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State Medical Marijuana Laws

State Medical Marijuana Laws

1/29/2015

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In 1996, California voters passed Proposition 215, making the Golden State the first in the union to allow for the medical use of marijuana. Since then, 22 more states, the District of Columbia and Guam have enacted similar laws.

A total of 23 states, the District of Columbia and Guam now allow for comprehensive public medical marijuana and cannabis programs. Recently approved efforts in 11 states allow use of "low THC, high cannabidiol (CBD)" products for medical reasons in limited situations or as a legal defense. Those programs are not counted as comprehensive medical marijuana programs but are listed as passed in Table 2. NCSL uses criteria similar to other organizations to determine if a program is "comprehensive":

  1. Protection from criminal penalties for using marijuana for a medical purpose.
  2. Access to marijuana through home cultivation, dispensaries or some other system that is likely to be implemented.
  3. It must allow a variety of strains; and
  4. It must allow either smoking or vaporization of some kind of marijuana products, plant material or extract. 

 

A doctor holds a container of medical marijuana.

Medical Uses of Marijuana

In response to California's Prop 215, the Institute of Medicine issued a report that examined potential therapeutic uses for marijuana. The report found that: "Scientific data indicate the potential therapeutic value of cannabinoid drugs, primarily THC, for pain relief, control of nausea and vomiting, and appetite stimulation; smoked marijuana, however, is a crude THC delivery system that also delivers harmful substances. The psychological effects of cannabinoids, such as anxiety reduction, sedation, and euphoria can influence their potential therapeutic value. Those effects are potentially undesirable for certain patients and situations and beneficial for others. In addition, psychological effects can complicate the interpretation of other aspects of the drug's effect." 

Further studies have found that marijuana is effective in relieving some of the symptoms of HIV/AIDS, cancer, glaucoma, and multiple sclerosis.1

 

State vs Federal Perspective

At the federal level, marijuana remains classified as a Schedule I substance under the Controlled Substances Act, where Schedule I substances are considered to have a high potential for dependency and no accepted medical use, making distribution of marijuana a federal offense. In October of 2009, the Obama Administration sent a memo to federal prosecutors encouraging them not to prosecute people who distribute marijuana for medical purposes in accordance with state law.

In late August 2013, the U.S. Department of Justice announced an update to their marijuana enforcement policy. The statement reads that while marijuana remains illegal federally, the USDOJ expects states like Colorado and Washington to create "strong, state-based enforcement efforts.... and will defer the right to challenge their legalization laws at this time." The department also reserves the right to challenge the states at any time they feel it's necessary.

Arizona and the District of Columbia voters passed initiatives to allow for medical use, only to have them overturned. In 1998, voters in the District of Columbia passed Initiative 59. However, Congress blocked the initiative from becoming law. In 2009, Congress reversed its previous decision, allowing the initiative to become law. The D.C. Council then put Initiative 59 on hold temporarily and unanimously approved modifications to the law.

Before passing Proposition 203 in 2010, Arizona voters originally passed a ballot initiative in 1996. However, the initiative stated that doctors would be allowed to write a "prescription" for marijuana. Since marijuana is still a Schedule I substance, federal law prohibits its prescription, making the initiative invalid. Medical marijuana "prescriptions" are more often called "recommendations" or "referrals" because of the federal prescription prohibition.

States with medical marijuana laws generally have some form of patient registry, which may provide some protection against arrest for possession up to a certain amount of marijuana for personal medicinal use. 

Some of the most common policy questions regarding medical marijuana include how to regulate its recommendation, dispensing, and registration of approved patients.  Some states and localities without dispensary regulation are experiencing a boom in new businesses, in hopes of being approved before presumably stricter regulations are made.  Medical marijuana growers or dispensaries are often called "caregivers" and may be limited to a certain number of plants or products per patient.  This issue may also be regulated on a local level, in addition to any state regulation. 

Table 1. State Medical Marijuana/Cannabis Program Laws
State
Statutory Language (year)
Patient Registry or ID cards
Allows Dispensaries
Specifies Conditions
Recognizes Patients from other states
State Allows for Retail Sales/Adult Use
Yes
No
Yes
 
Not yet operational
Yes
Yes
Yes
Yes
 
Proposition 215 (1996)  SB 420 (2003)
Yes
Yes
No
 
 
Colorado
 
 
Yes
Yes
Yes
 
HB 5387 (2012)
Yes

 

Yes
Yes
 
 
SB 17 (2011)
Yes
Yes
Yes
 Yes
 
Initiative 59 (1998)  L18-0210 (2010)
Yes
Yes
 Yes
 
Pending Congressional review and not yet operational
SB 862 (2000)
Yes
No
Yes
 
 
Yes
Yes
Yes
No
 
Question 2 (1999)  LD 611 (2002)  
Question 5 (2009)   LD 1811 (2010)
LD 1296 (2011)
Yes
Yes
Yes
Yes
 
HB 702 (2003) SB 308 (2011) HB 180/SB 580 (2013)  HB 1101- Chapter 403 (2013)
SB 923 (signed 4/14/14)
HB 881- similar to SB 923
Yes
Yes 
Yes
 
 
Question 3 (2012)
Regulations (2013)
Yes
Yes
Yes
 
 
Yes
No
Yes
Yes 
 
SF 2471, Chapter 311 (2014) 
Yes
Yes, limited, liquid extract products only
Yes
 
 
Initiative 148 (2004) SB 423 (2011)
Yes
No**
Yes
No
 
Yes
No
Yes 
 
 
HB 573 (2013)
Yes
Yes
Yes
Yes, with a note from their home state,  but they cannot purchase or grow their own in NH.
 
