State Medical Marijuana Laws

11/10/2020

California voters passed Proposition 215 in 1996, making the Golden State the first in the union to allow for the medical use of marijuana. Since then, 35 more states, the District of Columbia, Guam, Puerto Rico and U.S. Virgin Islands have enacted similar laws.

POST 2020 ELECTION UPDATE: As of Nov. 4 2020, voters in Mississippi and South Dakota approved a measure to regulate cannabis for medical use, bringing the total to 36 states and 4 territories.
 

POST 2020 ELECTION UPDATE: As of Nov. 4, 2020, voters in Arizona, Montana, New Jersey and South Dakota approved measures to regulate cannabis for adult-use.  This brings the total to 15 states and 3 territories.

A total of 36 states, District of Columbia, Guam, Puerto Rico and U.S. Virgin Islands have approved comprehensive, publicly available medical marijuana/cannabis programs. (See Table 1 below for more information.) 

Approved measures in 11 states allow use of "low THC, high cannabidiol (CBD)" products for medical reasons in limited situations or as a legal defense.  (See Table 2 below for more information). Low-THC programs are not counted as comprehensive medical marijuana programs. NCSL uses criteria similar to other organizations tracking this issue 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 allows a variety of strains or products, including those with more than "low THC."
  4. It allows either smoking or vaporization of some kind of marijuana products, plant material or extract. 
  5. Is not a limited trial program. (South Dakota and Nebraska have limited, trial programs that are not open to the public.)

United States map of State Cannabis Programs

 

Medical Uses of Marijuana

A doctor holds a container of medical 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  

In early 2017, the National Academies of Sciences, Engineering, and Medicine released a report based on the review of over 10,000 scientific abstracts from marijuana health research. They also made 100 conclusions related to health and suggest ways to improve cannabis research.

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 read 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.

More recently, in January 2018, former Attorney General Sessions issued a Marijuana Enforcement Memorandum that rescinded the Cole Memorandum, and allows federal prosecutors to decide how to prioritize enforcement of federal marijuana laws. Specifically, the Sessions memorandum directs U.S. Attorneys to “weigh all relevant considerations, including federal law enforcement priorities set by the Attorney General, the seriousness of the crime, the deterrent effect of criminal prosecution, and the cumulative impact of particular crimes on the community.” Text of the memo can be found here: https://www.justice.gov/opa/pr/justice-department-issues-memo-marijuana-enforcement 

NCSL's policy on state cannabis laws can be found under Additional Resources below.

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
(click state name to jump to program information)
Statutory Language (year Patient Registry or ID cards Allows Dispensaries Specifies Conditions Recognizes Patients from other states State Allows for Retail Sales/Adult Use
Alaska Measure 8 (1998) SB 94 (1999) Statute Title 17, Chapter 37 Yes Yes Yes No, but adults over 21 may purchase at retail adult dispensaries. Ballot Measure 2 (2014) Marijuana Regulations  
Arizona Proposition 203 (2010) Yes Yes Yes Yes, for AZ-approved conditions, but not for dispensary purchases. Proposition 207 (2020)
Arkansas Issue 6 (2016) Yes  Yes Yes Yes
California Proposition 215 (1996)  SB 420 (2003) Yes Yes (cooperatives and collectives) No No Proposition 64 (2016)
Colorado   Medical program info   Adult-use info Amendment 20 (2000) Yes Yes Yes No Amendment 64 (2012) Task Force Implementation Recommendations (2013)
Analysis of CO Amendment 64 (2013)
Colorado Marijuana Sales and Tax Reports 2014 "Edibles" regulation measure FAQ about CO cannabis laws by the Denver Post.   
Connecticut HB 5389 (2012) Yes

