honestly. The German Road Safety Council and the ADAC recommend this. The check helps you do it. It does not save or send anything and does not replace a conversation with your doctor.

08Police checks: what you have to do and what you don’t

A traffic check is no reason to panic. Stay calm and polite and follow the officers’ instructions. You do not, however, have to say anything about use, illness or medicines, and you do not have to take part in preliminary tests.

09After the check: blood sample and fine proceedings

If facts give rise to suspicion of an administrative offence under § 24a or § 24c StVG or a criminal offence under § 316 StGB, the police can order a blood sample without a judge (§ 46(4) OWiG, § 81a(2) StPO). A positive preliminary test or signs of use can be enough for this. The sample is taken by a doctor.

If your level is 3.5 ng⁠/⁠ml or more, fine proceedings usually follow, in which you are given the opportunity to comment (§ 55 OWiG). By now at the latest you need the evidence for the exemption: prescription with dosage instructions, medication plan and, if available, a medical certificate.

If there are signs of impairment, such as swerving or slowed reactions, the administrative offence can become a criminal offence under § 316 StGB: a fine or imprisonment of up to one year. Your licence is then usually at risk too, because the court generally withdraws it in such cases (§ 69 StGB).

Independently of this, the police inform the driving licence authority if they see facts that suggest more than temporary doubts about your fitness (§ 2(12) StVG). What happens there is explained in the next chapter.

10Driving licence authority, medical report and MPU

The driving licence authority does not look at a single journey but at whether you are generally fit to drive. For prescribed cannabis, administrative courts have applied the rules for medicines in urgent proceedings, i.e. Annex 4 No. 9.4 and 9.6 FeV, and not the stricter separation rule for cannabis in No. 9.2 (Administrative Court of Munich, decision of 22 Aug 2025; Administrative Court of Augsburg, decision of 25 Nov 2025).

The Bavarian Administrative Court of Appeal named conditions under which fitness to drive is retained during long-term treatment (decision of 24 Feb 2025 in legal aid proceedings, still under the law before April 2024). According to it, fitness is retained if

• taking it is medically indicated and prescribed,
• you reliably take the cannabis only as prescribed,
• your performance is not permanently impaired,
• your underlying condition does not itself call safe driving into question, and
• it is not to be expected that you will drive while impaired.

By contrast, anyone who misuses psychoactive medicines (No. 9.4) or whose performance is no longer sufficient because of long-term treatment (No. 9.6.2) is not fit to drive. In 2026 the Administrative Court of Appeal of Baden-Württemberg assumed misuse where there is no clear, consistent prescription, where the dose is too high, or where someone gets prescriptions from several doctors who do not know about each other (decision of 4 May 2026).

• Medical report: if facts give rise to doubts about your fitness, for example after a police notification (§ 11(2) FeV). If facts point to misuse, the authority must order it (§ 14(1) sentence 1 no. 3 FeV).
• MPU (medical-psychological assessment): if questions remain after the medical report, for example whether you reliably stick to your prescription (§ 11(3) no. 1 FeV), after repeated offences under § 24a StVG (§ 14(2) no. 3 FeV) or if there are signs of cannabis misuse, such as use outside the prescription (§ 13a FeV).
• Withdrawal: if it turns out that you are not fit to drive (§ 3 StVG, § 46 FeV). If you do not submit a report that was ordered on time, the authority may conclude that you are not fit (§ 11(8) FeV).

If you rely on the exemption, you have to explain and prove its conditions as far as this is within your control (Bavarian Administrative Court of Appeal 2025). A current medical certificate about your prescription, product, dosage and course of treatment helps. It is not a fitness-to-drive report, though: those are prepared by specially qualified bodies, for example specialists with a qualification in traffic medicine, who should not also be treating you (§ 11(2) FeV).

The outcome can also be a licence with conditions, for example regular medical check-ups and certificates (§ 46(2) FeV).

11Accidents and insurance

After an accident, first secure the scene and help anyone injured. If there are signs of cannabis use, expect a blood sample to be ordered.

Anyone who cannot drive safely as a result of intoxicating substances and thereby endangers other people or property of significant value commits an offence under § 315c StGB, punishable by up to five years’ imprisonment or a fine. The exemption from the law on administrative offences does not help here.

• Motor liability insurance: it pays for the damage caused to others. If you were not able to drive safely because of intoxicating substances, it can take recourse against you for up to 5,000 euros (§ 5(1) no. 5 and (3) KfzPflVV).
• Comprehensive cover: if you caused the accident through gross negligence, the insurer may reduce its payment according to the degree of fault, in extreme cases to zero (§ 81(2) VVG).

The German Road Safety Council points out that recourse is mainly a risk if the medicine was not taken as intended. Well-kept documents about your prescription help here too. Also read your insurance terms.

12Professional drivers, taxis and business trips

There is no separate THC limit for professional drivers. The same rules apply: limit with patient exemption, fitness to drive today, fitness to hold a licence. At work, however, further obligations apply.

• Lorries and buses: for classes C and D you prove your fitness with a medical certificate when the licence is issued and renewed (§ 11(9) FeV with Annex 5). The medicine rules in Annex 4 apply to these classes in the same way.
• Taxi, private hire, patient transport: the licence for passenger transport also requires a medical certificate of fitness (§ 48(4) FeV).
• Health and safety at work: employees must not put themselves into a state in which they endanger themselves or others through alcohol, drugs or other intoxicating substances. This explicitly also applies to medicines (§ 15 DGUV Regulation 1). The statutory accident insurers recommend “zero alcohol and zero cannabis” at work, and many companies have their own rules.
• Company doctor: if you are unsure, talk to the company doctor as well as your treating practice. They may only exchange information if you release them from medical confidentiality (DGUV).

13Driving abroad

The German patient exemption only applies in Germany. In Europe the rules range from THC limits from 1 ng⁠/⁠ml to zero tolerance, and only some countries have an exemption for prescribed medicines (European Union Drugs Agency EUDA, as of May 2025). Find out about the rules in your destination and transit countries before you travel, and if in doubt, do not drive there yourself.

To take your medicine to other Schengen countries you usually need a certified certificate under Article 75 of the Schengen Implementing Convention, valid for up to 30 days (ADAC). How this works is explained in the article Travelling with a cannabis prescription (in German).

14What changed between 2024 and 2026

15Seven myths about cannabis and driving

1. MythWith a prescription I can always drive.

   The factsThe prescription only exempts you from the THC limit. You still have to be fit to drive, otherwise penalties under § 316 StGB apply.

2. MythBelow 3.5 ng⁠/⁠ml nothing can happen to me.

   The factsAnyone showing signs of impairment can commit an offence even with a lower level. During probation and under 21 there is a ban anyway.

3. MythThe patient card is enough as proof.

   The factsIt is not an official document. What counts is the prescription and the dosage instructions.

4. MythAt a check I have to say that I am a patient.

   The factsYou do not have to say anything about use or illness. Whether you disclose your treatment is up to you.

5. MythI have to take the rapid drug test.

   The factsPreliminary tests are voluntary. If there is suspicion, however, the police can order a blood sample.

6. MythNone of this applies on an e-scooter or bicycle.

   The factsE-scooters are motor vehicles, so the limit applies. On a bicycle § 316 StGB applies: anyone who cannot ride safely because of the effect can commit an offence.

7. MythIf I feel fine, the THC is long gone.

   The factsWith regular use, THC can be detectable in the blood for days. That is exactly why your prescription is your most important proof.

16Frequently asked questions about driving with a cannabis prescription

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