State Medical Marijuana Laws

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Medical Uses of Marijuana and Cannabis

State Medical Marijuana/Cannabis Program Laws- Table 1

Limited Access Marijuana Product Laws (low THC/high CBD)- Table 2

Karmen Hanson, program director, Denver

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In 1996, California voters passed Proposition 215, making the Golden State the firstin the union to allow for the medical use of marijuana. Since then, 29more states, theDistrict of Columbia,Guam and Puerto Ricohave enacted similar laws.As of Jan. 22, 2018, the Vermont legislature passed adult-use legalization legislation and the governor signed the bill. The measure does NOT set up a regulatory for system for sales or production. See text of measure below.

A total of 30states, theDistrict of Columbia,Guam and Puerto Riconow allow for comprehensive public medical marijuana and cannabis programs.(See Table 1 below for more info.)Approved efforts in 16states allow use of low THC, high cannabidiol (CBD) products formedical reasonsin limited situations or as a legal defense. Those programs are not counted as comprehensive medical marijuana programs but are listed in Table 2. NCSL uses criteria similar to other organizations to determine if a program is comprehensive: See Table 2 below for more information.

Protection from criminal penalties for using marijuana for a medical purpose;

Access to marijuana through home cultivation,dispensaries or some other system that is likely to be implemented;

It allows a variety of strains, including those more than low THC;and

It allows either smoking or vaporization of some kind of marijuana products,plant material or extract.

In response to Californias Prop 215, the Institute of Medicineissuedareportthat examinedpotential 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 drugs 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, theNational Academies of Sciences, Engineering, and Medicine released a reportbased on the review of over 10,000 scientific abstracts from marijuana health research. They also made100 conclusionsrelated to health and suggestways to improve cannabis research.

At the federal level, marijuana remains classified as a Schedule I substance under theControlled Substances Act, where ScheduleI 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, theU.S. Department of Justice announced an update to their marijuana enforcement policy.The statement readthat 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 its necessary.

More recently, in January 2018, 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:

NCSLs policy on state cannabis laws can be found underAdditional 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 passedInitiative 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 dical 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 someprotection against arrest for possession up to a certain amount of marijuana for personal medicinal use.

Someof themost common policyquestions regarding medical marijuanainclude how to regulate its recommendation, dispensing, and registration of approved patients. Some states and localities withoutdispensaryregulation are experiencinga boom in new businesses, in hopes ofbeing approved before presumablystricterregulations 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.

(click statename to jump to program information)

Recognizes Patients from other states

State Allows for Retail Sales/Adult Use

Measure 8(1998)SB 94(1999)Statute Title 17, Chapter 37

No, but adults over 21 may purchase at retail adult dispensaries.

Yes, for AZ-approved conditions, but not for dispensary purchases.

Approved in Nov. 2014, not yet operational.

Yes, but not for dispensary purchases.

HB 702(2003)SB 308(2011)HB 180/SB 580(2013)(2013)

Not in state law, but localities may create ordinances to allow them and regulate them.

Yes, for legal protection of posession, but not for dispensary purchases.

Yes, limited, liquid extract products only

Yes, if the other states program are substantially similar. Patients must fill out Nevada paperwork. Adults over 21 may also purchase at adult retail dispensaries.

Yes, with a note from their home state, but they cannot purchase through dispensaries.

A6357(2014) Signed by governor 7/5/14

Ingested doses may not contain more than 10 mg of THC, product may not be combusted (smoked).

Measure 5(2016) Final details pending

HB 523(2016) Approved by legislature, signed by governor 6/8/16, not yet operational

No, but adults over 21 may purchase at adult retail dispensaries.

SB 3(2016) Signed by governor 4/17/16 Not yet operational

Public Health DepartmentRegulation 155(2016)Not yet operational

H.511approved by legislature, signed bygovernor 1/22/18.

Does NOT provide for legal production or sales.

Allows adults 21 years or older to possess up to one ounce of marijuana.

Selling marijuana in Vermont remains illegal.

Allows adults to grow two mature plants.

Public consumption of marijuana is also not allowed.