Yes

Yes    
Delaware SB 17 (2011) Yes Yes Yes  Yes, for DE-approved conditions.  
District of Columbia Initiative 59 (1998)  L18-0210 (2010) Yes Yes Yes   Initiative 71 (2014)  
Florida Amendment 2 (2016) Details pending Yes Yes Yes No  
Guam Proposal 14A Approved in Nov. 2014, fully operational.- home growing currently allowed until dispensaries open Draft rules released in July 2015   Adult use- 2019 Bill No. 32-35 signed by governor in April, 2019 Yes Yes Yes No Yes. Adult use- 2019 Bill No. 32-35 signed by governor in April, 2019
Hawaii SB 862 (2000) Yes Yes Yes No  
Illinois HB 1 (2013) Eff. 1/1/2014 Rules    Adult use legalization SB 0007 bill passed legislature May, 2019, signed by governor June 25, 2019, Effective Jan. 1, 2020. Yes Yes Yes No Measure approved by legislature in May, 2019, signed by governor June 25, 2019. Effective Jan. 1, 2020.
Louisiana SB 271 (2017) (not yet in effect) Pending Yes Yes No  
Maine Question 2 (1999)  LD 611 (2002)   Question 5 (2009)   LD 1811 (2010) LD 1296 (2011) Yes Yes Yes Yes, but not for dispensary purchases. Question 1 (2016) page 4 Chapter 409 (2018) 
Maryland 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 No  
Massachusetts Question 3 (2012)
Regulations (2013)
Yes Yes Yes No Question 4 (2016)
Michigan Proposal 1 (2008) Yes Not in state law, but localities may create ordinances to allow them and regulate them. Yes Yes, for legal protection of posession, but not for dispensary purchases. Proposal 18-1 (2018)
Minnesota SF 2471, Chapter 311 (2014)  Yes Yes, limited, liquid extract products only Yes No  
Mississippi Initiative 65 (2020) Yes Yes Yes Yet to be determined  
Missouri Amendment 2 (2018) Yes Yes, details pending Yes Yet to be determined  
Montana Initiative 148 (2004) SB 423 (2011)
Initiative 182 (2016)
Yes

Yes 
No**   Yes Yes   Yes No     Initiative 190 (2020)
Nevada Question 9 (2000) NRS 453A NAC 453A Yes Yes Yes  Yes, if the other state's program are "substantially similar." Patients must fill out Nevada paperwork. Adults over 21 may also purchase at adult retail dispensaries. Question 2 (2016) page 25
New Hampshire HB 573 (2013) Yes Yes Yes Yes, with a note from their home state, but they cannot purchase through dispensaries.  
New Jersey SB 119 (2009)  
Program information
Yes  Yes  Yes  No Public Question 1 (2020)
New Mexico SB 523 (2007) 
Medical Cannabis Program
Yes  Yes  Yes  No  

 

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 No  
North Dakota Measure 5 (2016) NDCC 19-24.1 NDAC 33-44 Yes Yes Yes No  
Northern Mariana Islands Does not have a medical program.         Yes, HB 20-178 HD 4- Public Law 20-66 (2018)
Ohio HB 523 (2016) Approved by legislature, signed by governor 6/8/16

 

Yes Yes Yes Details pending, but will require reciprocity.   
Oklahoma    SQ 788 Approved by voters on 6/26/18 Yes Yes Not as voted on Yes but must apply as a temporary patient  
Oregon Oregon Medical Marijuana Act (1998) SB 161 (2007)  Yes  Yes Yes  No, but adults over 21 may purchase at adult retail dispensaries. Measure 91 (2014) 
Pennsylvania SB 3 (2016) Signed by governor 4/17/16 Yes Yes Yes No  
Puerto Rico Public Health Department Regulation 155 (2016) in Spanish Yes Cannot be smoked Yes Yes  
Rhode Island S 710 B (2006)- Legislature overturned governor's veto.
SB 791 (2007)  SB 185 (2009)
Yes  Yes  Yes  Yes  
South Dakota Initiated Measure 26 (2020) Yes Yes Yes Yet to be determined Amendment A (2020)
US Virgin Islands SB 135 (2017) signed by governor 1/19/19          
Utah Prop 2 (2018) replaced by HB 3001 HB 3001 2018- Third Special Session Yes Yes Yes Yet to be determined  
Vermont SB 76 (2004) SB 7 (2007) SB 17 (2011) H.511 (2018) Yes  Yes Yes  No H.511 approved by legislature, signed by governor 1/22/18. 
Effective July 1, 2018.
S.54 (2020) establishes sales regulations. Effective Oct. 7, 2020.
Governor's letter re: S. 54, going into effect without his signature.    Additional info:
Governor's Marijuana Advisory Commission Final Report- December, 2018
Virginia

