NCSL - National Conference of State Legislatures

06/05/2025 | Press release | Distributed by Public on 06/05/2025 10:33

State Medical Cannabis Laws

Related Topic:Health

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Legislative Updates
Medical Uses of Cannabis
State vs. Federal Perspective
Table 1. State Medical Marijuana/Cannabis Program Laws
Table 2. Limited Access Cannabis Product Laws (low THC/high CBD- cannabidiol)

Medical-Use Update

Thirty-nine states, three territories and the District of Columbia allow the medical use of cannabis products as of Feb. 1, 2025. See Table 1 below for additional information.

Non-Medical/Adult-Use Update

Twenty-four states, three territories and the District of Columbia allow or regulate cannabis for non-medical adult (recreational) use as of the same date.

Low-THC Update

Nine states allow the use of "low THC, high cannabidiol" 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 cannabis 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 cannabis for a medical purpose.
  2. Access to cannabis 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 cannabis products, plant material or extract. 
  5. Is not a limited trial program.

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Notes: The District of Columbia allows limited adult possession and growing, no regulated production or sales.

Medical Uses of Cannabis

In response to California's Prop 215, the Institute of Medicine issued a report in 1999 that examined potential therapeutic uses for cannabis. 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 cannabis is effective in relieving some of the symptoms of HIV/AIDS, cancer, glaucoma, and multiple sclerosis.

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 cannabis health research. They also made 100 conclusions related to health and suggest ways to improve cannabis research.

The National Academies released a second report, Cannabis Policy Impacts Public Health and Health Equity, in 2024, following a review of regulatory frameworks for the cannabis industry. The report suggests ways to "minimize public health harms through a stronger federal leadership and robust research agenda."

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

Some of the most common policy questions regarding medical cannabis include how to regulate its recommendation, dispensing and registration of approved patients. Some small cannabis growers or are often called "caregivers" and may grow a certain number of plants per patient. This issue may also be regulated on a local level, in addition to any state regulation.

State vs. Federal Perspective

At the federal level, cannabis 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 cannabis a federal offense. However, federal administrations have generally not interfered with state regulated cannabis programs.

In May 2024, the Department of Justice posted a proposal to transfer marijuana from schedule I of the Controlled Substances Act to schedule III, to better align with the comments by the Department of Health and Human Services that marijuana has accepted medical use and a lower abuse potential and level of physical or psychological dependence than other schedule I substances. The DOJ under the Biden Administration accepted public comment through July 2024 and considered action.

Table 1. State Medical Marijuana/Cannabis Program Laws
State
(click state name to jump to program information)
Statutory Language (year) State Allows for Retail Sales/Non Medical Adult Use

Alabama

SB 46 (2021)

Act 2021-450

Alaska

Measure 8 (1998)

SB 94 (1999)

Statute Title 17, Chapter 37

Yes. Ballot Measure 2 (2014)

Marijuana Regulations

Arizona

Proposition 203 (2010)

Yes. Proposition 207 (2020)

Arkansas

Issue 6 (2016)

California

Proposition 215 (1996)

SB 420 (2003)

Yes. Proposition 64 (2016)

Colorado

Medical program info

-Non medical adult use info

Amendment 20 (2000)

Yes. Amendment 64 (2012)

Connecticut

HB 5389 (2012)

Yes. SB 1201 (2021)

Delaware

SB 17 (2011)

Yes. Nonmedical adult-use legislation HB 1 and HB 2 (2023) passed the legislature and enacted without governor's signature.

District of Columbia

Initiative 59 (Passed by voters but blocked by the Barr Amendment in 1998)

L18-0210 or Act B18-622 (2010)

Yes. Initiative 71 (2014)

Florida

Amendment 2 (2016)

Guam

Joaquin (KC) Concepcion II Compassionate Cannabis Use Act (2013)

Proposal 14A (2014)

Yes. Bill No. 32-35 (2019)

Hawaii

SB 862 (2000)

Illinois

HB 1 (2013)

Yes. SB 0007 (2020)

Kentucky

SB 47 (2023)

Louisiana

SB 271 (2017)

Maine

Question 2 (1999)

LD 611 (2002)

Question 5 (2009)

LD 1811 (2010)

LD 1296 (2011)

Yes. 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 similar to HB 881 (2014)

Yes. Question 4 (2022)

Massachusetts

Question 3 (2012)

Regulations (2013)

Yes. Question 4 (2016)

Michigan

Proposal 1 (2008)

Yes. Proposal 18-1 (2018)

Minnesota

SF 2471 Chapter 311 (2014)

Yes. HF 100 (2023)

Mississippi

SB 2095 (2022)

Missouri

Amendment 2 (2018)

Yes. Amendment 3 (2022)

Montana

Initiative 148 (2004)

SB 423 (2011)

Initiative 182 (2016)

Yes. Initiative 190 (2020)

Nebraska

Measure 437 (2024)- Legalizes medical marijuana
Measure 438 (2024)- Regulates the medical marijuana industry

 No.