Yes, approved as of Nov. 2012, stores opened in July, 2014.

No, but adults over 21 may purchase at an adult retail dispensary.

WAC Marijuana rules: Chapter 314-55 WAC

FAQ about WA cannabis lawsby the Seattle Times.

Yes. No whole flower/cannot be smoked but can be vaporized.

No, but may allow terminally ill to buy in other states.

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

**While Montanas revised medical marijuana law limits caregivers to three patients, caregivers may serve an unlimitednumber of patients due to an injunction issued on January 16, 2013.

Table 2. Limited Access Marijuana Product Laws (low THC/high CBD- cannabidiol)

Program Name andStatutory Language (year)

Dispensaries or Source of Product(s)

Recognizes Patients from other states

SB 174 Carlys Law(Act 2014-277) Allows University of Alabama Birmingham to conduct effectivenessresearch usinglow-THC products fortreating seizure disorders for up to 5 years.

HB 61(2016) Lenis Law allows more physicians to refer patients to use CBD for more conditions.

Provides legal defense for posession and/or use of CBD oil. Does not create an in-stateproduction method.

Yes, debilitating epileptic conditions,life-threatening seizures, wasting syndrome, chronic pain, nausea, muscle spasms, any other sever condition resistant to conventional medicine.

(NEW comprehensive program approved in 2016, included in table above)

Compassionate Medical Cannabis Act of 2014CS for SB 1030 (2014)

Patient treatment information and outcomes will be collected and used for intractable childhood epilepsy research

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

Cannabis with low THC= below .8% THC and above 10% CBD by weight

HB 1 (2015)(signed bygovernor4/16/15)

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, Crohns, mitochondrial disease, Parkinsons, Sickle Cell disease

Cannabis oils with low THC= below 5% THC and at least an equal amount of CDB.

SF 2360, Medical Cannabidiol Act of 2014(Effective 7/1/14)

Doesnt define or provide in-state methods of access or production.

Cannabidiol- a non-psychoactive cannabinoid that contains below 3% THC, no more than 32 oz, and essentially free from plant material.

The possessor has, or is a parent or guardian of a person thathas, cancer, amyotrophic lateral sclerosis, seizure disorders,multiple sclerosis, Crohns disease, mitochondrial disease, fibroymyalgia, Parkinsons disease or sickle cell disease;

Is composed of no more than three-tenths percent (0.3%)tetrahydrocannabidiol by weight; is composed of at least fifteen (15) times more cannabidiolthan tetrahydrocannabidiol by weight; andcontains no other psychoactive substance.

At least 5 percent CBD by weight. No more than .3 percent THC by weight.

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.

Universities in Kentucky with medical schools that are able to get a research trial. Doesnt allow for in-state production of CBD product.

HB 1231Harper Graces 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

CBD oil – processed cannabis plantextract, 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, createscannabidiol oil care centers and cultivation and production facilities/laboratories.

Yes, intractable epilepsy that has not responded to three or more other treatment options.

Hemp extracts equal or less than .3% THC and at least 5% CBD by weight.

HB 1220(2014) Epilepsy Alternative Treatment Act- Pilot Study

HB 766(2015) Removes Pilot Study designation

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.

Hemp extracts with less than nine-tenths of one percent (0.9%) tetrahydrocannabinol (THC) by weight.

Is composed of at least fivepercent (5%) cannabidiol by weight.

Contains no other psychoactive substance.

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

A preparation of cannabis with no more than .3% THC in liquid form.

SB 1035(2014) Medical Cannabis Therapeutic Treatment Act- Julians Law

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.

Cannabidiol or derivative of marijuana that contains 0.9% THC and over 15% CBD, orleast 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

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

______NoOnly 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, howevermost 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.

Cannabis oil withless than .9% THC as part of a clinical research study

Low-THC Cannabis with not more than 0.5 percent by weight of tetrahydrocannabinols; and not less than 10 percent by weight of cannabidiol

HB 105(2014) Hemp Extract Registration Act

Not completely clear, however it may allowhigher education institution to grow or cultivate industrial hemp.

Yes, intractable epilepsy that hasnt responded to three or more treatment options suggested by neurologist.