H 1460 (2020)

S 646 (2020)

H 1617 (2020)

S 976 (2020)

Legislative Timeline (2020)

Board of Pharmacy overview
Board of Pharmacy FAQ
 

Yes Yes No No, but allows for temporary residents to apply with approval from the Board of Pharmacy.  
Washington Initiative 692(1998) SB 5798 (2010) SB 5073 (2011) No  Yes, approved as of Nov. 2012, stores opened in July, 2014. Yes  No, but adults over 21 may purchase at an adult retail dispensary. Initiative 502 (2012)
WAC Marijuana rules: Chapter 314-55 WAC
  FAQ about WA cannabis laws by the Seattle Times.
West Virginia SB 386 (2017) Yes Yes. No whole flower/cannot be smoked but can be vaporized. Yes No, but may allow terminally ill to buy in other states.  

*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 Definition 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. 
HB 61 (2016) Leni's Law allows more physicians to refer patients to use CBD for more conditions.
No
Provides legal defense for posession and/or use of CBD oil.  Does not create an in-state production method.
Yes, debilitating epileptic conditions, life-threatening seizures, wasting syndrome, chronic pain, nausea, muscle spasms, any other sever condition resistant to conventional medicine.

 

No
Extracts that are low THC= below 3% THC
Yes
Yes
Florida
(NEW comprehensive program approved in 2016, included in table above)
Compassionate Medical Cannabis Act of 2014 CS for SB 1030 (2014)
Yes
Yes, 5 registered nurseries across the state by region, which have been in business at least 30 years in Florida.
Yes, cancer, medical condition or seizure disorders that chronically produces symptoms that can be alleviated by low-THC products
No
Cannabis with low THC= below .8% THC and above 10% CBD by weight
 
Yes, with approval from 2 doctors
Georgia
HB 1 (2015) (signed by governor 4/16/15)
 
Yes
Law allows University System of Georgia to develop a lot THC oil clinical research program that meets FDA trial compliance. 
Yes, end stage cancer, ALS, MS, seizure disorders, Crohn's, mitochondrial disease, Parkinson's, Sickle Cell disease
No
Cannabis oils with low THC= below 5% THC and at least an equal amount of CDB. 
Yes
Yes

 Idaho- VETOED BY GOVERNOR

SB 1146 (VETOED by governor 4/16/15)
No
Doesn't define.
The possessor has, or is a parent or guardian of a person that has, cancer, amyotrophic lateral sclerosis, seizure disorders, multiple sclerosis, Crohn's disease, mitochondrial disease, fibroymyalgia, Parkinson's disease or sickle cell disease;
No
Is composed of no more than three-tenths percent (0.3%)  tetrahydrocannabidiol by weight;  is composed of at least fifteen (15) times more cannabidiol than tetrahydrocannabidiol by weight; and contains no other psychoactive substance.
Yes
Yes
Indiana
HB 1148 (2017)
Yes
Doesn't define.
Treatment resistant epilepsy.
No
At least 5 percent CBD by weight. No more than .3 percent THC by weight.
Yes
Yes
SF 2360, Medical Cannabidiol Act of 2014 (Effective 7/1/14 and repealed in 2017 and replaced)
HF 524 of 2017 now Section 124E
Yes
Yes
Yes
Yes, for possession or use only, not for purchasing CBD in Iowa. 
Less than 3 percent THC
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 that are able to get a research trial. Doesn't allow for in-state production of CBD product. 
Intractable seizure disorders
No
No, only "cannabidiol".
 
