In the United States, the use of cannabis for medical purposes is legal in 36 states, four out of five permanently inhabited U.S. territories and the District of Columbia.
As of June 2021, these 36 states and 4 territories allow for the medical use of cannabis products. In November, 2020, voters in Mississippi passed a ballot initiative to allow for medical use, but it was overturned by the state supreme court on May 14, 2021 and is not counted in the state totals. As of April 14, 2021, South Dakota’s overturned adult-use ballot measure is currently under appeal as of March 11, 2021.
In the fall, another three states will attempt to legalize medical cannabis, although the Covid-19 crisis may cause problems for securing ballot initiatives. The states that are considering medical cannabis approval include Idaho, South Dakota and Nebraska.
There are significant variations in medical cannabis laws from state to state, including how it is produced and distributed, how it can be consumed, and what medical conditions it can be used for treatment.
Medical Marijuana Legal States:
- District of Columbia
- New York
- New Jersey
- New Mexico
- New Hampshire
- North Dakota
- Rhode Island
- West Virginia
Marijuana is legal in Alaska and has been among U.S. medical marijuana states since November 1998. Alaska has a law built into its constitution concerning the resident’s right to privacy, and cannabis Use has always been somewhat protected under this law.
Arizona has been providing medical marijuana to select patients since 2010. Under medical marijuana laws in Arizona, patients are allowed to possess up to 2.5 oz. of marijuana, and may grow up to 12 plants.
In November 2016, Arkansas voters opted to make marijuana legal under limited circumstances, passing ballot Measure 6 for medical marijuana. Possession laws for the new medical marijuana program is 3 ounces of marijuana per 2-week period.
California has been a medical marijuana state since 1996. Possession laws for medical marijuana patients in California include an eight-ounce limit. Patients may grow as many as 12 immature marijuana plants or 6 mature plants. Consumers may buy up to an ounce of marijuana flower.
Colorado has been a medical marijuana state since 2000. Adults 21 or older can grow up to three immature and three mature marijuana plants privately in a locked space and may legally possess all marijuana from the plants if it stays where it was grown. Adults may legally possess up to one ounce of marijuana while traveling, and give as a gift up to one ounce to other citizens 21 years of age or older. Consumption is permitted in a manner like alcohol (with social consumption laws coming soon), and equivalent offenses prescribed for driving under the influence.
Connecticut has been a medical marijuana state since 2012. Possession laws for medical marijuana patients in Connecticut put a 2.5-ounce limit on marijuana.
Delaware has been one of the medical marijuana states since 2011. Delaware’s possession laws include 6 oz. of marijuana.
District of Columbia:
District of Columbia has allowed medical marijuana for almost 20 years. Under Initiative 71, an individual 21 or older can possess up to two ounces of marijuana for personal Use and can grow no more than six cannabis plants with 3 or fewer being mature, within the person’s principal residence. The Initiative also allows an individual to transfer without payment (but not sell) up to one ounce of marijuana to another person 21 years of age or older.
Florida has been a medical state since early 2016, operating first a highly limited CBD-only medical marijuana program. In November 2016, voters backed Amendment 2, allowing a larger group of patients to have access to cannabis use. Under Amendment 2, cannabis treatment is not limited to CBD-only. In March 2019, Florida legislators approved smokable cannabis.
Hawaii has been a medical marijuana state since 2000. Hawaii also recently decriminalized marijuana. The law allows registered patients to grow up to seven of their own plants, but initially did not allow any medical marijuana dispensaries to be opened. That has changed. Possession laws include 4 oz. of marijuana and 7 plants.
Illinois has been a medical marijuana state since 2013. Possession includes will be 30 grams of flower, five grams of concentrate, and 500 milligrams of THC in any cannabis-infused products.
The Louisiana Governor signed legislation that would set up rules for dispensing marijuana in 2015. It was the first state in the south to accept cannabis.
Maine has been a medical marijuana state since 1999. Possession laws include 2.5 ounces of marijuana and 6 plants
Maryland has been a medical marijuana state since 2014. For medical marijuana patients, possession laws include a 30-day supply as determined by the recommending physician.
Massachusetts has been a medical marijuana state since 2012. Voters passed Question 4 in 2016, setting up the state to become the largest legal marijuana state the East Coast. Possession laws include a 60-day (10 ounces) supply.
Michigan has been a medical marijuana state since 2008. Although states could opt-in or out, most jurisdictions have chosen to wait to open medical marijuana provisioning centers.
Minnesota has been a medical marijuana state since 2014. Possession laws include a 30-day supply of non-smokable marijuana.
Amendment 2 passed in Missouri in November 2018 and legalized marijuana for certain qualifying conditions. The laws went into effect December 2018. The state began to accept applications for Missouri medical cards in July 2019.
