MPU despite cannabis prescription?

Cannabis can be prescribed by a doctor for a variety of conditions, from asthma and anxiety to tinnitus and even cancer. While prescription cannabis patients are generally permitted to possess and consume it, there are certain restrictions on road traffic. 

If you drive under the influence of cannabis, you are subject to the same laws and regulations as people who have taken cannabis or other drugs without a prescription. 

Cannabis on prescription: Normal procedure after being arrested by the police in traffic

Even if you have been prescribed cannabis, if you attract attention due to unsafe driving or even a potential danger to road traffic, the police are initially obligated to treat the matter as a standard traffic violation. However, if you can present a corresponding patient identification card, the driver's license authority may later change its stance. 

1. Arrest by the police

• Section 2, paragraph 12 of the Road Traffic Act (Road Traffic Act) states: “The police must transmit information on facts that indicate non-temporary deficiencies in the suitability or ability of a person to drive motor vehicles to the driving licence authorities, insofar as this is necessary for the verification of suitability or ability from the point of view of the transmitting authority.”

The police themselves cannot apply special treatment if the patient has received cannabis on prescription. They must report the case to the driver's license authority, which will then initiate further action.

2. This is how the driving license authority usually proceeds

The driver's license office is not satisfied if you can show a patient ID card, but they will usually withdraw the order for the MPU during this evaluation phase. They need further information to decide whether a Drug MPU will actually be ordered in the end or not.

This information is often very comprehensive and also includes a statement from the treating physician. You usually have about two weeks to provide this information, and submitting it on time is highly recommended. In the event of delays, the MPU order can be reinstated immediately. 

The information requested by the driver's license office includes, among others, the following questions (although these may vary depending on the authority):

• What underlying disease(s) do you have (according to ICD-10)? [Editor's note: ICD-10 is the official classification for coding diagnoses in outpatient and inpatient care in Germany.]
• How long has the condition existed or when was it diagnosed?
• How has the condition been treated so far? Which medications were used, for how long, and with what results? Were there any side effects, and if so, which ones?
• For what reason is further conventional treatment (without anesthetic) not possible or promising?
• In what form and dosage should the medication be taken?
• For what period does the regulation apply?
• Under what conditions will the regulation be extended and, if so, for what period?
• Are regular check-ups carried out and, if so, at what intervals?
• Are there regular doctor-patient contacts?
• Is there sufficient compliance and is it being implemented? In particular, is medical cannabis being consumed according to the prescription?
• Prescription information: Cannabis strain, exact prescription (primarily the method of administration), and dosage instructions from the treating physician. Please enclose all prescriptions and copies of your cannabis card. 
• Has the patient been informed about the risks associated with participating in road traffic?
• Has the patient been informed about the exclusion of the use of other psychotropic substances (especially alcohol)?
• Do you take any other medications besides cannabis? If so, which ones?

3. Conclusions of the driving license authority

After you return the questionnaire, the driving license authority will thoroughly check the information. 

3.1 Conclusive answers = no MPU

If all answers are provided in detail and to the satisfaction of the authorities, a further medical report as part of an MPU is often waived. The authorities examine whether the illness actually justifies the use of cannabis on prescription and how the patient is coping with it. 

3.2 Inconclusive answers = MPU

However, if the questions are answered incompletely, inconclusively or inadequately, the driving license authority will order an MPU. 

3.3 Uncertainties = MPU

However, it's also conceivable that the authorities may order a medical examination due to certain ambiguities, despite largely conclusive answers. Therefore, completing the questionnaire conscientiously is extremely important. 

4. MPU

In cases 3.2 and 3.3, a MPU If there were only certain ambiguities, one can usually assume that a specialist medical report is sufficient and no MPU is necessary.

However, if the questions are answered inconclusively or even sloppily, you will be hit by the full force of an MPU (Medical-psychological examination), which they then have to pass. Here, the experts make a clear distinction between three different groups of cannabis patients. Tricks By the way, they are of little help here — the assessors are very well trained in this regard. 

4.1 Patients who receive cannabis on prescription but have little experience with cannabis

These are individuals who have encountered cannabis for more or less the first time through a doctor's prescription and therefore have little or no experience. The primary focus for this group is to educate them about the effects of cannabis, its impact on driving ability, and adherence to the prescribed dosage (compliance).

4.2 Patients who have some previous experience with cannabis

This group includes people who currently use cannabis on prescription but have previously experienced minor drug-related incidents. Some of them self-medicated with cannabis before legalization. 

4.3 Patients who currently receive cannabis on prescription and who previously had a higher incidence of drug abuse

These patients are people who, while currently legally receiving cannabis on prescription, have a long history of drug abuse cases, which are also on record. It appears as if the misuse of cannabis is now merely being legitimized by a doctor, without any real medical indication behind it. In these cases, an MPU with 12-month proof of abstinence arranged. 

The right doctor is crucial

Your treating physician plays a truly pivotal role. If you're receiving a prescription for cannabis and your driver's license is at risk of being suspended, your doctor's answers can be the deciding factor in whether or not you'll be ordered to take a drug test. 

It is the doctor who explains to the driving license authority why you are receiving cannabis on prescription and why this is the best treatment for you. It is the doctor who explains why no other medication is promising for you and that he has thoroughly explained all important issues to you. 

Prescription cannabis: THC levels are not necessarily important

Another interesting piece of information for you: When evaluating your case, the actual THC level in your blood will be considered less for assessing your ability to drive, but rather other aspects:

• Why do you take cannabis?
• How is your physical performance in general?
• What interactions exist between your illness and cannabis – how effective is cannabis as a therapy for your illness?
• How accustomed are you to consuming cannabis on prescription?
• How willing are you to to adapt to a situation and act to reduce risk? 

To answer these questions in a Prepare for the MPUWe have developed our own system specifically tailored to these cases. We know the mindset of the examiners very well, as we have sometimes worked as such ourselves. As traffic psychologists, we are trained to prepare you specifically for an MPU for prescription cannabis and the impending loss of your driver's license.