Yes 
Yes 
Yes 
 
 
Yes 
Yes 
Yes 
 
 
New York
A6357 (2014) Signed by governor 7/5/14
Yes
Ingested doses may not contain more than 10 mg of THC, product may not be combusted (smoked).
Yes
 
 
SB 161 (2007) 
Yes 
No 
Yes 
 
Measure 91 (2014) 
Not yet operational
SB 791 (2007)  SB 185 (2009)
Yes 
Yes 
Yes 
Yes 
 
SB 76 (2004) SB 7 (2007) SB 17 (2011)
Yes 
Yes
Yes 
 
 
SB 5073 (2011)
No 
No 
Yes 
 

*The links and resources are provided for information purposes only. NCSL does not endorse the views expressed in any of the articles linked from this page.

** While Montana's revised medical marijuana law limits caregivers to three patients, caregivers may serve an unlimited number of patients due to an injunction issued on January 16, 2013.

Table 2. Limited Access Marijuana Product Laws (low THC/high CBD- cannabidiol)
State Program Name and Statutory Language (year) Patient Registry or ID cards Dispensaries or Source of Product(s) Specifies Conditions Recognizes Patients from other states Defintion of Products Allowed
Allows for Legal Defense
Allowed for Minors
Alabama 
SB 174 "Carly's Law" (Act 2014-277) Allows University of Alabama Birmingham to conduct effectiveness research using low-THC products for treating seizure disorders for up to 5 years.
 
Only the Univ. Alabama Birmingham is allowed to dispense
Yes, debilitating epileptic conditions
No
Low THC= below 3% THC
Yes
Yes
Florida
Compassionate Medical Cannabis Act of 2014 CS for SB 1030 (2014)
Yes
Yes, 5 across the state by region.
Yes, cancer, medical condition or seizure disorders that chronically produces symptoms that can be alleviated by low-THC products
No
Low THC= below .8% THC and above 10% CBD by weight
 
Yes, with approval from 2 doctors
Iowa
Yes
Doesn't define,
Yes, intractable epilepsy
No
Low THC= below 3% THC, no more than 32 oz.
Yes
Yes
Kentucky
SB 124 (2014) Clara Madeline Gilliam Act
Exempt cannabidiol from the definition of marijuana and allows it to be administerd by a public university or school of medicine in Kentucky for clinical trial or expanded access program approved by the FDA.
No
Universities in Kentucky with medical schools.
No
No
No
 
 
Mississippi
HB 1231 "Harper Grace's Law" 2014
 
All provided through National Center for Natural Products Research at the Univ. of Mississippi and dispensed by the Dept. of Pharmacy Services at the Univ. of Mississippi Medical Center
Yes, debilitating epileptic condition or related illness
No
Processed cannabis plant extract, oil or resin that contains more than 15% cannabidiol, or a dilution of the resin that contains at least 50 milligrams of cannabidiol (CBD) per milliliter, but not more than one-half of one percent (0.5%) of tetrahydrocannabinol (THC)
Yes, if an an authorized patient or guardia
Yes
Missouri
HB 2238 (2014)
Yes
Yes, creates cannabidiol oil care centers and cultivation and production facilities.
Yes, intractable epilepsy
No
Equal or less than .3% THC and at least 5% CBD by weight.
Yes
Yes
North Carolina
HB 1220 (2014) Epilepsy Alternative Treatment Act- Pilot Study
Yes
University research studies with a hemp extract registration card from the state DHHS.
Yes, intractable epilepsy
No
 Less than three-tenths of one percent (0.3%) tetrahydrocannabinol (THC) by weight.
Is composed of at least ten percent (10%) cannabidiol by weight.
Contains no other psychoactive substance. 
Yes
Yes
South Carolina
 SB 1035 (2014) Medical Cannabis Therapeutic Treatment Act- Julian's Law
 Yes
Must use CBD product from an approved source; and
(2)    approved by the United States Food and Drug Administration to be used for treatment of a condition specified in an investigational new drug application.
(B)    The principal investigator and any subinvestigator may receive cannabidiol directly from an approved source or authorized distributor for an approved source for use in the expanded access clinical trials.
Lennox-Gastaut Syndrome, Dravet Syndrome, also known as severe myoclonic epilepsy of infancy, or any other form of refractory epilepsy that is not adequately treated by traditional medical therapies.
No
At least 98 percent cannabidiol (CBD) and not more than 0.90 percent tetrahydrocannabinol (THC) by volume that has been extracted from marijuana or synthesized in a laboratory
Yes
 Yes
Tennessee
SB 2531(2014)
Creates a four-year study of high CBD/low THC marijuana at TN Tech Univ.
Researchers need to track patient information and outcomes
Only products produced by Tennessee Tech University.
Yes, intractable seisure conditions.
No
Less than .9% THC as part of a clinical research study
 
 
Utah
HB 105 (2014) Hemp Extract Registration Act
Yes
Allows higher education institution to grow or cultivate industrial hemp
Yes, intractable epilepsy that hasn't responded to three or more treatment options suggested by neurologist
No
Less than .3% THC by weight and at least 15% CBD by weight and contains no other psychoactive substances
Yes
Yes
Wisconsin
No
No in-state production/manufacturing mechanism provided.
Seizure disorders
 
"Cannabidiol in a form without a psychoactive effect."
No
Yes

*The links and resources are provided for information purposes only. NCSL does not endorse the views expressed in any of the articles linked from this page.

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