Montana has been a medical marijuana state since 2004. In 2011, Montana enacted an entirely new medical marijuana program, placing more restrictions on medical marijuana use and increasing the requirements for patients, caregivers and physicians in the program. Many patients feel the amendment has made the process of obtaining medical marijuana even more difficult and discouraging. Possession laws include 1 oz. and 4 plants (mature); and 12 seedlings.
Nevada began working on legalizing medical cannabis in 2000, but it took six years to pass and open dispensaries. Now the state has one of the safest and most-regulated programs in the country. Possession laws include 2.5 ounces of cannabis and up to 12 plants.
New Hampshire made marijuana legal for medical purposes in 2013. Possession laws include two ounces of cannabis during a 10-day period.
New Jersey has made marijuana legal for medical purposes in 2010. Possession laws include two ounces of marijuana.
New Mexico has been a medical state since 2007. Current possession laws in New Mexico include 6 ounces of marijuana and up to 16 plants (4 mature, 12 immature).
New York has been a medical marijuana state since 2014. Current possession laws include a 30-day supply of non-smokable marijuana.
North Dakota became a medical marijuana state in 2016, with dispensaries opening in late 2018. The list of qualifying conditions for a medical marijuana card in North Dakota is fairly typical of other medical marijuana states. Cannabis flower, concentrates, tinctures, capsules, patches, and topicals are all allowed; edibles are not permitted at this time.
Ohio has been a medical marijuana state since 2019. The med program serves a small margin of people with merely a few medical conditions. Possession laws include a maximum of a 90-day supply, with the exact amount yet to be determined.
Oklahoma passed State Question 788 in June 2018. The initiative had a lot of holes, so emergency rules were put in place soon after. The state’s medical marijuana program is fully functional, with tons of dispensaries open in the state. As of March 2019, there are 68,000 approved medical marijuana cardholders in Oklahoma.
Oregon has been a medical marijuana state since 1998. Oregon has long been a very marijuana-friendly state, and it was the first to decriminalize cannabis in 1973. Current possession laws include 24 ounces of marijuana along with 24 plants (6 mature, 18 immature)
Pennsylvania passed a basic medical marijuana law earlier in 2019. There are currently no bills or amendments planned for expanding the medical laws. Current possession laws include a 30-day supply.
Rhode Island has been a medical marijuana state since 2006. Possession laws currently include 2.5 ounces of marijuana along with 12 plants.
Utah voters passed Proposition 2, which legalized medical marijuana, in November 2018, but many people were displeased with the program. Lawmakers got together and passed a compromise bill in December 2018. The Utah Cannabis Act limited the acceptable qualifying conditions for medical marijuana in Utah, decreased the amount of dispensaries that would be allowed in the state, and began calling dispensaries “pharmacies.”
Vermont made medical marijuana legal in 2007. Current possession laws for medical patients in Vermont include two ounces of marijuana along with 9 plants (2 mature, 7 immature).
Washington has been one of the medical marijuana states since 1998 and the program has become a model for other states to use.
West Virginia’s medical marijuana laws were signed in August 2017, but the program has been slow to get off the ground. Cards became issued in July 2019.
Low THC, High Cannabidiol (CBD) Legalised States
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.
These states include:
- North Carolina
- South Carolina
Low-THC programs are not counted as comprehensive medical marijuana programs. The National Council of State Legislatures uses criteria similar to other organizations tracking this issue to determine if a program is “comprehensive”:
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 or products, including those with more than “low THC.”
- It allows either smoking or vaporization of some kind of marijuana products, plant material or extract.
- Is not a limited trial program. (South Dakota and Nebraska have limited, trial programs that are not open to the public.)
ADULT-USE UPDATE: As of April 14, 2021, 17 states, two territories and the District of Columbia have enacted legislation to regulate cannabis for adult use.
Voters in Arizona, Montana, New Jersey, and South Dakota approved measures to regulate cannabis for adult use.
- On February 8, 2021, South Dakota Circuit Judge Christina Klinger ruled that the measure was unconstitutional. The decision is being appealed as of March 31, 2021.
- New Jersey’s governor signed enacting legislation on March 1, 2021.
- New York’s legislature and governor enacted AB 1248/SB 854 on March 31, 2021.
- The Virginia legislature passed legislation on February 27 and approved the governor’s amendments on April 7, 2021.
- New Mexico legislature passed legislation on March 31 and the governor signed legislation on April 12, 2021.
- These actions bring the number of states with adult-use regulated cannabis to 17, plus two territories and the District of Columbia. This total does NOT include South Dakota’s court-overturned measure, which is pending appeal.