The medical use of cannabis oil and cannabis flowers is gaining increasing importance in Germany. Supported by new legal frameworks, cannabis therapy is establishing itself as a valuable supplement for the treatment of chronic pain, sleep disorders, and anxiety, as well as an adjunct medication for other medical treatments, such as for nausea and loss of appetite. At the heart of therapeutic applications of medical cannabis are two forms of administration: cannabis flowers vs. cannabis oil.
Medical cannabis flowers are a natural product. They are the harvested yield of female cannabis plants specifically cultivated for medical use. Their primary active components are tetrahydrocannabinol (THC) and cannabidiol (CBD). Additionally, as with all plant-based products, they contain various terpenes that vary depending on the strain. Cannabis oil, on the other hand, is an extract obtained from the flowers, carrying their essential components in a highly concentrated form for application.
In this article, we provide information about the areas of application for medical cannabis flowers on one hand, and cannabis oil on the other. We also highlight the specific benefits of both forms of administration and outline the current possibilities for patients to begin a medically supervised cannabis therapy.
What Are Cannabis Flowers?
Cannabis flowers are the flower clusters of the female cannabis plant. They appear as compact, often slightly sticky structures with colors ranging from green to violet. Cannabis flowers are covered with fine, crystal-like trichomes. These contain the majority of the active ingredients effective for medical use. Depending on the strain, cannabis flowers differ in size and shape. Usually, they are 1 to 3 centimeters long and have a rounded shape. Additionally, cannabis strains have different ratios of active ingredients and vary in aroma and taste. Therefore, choosing the right product is crucial to fully realize the potential of cannabis therapy.[1]
The medical effects of cannabis flowers are diverse. They may be used to relieve pain [2], counteract sleep disorders [3], reduce anxiety [4], alleviate muscle spasms (in multiple sclerosis) [5], or complement other therapies by reducing nausea and stimulating appetite [6]. Furthermore, there are successful applications of medical cannabis for treating rheumatism and arthritis [7].
Cannabis Flowers via Vaporizer
The intake of medical cannabis flowers is carried out using a special vaporizer designed for this purpose. When using the vaporizer, the prescribed dose of cannabis is heated to release the active compounds it contains. The resulting vapor is then inhaled, enters the bloodstream through the lungs, and the effect occurs almost immediately, but no later than one to two minutes. The rapid onset of effect is particularly advantageous for acute symptoms [8].
Medical cannabis flowers are prescription-only in Germany. However, all doctors (except veterinarians and dentists) are generally authorized to issue a cannabis prescription. The only requirement is that they must consider cannabis therapy to be medically promising. The prescription can be redeemed at a pharmacy that carries cannabis products. Cost coverage by health insurance is possible if other forms of therapy have already been tried. Patients without health insurance coverage receive medical cannabis flowers through a private prescription. The cost of cannabis flowers with a private prescription is approximately 5-15 euros per gram. In this context, it is advisable to use specialized mail-order pharmacies to benefit from the timely availability of the prescribed product.
What Is Cannabis Oil?
Cannabis oil is a concentrated extract of the cannabis plant, produced for medical purposes. The active compounds are extracted from the plant material using various extraction methods. Two common procedures are CO2 extraction and ethanol extraction. Both methods ensure the gentle extraction of the active ingredients relevant for medical use. The raw oil is then processed to remove unwanted plant substances and achieve a standardized concentration of active compounds. Finally, depending on the product, the oil is formulated to achieve the desired potency and dosage [9].
Just like cannabis flowers, cannabis oil is used, for example, to relieve pain, sleep disorders, anxiety, or loss of appetite. The key difference lies in the high concentration of THC and the duration of its effect. Unlike cannabis flowers, the active ingredients are not inhaled as vapor but are absorbed orally through the mucous membranes of the mouth. The effect of cannabis oil begins after 30 to 90 minutes but can last for up to eight hours, covering half a day or an entire night. However, the prolonged duration of action can also be a disadvantage. While inhaling cannabis flowers allows for immediate adjustment of medication to symptoms, the intake of cannabis oil requires advance planning. Therefore, cannabis oil is primarily suitable for alleviating symptoms that persist over a longer period. [10]
Legal Situation and Prescription
In Australia, cannabis oil is subject to the same legal regulations as cannabis flowers. To obtain THC-containing products, a medical prescription is required. All registered doctors in Australia are authorized to prescribe medical cannabis. If they are not registered as Authorized Prescribers (AP), they must prescribe through the Special Access Scheme (SAS).