 
Mississippi
(NEW comprehensive medical use program approved in 2020, included in table above.)
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
"CBD oil" - 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 guardian
Yes
Missouri 
(NEW comprehensive program approved in 2018, included in table above)

 

HB 2238 (2014)
Yes
Yes, creates cannabidiol oil care centers and cultivation and production facilities/laboratories.
Yes, intractable epilepsy that has not responded to three or more other treatment options.
No
"Hemp extracts" 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
HB 766 (2015) Removes Pilot Study designation
Yes
University research studies with a hemp extract registration card from the state DHHS or obtained from another jurisdiction that allows removal of the products from the state.
Yes, intractable epilepsy
No
"Hemp extracts" with less than nine-tenths of one percent (0.9%) tetrahydrocannabinol (THC) by weight.
Is composed of at least five percent (5%) cannabidiol by weight.
Contains no other psychoactive substance. 
Yes
Yes
Oklahoma
(NEW comprehensive medical program approved in 2018 and listed above)
 HB 2154 (2015)
Yes
No in-state production allowed, so products would have to be brought in. Any formal distribution system would require federal approval.
People under 18 (minors) Minors with Lennox-Gastaut Syndrome, Dravet Syndrome, or other severe epilepsy that is not adequately treated by traditional medical therapies
No
A preparation of cannabis with no more than .3% THC in liquid form.
Yes
Yes, only allowed for minors 
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.
-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.
Some have interpreted the law to allow patients and caregivers to produce their own products.
 
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
Cannabidiol or derivative of marijuana that contains 0.9% THC and over 15% CBD, or least 98 percent cannabidiol (CBD) and not more than 0.90% 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.
______
 
HB 197 (2015)
Researchers need to track patient information and outcomes
______
 
No
Only products produced by Tennessee Tech University.
Patients may possess low THC oils only if they are purchased "legally in the United States and outside of Tennessee," from an assumed medical cannabis state, however most states do not allow products to leave the state.
_____
Allows for legal defense for having the product as long as it was obtained legally in the US or other medical marijuana state.
Yes, intractable seizure conditions.
______
 
Yes, intractable seizure conditions.
No
______
 
No
"Cannabis oil" with less than .9% THC as part of a clinical research study
______
 
Same as above.
Yes
Yes
Texas

SB 339 (2015)
Texas Compassionate Use Act

HB 3703 (2019)

Yes
Yes, licensed by the Department of Public Safety.
Yes, intractable epilepsy, incurable neurodegenerative disease, terminal cancer, multiple sclerosis, spasticity, ALS, autism. 

 

No
"Low-THC Cannabis" with not more than 0.5 percent by weight of tetrahydrocannabinols.
Yes
Yes
Utah
(NEW comprehensive program approved in 2018, included in table above)
HB 105 (2014) Hemp Extract Registration Act
Yes
Not completely clear, however it may allow 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
"Hemp extracts" with less than .3% THC by weight and at least 15% CBD by weight and contains no other psychoactive substances
Yes
Yes

 Virginia
(NEW comprehensive medical program approved in 2020 and listed above)

HB 1445- no longer in effect
No
No in-state means of acquiring cannabis products.
Intractable epilepsy
No
Cannabis oils with at least 15% CBD or THC-A and no more than 5% THC.
Yes

 

Yes
Wisconsin
No
Physicians and pharmacies with an investigational drug permit by the FDA could dispense cannabidiol. Qualified patients would also be allowed to access CBD from an out-of-state medical marijuana dispensary that allows for out-of-state patients to use their dispensaries as well as remove the products from the state.
No in-state production/manufacturing mechanism provided.
Seizure disorders
 
Exception to the definition of prohibited THC by state law, allows for possession of "cannabidiol in a form without a psychoactive effect."  THC or CBD levels are not defined.
No
Yes
Wyoming
 
HB 32 (2015)
Supervised medical use of hemp extracts. Effective 7/1/2015
Yes
No in-state production or purchase method defined.
Intractable epilepsy or seizure disorders
No
"Hemp extracts" with less than 0.3% THC and at least 5% CBD by weight.
Yes
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.

Additional Resources