Traffic Inj Prev. 2026 Feb 18:1-11. doi: 10.1080/15389588.2026.2616385. Online ahead of print.
ABSTRACT
OBJECTIVE: On April 1, 2024, cannabis was partially legalized in Germany, accompanied by an increase in the statutory Δ9-tetrahydrocannabinol (THC) threshold for administrative traffic offenses from 1.0 to 3.5 ng THC/mL serum in August 2024. A key legislative objective was to protect frequent cannabis users who separate consumption from driving but still display THC levels exceeding 1.0 ng/mL from disproportionate sanctions. The law mandates a statistical evaluation of its impact after three years. Since no national statistics differentiate substance-impaired driving offenses by a specific drug class, we analyzed all traffic-related blood samples containing THC or THC-carboxylic acid detected in our laboratory over four years.
METHODS: Included were cases from three federal states between April 1, 2021, and March 31, 2025, submitted for toxicological analysis with the legal context of administrative (§24 German Road Traffic Act) or criminal offenses (§316/§315c German Criminal Code). We examined case frequencies, age distributions, co-use of other substances, time intervals between incident and blood collection, consumption patterns, THC and THC-carboxylic acid concentrations, and frequencies of sanctions and driving errors.
RESULTS: Among 48,058 total cases, 83% were administrative and 17% criminal offenses. 46% of drivers were aged 21-30 years; the proportion of those below 21 years decreased from 18.2% to 13.3%. In administrative offenses, THC alone was detected in 74% of cases, compared to only 30% in criminal cases. The time from incident to blood sampling was under 1.5 h in 82% of cases. Based on THC-carboxylic acid concentrations, four consumption categories were established: occasional, regular, repeated and chronic. The distribution across these groups was 47%, 22%, 19%, and 11%, respectively and median THC concentrations were 1.3, 4.5, 8.4, and 14.9 ng/mL serum. Remarkably, median THC levels in administrative and criminal offenses were identical: 3.44 ng/mL serum. Across individual years, the highest THC medians in serum occurred in the year following legalization (3.95 and 3.97 ng/mL). Applying the new 3.5 ng/mL limit to our case cohort would exempt 899 frequent and 11,855 occasional users with serum THC levels between 1.0 and < 3.5 ng/mL from sanctions.
CONCLUSION: Our data indicate a modest upward shift in THC concentrations, continuing beyond April 2024, alongside a demographic shift toward older drivers. The nearly identical THC medians between drivers with and without conspicuous driving performance challenge the validity of the new threshold. Notably, almost half of the unimpaired drivers exceeded 3.5 ng/mL, whereas half of the impaired drivers remained below it. 7.4% of the frequent users benefited from the raised threshold, while at the same time 58.3% of occasional users-whose driving ability at THC concentrations between 1 and <3.5 ng/mL may be compromised-fell out of legal sanction. While substantial doubt remains if the initial goal was achieved, the question of an appropriate THC threshold remains unresolved and calls for alternative legal approaches.
PMID:41707218 | DOI:10.1080/15389588.2026.2616385