Due to the delayed onset of action of cannabis oil and its lower bioavailability (meaning that fewer active compounds actually reach the patient’s bloodstream), it is prescribed less frequently than cannabis flowers. In certain cases, such as when a lung condition prevents the inhalation of cannabis flowers or when patients have adverse reactions to specific terpenes, cannabis oil can be a therapeutic alternative.
Cannabis oil is available in specialized pharmacies upon presentation of a valid prescription. Cost coverage by health insurance depends on the specific policy and is generally considered on a case-by-case basis. The price of cannabis oil in Australia varies depending on the concentration and THC content, typically ranging from approximately AUD 50 to AUD 200 per bottle. [18]
Cannabis Flowers vs. Cannabis Oil – What Is the Difference?
Preparation | Administration Method | Benefits | Cost (Australia) | THC Content |
Cannabis Flowers | Heated with a vaporizer and inhaled | – Rapid onset of effects – Flexible dosing – Different strains with varied effect profiles | AUD 10-30 per gram | Varies significantly by strain; average of 2% |
Cannabis Oil | Oral intake through the mucous membranes | – Long-lasting effects | AUD 200 for a 30ml bottle (depending on THC content) | Varies by product, but can reach high levels of up to 30% |
Potential Therapeutic Benefits of Cannabis
Cannabis, depending on the strain, exhibits a wide variety of effect profiles. Accordingly, cannabis therapy can and should be tailored to the individual medical condition of each patient. Cannabis is particularly known for its pain-relieving properties but can also alleviate anxiety, elevate mood, and reduce muscle spasms. Additionally, some effect profiles improve sleep and relieve nausea. When used correctly under medical supervision, medical cannabis has little to no side effects [11]. Therefore, it can serve as an alternative to conventional painkillers and sleep aids. Dependence is very unlikely when the prescribed dosage is followed and can be reversed relatively quickly [10]. In compatible treatment forms, cannabis may reduce the side effects of other medications, thereby enhancing the effectiveness of therapy and improving patients’ quality of life.
One unique feature of medical cannabis is that its cannabinoids, THC and CBD, interact with the body’s endocannabinoid system. This system, distributed throughout the body, helps regulate the central nervous system and the immune system. In conjunction with the cannabinoids found in medical cannabis products, the body can, for example, initiate pain relief and anti-inflammatory effects [12].
A study published in 2022 showed that 79% of participants experienced pain relief from medical cannabis products, and their need for other medications decreased [13]. Another study focusing on the ingredient CBD revealed in 2021 that cannabis therapy could alleviate anxiety, restlessness, and symptoms of depression. Additionally, a scientific article published in 2019 summarized several clinical studies indicating the successful use of cannabis flowers in treating sleep disorders [15].
Ongoing research continues to explore the further potential of medical cannabis, aiming to unravel the exact mechanisms of the endocannabinoid system and to harness the therapeutic effects of other cannabinoids besides THC and CBD.
Purchasing Cannabis Flowers: How to Become a Cannabis Patient
In Australia, anyone who wants to purchase medical cannabis flowers or oils requires a medical prescription. All registered doctors are authorized to prescribe medical cannabis. If they are not registered as Authorized Prescribers (AP), they must prescribe through the Special Access Scheme (SAS). There are no specific clinical requirements for obtaining a prescription, and patients must have an initial consultation, which can be conducted either in person or via telehealth. There are no restrictions on specific conditions or patient groups, meaning the decision to prescribe medical cannabis is at the discretion of the treating doctor.
However, personal reservations about cannabis, a lack of expertise, or the doctor’s medical specialty could make obtaining a prescription more challenging. Patients who are specifically seeking cannabis therapy are advised to research clinics and medical practices specializing in this field. The medical staff at these specialized facilities are better equipped to assess the suitability of cannabis therapy, taking into account pre-existing conditions, potential addiction issues, and concurrent medications, ensuring a safe and patient-focused approach.
There is sometimes confusion among patients regarding the legal context of cannabis use in Australia. It is important to note that there is a clear legal distinction between recreational cannabis and medical cannabis. Recreational cannabis remains illegal in Australia, except in the Australian Capital Territory (ACT), where limited possession and personal cultivation are allowed. In all other states and territories, the purchase, sale, and possession of recreational cannabis are prohibited.
Medical cannabis, on the other hand, is regulated under the Therapeutic Goods Administration (TGA) and the Office of Drug Control (ODC). It can only be obtained through a valid prescription in the prescribed quantity from authorized pharmacies. Health insurance does not generally cover the cost of medical cannabis in Australia, so patients typically bear the expenses out of pocket. However, some private health insurers may offer partial reimbursement depending on the policy.
This clear legal framework ensures that medical cannabis is regulated for therapeutic use, while recreational cannabis remains tightly controlled under Australian law. [19][20]
Where Can You Buy Cannabis Flowers in Australia?