Hemp extracts with less than .3% THC by weight and at least 15% CBD by weight and contains no other psychoactive substances

No in-state means of acquiring cannabis products.

Cannabis oils with at least 15% CBD or THC-A and no more than 5% THC.

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.

Exception tothe 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.

Supervised medical use of hemp extracts. Effective 7/1/2015

No in-state production or purchase method defined.

Intractable epilepsy or seizure disorders

Hemp extracts with less than 0.3% THC and at least 5% CBD by weight.

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

NCSLs Marijuana Deep Dive pagefeaturing marijuana and cannabis laws on criminal justice, health and other resources.

NCSL FY 2018 letter the LCJPS Committee sent to the Hill opposing the withholding of funding for state with medical marijuana laws:

NCSL FY 2018 CJS Appropriations Support Letter.(May 16, 2017)

State Marijuana Policy covered in Episode 4 of NCSLs podcast,Our American States.

You can find iton our websiteor subscribe to the podcast inor your favorite podcast app.

Comparison of all state medical marijuana programs with contact information. Prepared by the Network for Public Health Law as of June 2014

State-by-State Medical Marijuana LawsMarijuana Policy Project, 2015

25 Legal Medical Marijuana States and DC: Laws, Fees, and Possession Limits,by

Regulating Marijuana: Taxes, Banking and Federal Laws, November 2015

State Medical Marijuana Programs Financial Information, Marijuana Policy Project, July 2013

Medical Marijuana Dispensary Laws: Fees and Taxes, Marijuana Policy Project, February 2015

Colorado Marijuana Sales andTax Reports(updated monthly)

Washington State Sales and Tax Information (updated weekly)

Taxing Marijuana: The Washington and Colorado Experience, Tax Foundation, August 2014

What Law Enforcement Can Learn from Marijuana Legalization in Colorado, Prepared by American Military University, March, 2015

Statement by ONDCP Director Gil Kerlikowske regarding Federal guidelines for medical marijuana prosecution

Medical marijuana research and reports

The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research, 2017

Marijuana and Medicine: Assessing the Science Base, Institute of Medicine, 1999

Treatment Research Institutes (TRI) policy position statement regarding medical marijuana

ProCon.orgs resources on medical marijuana. Medical Marijuana ProCon.org presents laws, studies, statistics, surveys, government reports, and pro and con statements on questions related to marijuana as medicine.

Exposing the Myth of Smoked Medical Marijuana, U.S. Drug Enforcement Administration

State-by-State Medical Marijuana LawsMarijuana Policy Project, 2014

Becoming a State-Authorized Patient, Americans for Safe Access

DEA: Pharmaceutical products already exist; they are called Marinol and Cesamet

Retail/Adult Use information and news

Regulating Marijuana: Taxes, Banking and Federal Laws, November 2015

Regulating Marijuana: A Year and a Half In, NCSL, October 2015

Marijuana: Selected Legal Issues. Congressional Research Service, April 2013

Analysis of CO Amendment 64 (rec use initiative)by Colorado State University, April 2013

Colorado Marijuana Sales andTax Reports

Colorado Marijuana Enforcement Division Annual Update, February 2015

Public Health Law Research Law Atlas: Recreational Marijuana Laws – Interactive Map

Brookings Institution:Colorados Rollout of Legal Marijuana Is Succeeding

Public health and youth information

Regulating Recreational Use of Marijuana and the Role of Public Health LawPrepared by the Network for Public Health Law

Marijuana Impact on Public Health and Safety in Colorado: conference by CO Association of Chiefs of Police, January 14-16, 2015

Smart Colorado: Protecting youth from marijuana

Interest groups and position statements

Smart Colorado: Protecting youth from marijuana

Treatment Research Institutes (TRI) policy position statement regarding medical marijuana

National Families in Action: Marijuana Studies Program Marijuana Report

State-by-State Medical Marijuana LawsMarijuana Policy Project, 2016

Key Aspects of State and DC Medical Marijuana Laws,Marijuana Policy Project,2016

Becoming a State-Authorized Patient, Americans for Safe Access

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