Nevada

Question 9 (2000)

NRS 453A

NAC 453A

Yes. Question 2 (2016) page 25

New Hampshire

HB 573 (2013)

HB 89 (2021)

New Jersey

SB 119 (2010)

Program information

Yes. Public Question 1 passed by voters in 2020 to allow legislature to enact legislation and

NJ AB 21 (2021)

New Mexico

SB 523 (2007)

Medical Cannabis Program

Yes. HB 2 (2021)

New York

A6357 (2014)

Yes. AB 1248A/SB 854 (2021)

North Dakota

Measure 5 (2016)

NDCC 19-24.1

NDAC 33-44

Northern Mariana Islands

Does not have a medical program.

Yes. HB 20-178 HD 4- Public Law 20-66 (2018)

Ohio

HB 523 (2016)

Yes. Issue 2 (2023)

Oklahoma

SQ 788 (2018)

Oregon

Oregon Medical Marijuana Act (1998)

Oregon Health Authority Public Health Division Chapter 333-008-0010

Yes. Measure 91 (2014)

Chapter 475 C

Pennsylvania

SB 3 (2016)

Puerto Rico

Public Health Department Regulation 155 (2016)

Rhode Island

Chapter 28.6 Medical Marijuana Act (2007)

Yes. Chapter 28.11 Rhode Island Cannabis Act (2022)

South Dakota

Initiated Measure 26 (2020)

US Virgin Islands

SB 135 (2017) signed by governor (2019)

Yes. The Virgin Islands Cannabis Use Act 34-0345 (2022)

Utah

Prop 2 (2018) replaced by HB 3001 (2018) Third Special Session

Utah Medical Cannabis Code

Vermont

SB 76 (2004)

SB 7 (2007)

SB 17 (2011)

H.511 (2018)

S.54 (2020) establishes sales regulations.

Governor's letter about S.54 going into effect without signature.

Additional information:

Governor's Marijuana Advisory Commission Final Report (2018)

Virginia

H 1460 (2020)

S 646 (2020)

H 1617 (2020)

S 976 (2020)

Yes. HB2312 and SB1406 (2021)

Washington

Initiative 692 (1998)

SB 5798 (2010)

SB 5073 (2011)

Initiative 502 (2012)

WAC Marijuana rules: Chapter 314-55 WAC

West Virginia

SB 386 (2017)

Read More
Table 2. Limited Access Cannabis Product Laws (low THC/high CBD- cannabidiol)
State Program Name and Statutory Language (year) Definition of Products Allowed

Georgia

HB 1 (2015)

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

Indiana

HB 1148 (2017)

At least 5% CBD by weight. No more than 0.3% THC by weight.

Iowa

HF 524 (2017)

now Section 124E

Less than 0.3% THC.

Kansas*

(Not marked on map above because the state does not regulate the production or sale of low-CBD products.)

SB 28 Clare and Lola's law (2019)

Concentrated cannabidiol with THC of no more than 5% relative of weight by third party testing.

North Carolina

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

HB 766 (2015) Removes Pilot Study designation

"Hemp extracts" with less than 0.9% THC by weight and is composed of at least 5% cannabidiol by weight and contains no other psychoactive substance.

South Carolina

SB 1035 (2014) Medical Cannabis Therapeutic Treatment Act- Julian's Law

Cannabidiol or derivative of marijuana that contains 0.9% THC and over 15% CBD, or at least 98% cannabidiol and not more than 0.9% THC by volume that has been extracted from marijuana or synthesized in a laboratory.

Tennessee

SB 2531 (2014)

Creates a four-year study of high CBD/low THC cannabis at Tenn. Tech Univ.

HB 197 (2015)

Tennessee Medical Cannabis Commission Report (2022)

"Cannabis oil" with less than .9% THC as part of a clinical research study.

Texas

SB 339 (2015)

Texas Compassionate Use Act

HB 3703 (2019)

"Low-THC Cannabis" with not more than 0.5% by weight of tetrahydrocannabinols.

Wisconsin

AB 726 Act 267 (2013)

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.

Wyoming

HB 32 (2015)

Supervised medical use of "hemp extracts" with less than 0.3% THC and at least 5% CBD by weight.

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