In Australia, medical cannabis flowers can be purchased at authorized pharmacies with a valid prescription from a registered medical practitioner. However, not all pharmacies stock medicinal cannabis products. Unlike conventional medicines, most medicinal cannabis products are unapproved products and are not listed on the Australian Register of Therapeutic Goods (ARTG).
How to Access Medical Cannabis:
Because these products are unapproved, they cannot be obtained in the usual way at every local pharmacy. Instead, access to medicinal cannabis is regulated through special pathways by the Therapeutic Goods Administration (TGA):
- Special Access Scheme (SAS): Allows doctors to prescribe medicinal cannabis to individual patients on a case-by-case basis.
- Authorised Prescriber (AP): Allows doctors to prescribe to multiple patients with similar medical conditions.
Where to Buy:
- Specialized Pharmacies: Medical cannabis flowers are available at specialized pharmacies, including mail-order pharmacies that focus on medicinal cannabis products. These pharmacies are authorized to dispense unapproved products and often have a more extensive selection.
- Limited Local Availability: Some local pharmacies may stock medicinal cannabis, but availability is generally limited. It’s recommended to check with the pharmacy beforehand or use specialized online pharmacies for a more reliable supply.
Important Considerations:
- Travel Restrictions: Medical cannabis is classified as a controlled substance. When traveling, check the legal regulations of your destination country. It is illegal to carry medical cannabis outside of Australia without the necessary documentation.
- Import Restrictions: Importing cannabis products into Australia without proper licenses is strictly prohibited. [21][19]
Inhaling Medical Cannabis Flowers
The medically recommended method of administering cannabis flowers is through inhalation using a vaporizer. Due to health risks and an increased likelihood of side effects, smoking cannabis flowers is strongly discouraged. Burning cannabis products not only produces harmful substances but also reduces the amount of active compounds absorbed by the body. As a result, the therapeutic effectiveness becomes less reliable.
A similar issue applies to cannabis oil. Although it does not affect the lungs, some of its potential is lost as the active compounds enter the bloodstream indirectly through the mucous membranes.
Summary – Cannabis Flowers or Cannabis Oil?
Medical cannabis flowers, when used correctly, provide a rapid onset of effects with minimal side effects. In direct comparison, the effects and application of cannabis oil are generally less reliable. Although similar therapeutic outcomes can be expected, and positive experiences with cannabis oil are well-documented, its lower bioavailability and delayed onset make precise dosing more challenging. However, cannabis oil can be beneficial when inhaling cannabis flowers is not suitable, such as for patients with respiratory issues or sensitivities to certain terpenes.
For those considering cannabis therapy, specialized cannabis doctors offer expert guidance. If treatment with cannabis flowers is deemed appropriate, doctors can issue the necessary prescription for obtaining the products. To ensure the success of cannabis therapy, it is important to regularly monitor the treatment and adhere to the prescribed dosage. This approach helps prevent unwanted side effects and maximizes the therapeutic potential of the treatment.
FAQ’s
Are CBD Flowers the Best Choice for Anxiety?
Yes, CBD (Cannabidiol) has anxiolytic (anxiety-reducing) properties. Cannabis flowers with a high CBD content can therefore be considered for therapy to alleviate anxiety and nervousness.
When Do Doctors Prescribe Cannabis Oil?
Cannabis flowers are generally considered a more reliable form of medical cannabis. Therefore, cannabis oil is rarely prescribed. It is primarily considered when inhalation of cannabis flowers is unsuitable or contraindicated, such as for patients with respiratory conditions.
Are Cannabis Flowers Cheaper Than Cannabis Oil?
It depends on how the price is measured. Cannabis oil can cost more than AUD 200 per 30ml bottle but often has a much higher concentration of THC compared to comparable flower products. In contrast, cannabis flowers, priced between AUD 10-30 per gram, can be used for a greater number of applications. In most cases, this makes them more cost-effective than cannabis oil.
Is Cannabis Oil Easier to Take?
Cannabis oil is typically administered by placing the prescribed dose under the tongue, where it is absorbed through the mucous membranes. This method is faster and more discreet compared to inhaling cannabis flowers with a vaporizer. However, the effects take longer to set in and are less predictable in duration compared to inhalation.
How Much Do Medical Cannabis Flowers Cost?
In Australia, medical cannabis flowers are generally priced between AUD 10-30 per gram, depending on the strain and THC/CBD concentration.
What Are Irradiated Cannabis Flowers?
To prevent contamination by microorganisms, some cannabis flowers are exposed to ionizing radiation. This process largely preserves the active ingredient content. Since the flowers do not come into contact with the radiation source, they are not radioactively contaminated. Therefore, irradiated flowers are safe for patients to use.
What Medical Conditions Can Cannabis Help With?
Medical cannabis can be used to treat a variety of conditions, including:
- Chronic Pain Relief
- Anxiety and Nervousness
- Sleep Disorders and Insomnia
- Depression
- Muscle Spasms (e.g., in Multiple Sclerosis)
- Rheumatism and Arthritis Relief
- Small, E. (2017). Cannabis: A Complete Guide. Boca Raton: CRC Press.
- Kalant, H. (2001). Medicinal Use of Cannabis: History and Current Status. Pain Research and Management, vol. 6.
https://doi.org/10.1155/2001/469629 - Moltke, J. & Hondocha, C. (2021). Reasons for cannabidiol use: a cross-sectional study of CBD users, focusing on self-perceived stress, anxiety and sleep problems. Journal of Cannabis Research, 3(5).
https://doi.org/10.1186/s42238-021-00061-5 - Skelley, J. W. et al. (2020). Use of cannabidiol in anxiety and anxiety-related disorders. Journal of the American Pharmacists Association, 60(1), 253-261.
https://doi.org/10.1016/j.japh.2019.11.008 - Neuhaus, O. & Hartung, H. P. (2004). Cannabinoide – symptomatische Therapie der Multiplen Sklerose? Psychoneuro, 30(7), 389-392.
https://doi.org/10.1055/s-2004-831084 - https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/5_Publikationen/Drogen_und_Sucht/Berichte/Broschuere/BMG_CaPris_A5_Info_web.pdf
- Atalay, S. et al. (2020). Antioxidative and Anti-Inflammatory Properties of Cannabidiol. Antioxidants, 9(1), 21.
https://doi.org/10.3390/antiox9010021 - Plenert, M. & Stöver, H. (2020). Cannabis als Medizin. Praxis-Ratgeber für Patienten, Ärzte und Angehörige. Frankfurt am Main: Fachhochschulverlag.
- Knodt, M. (2020). Cannabis-Extraktion. Konzentrate, Extrakte und Haschisch-Herstellung. Solothurn: Nachtschatten Verlag.
- Müller-Vahl, K. & Grotenhemen, F. (2017, Februrary 24). Medizinisches Cannabis. Die wichtigsten Änderungen. Deutsches Ärzteblatt, 114(8), 352-356.
https://www.aerzteblatt.de/pdf.asp?id=186476 - Johnson, J. R. et al. (2010). Multicenter, Double-Blind-Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety and Tolerability of THC:CBD Extract and THC Extract in Patients with Intractable Cancer-Related Pain. Journal of Pain and Symptom Management, 39(2), 167-179.
https://doi.org/10.1016/j.jpainsymman.2009.06.008 - Mouslech, Z., Valla, V. (2009). Endocannabinoid system: An overview of its potential in current medical practice. PubMed, 30(2), 153-179.
https://pubmed.ncbi.nlm.nih.gov/19675519/# - Pritchett, C. et al. (2022). Mecial Cannabis Patients Report Improvements in Health Functioning and Reductions in Opiate Use. Substance Use & Misuse, 57(13), 1883-1892.
https://doi.org/10.1080/10826084.2022.2107673 - Rapin, L. et al. (2021). Cannabidiol use and effectiveness: real-world evidence from a Canadian medical cannabis clinic. J Cannabis Res 3, 19.
https://doi.org/10.1186/s42238-021-00078-w - Kuhathasan, N. et al. (2019). The use of cannabinoids for sleep: A critical review on clinical trials. Experimental and Clinical Psychopharmacology, 27(4), 383-401.
https://doi.org/10.1037/pha0000285 - Peschel, T. & Waitz, M. (2024). Medizinisches Cannabis vaporisieren: So funktioniert ein Vaporisator. Barmer.
https://www.barmer.de/gesundheit-verstehen/medizin/cannabis/cannabis-vaporisieren-1132206
18. Alternaleaf. (n.d.). Medical Cannabis Costs in Australia. https://consult.alternaleaf.co.uk/post/medical-cannabis-costs-in-australia
- Therapeutic Goods Administration (TGA). (n.d.). Medicinal Cannabis Guidance Documents.https://www.tga.gov.au/products/unapproved-therapeutic-goods/medicinal-cannabis-hub/medicinal-cannabis-guidance-documents
- Healthdirect. (n.d.). Medicinal Cannabis. https://www.healthdirect.gov.au/medicinal-cannabis
- University of Sydney. (n.d.). How to Get Medicinal Cannabis. https://www.sydney.edu.au/lambert/how-to-get-medicinal-cannabis.html