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Medical marijuana laws in the United States

Despite federal law prohibiting the use of cannabis, there are many states with their own medical marijuana programs. Medical marijuana programs allow qualified patients to access cannabis from state-sanctioned dispensaries once certified by a qualified medical professional.

Due to the unique attributes of each state’s medical marijuana program and the ever-changing nature of marijuana legislation, it’s important to stay up to date with medical marijuana legalization in your state.

Learn more about medical marijuana legalization by browsing through the sections below.

What is medical marijuana?

Cannabis is medicinal due to its cannabinoids, chemical compounds found naturally in the plant. Medical marijuana is medicine derived from the cannabis plant that is used to treat specific conditions and diseases.

States with medical marijuana programs have passed legislation through their government to legalize the use of cannabis for medicinal use. These states have unique rules about who can grow, sell, and use medical cannabis.

Each state runs its medical marijuana program independently. Everything from the formats of cannabis that qualified patients can consume to the number of cannabis plants patients can grow at home is governed by the state legislature.

In many states where marijuana is recreationally legal, there are still programs exclusive to medical marijuana patients that provide them with access to higher potency products, greater cultivation allowances, and the ability to purchase more cannabis at one time.

Common qualifying conditions

Qualifying conditions are the diagnosable conditions that patients may seek medical marijuana to help treat. Each state has a different list of qualifying conditions. The following conditions are among the most commonly approved for use of medical cannabis.

Epilepsy and seizure disorders

Approved in almost every state, cannabis has become widely recognized for its anti-seizure properties. The non-intoxicating cannabis compound called cannabidiol (CBD) has been found to significantly reduce seizure frequency—as much as 42%, according to a 2018 study. Many states may also approve cannabis, specifically CBD, for the treatment of pediatric epilepsy in minors.

Cancer

While research is still exploring the ways cannabis may treat cancer itself, most states now acknowledge its ability to abate symptoms relating to cancer and chemotherapy, including pain, nausea, and appetite loss. For cancer-related symptoms, many patients prefer cannabis products that contain a balance of THC or CBD.

Multiple sclerosis (MS)

Some of the strongest advocates in the cannabis movement are patients with multiple sclerosis, as they’ve experienced firsthand the benefits cannabis has to offer. Cannabis has been found to alleviate many symptoms associated with MS, including pain, insomnia, inflammation, muscle spasms, abdominal discomfort, and depression.

HIV/AIDS

Some of the earliest and most effective medical cannabis advocacy in the US was rooted in its ability to treat HIV/AIDS symptoms. It makes sense, then, that so many states have approved the condition for HIV/AIDS patients suffering symptoms like appetite loss, nausea, and fatigue.

Neurodegenerative disease

Medical cannabis has become widely approved for neurodegenerative diseases such as Lou Gehrig’s Disease (ALS), Alzheimer’s, Parkinson’s, Huntington’s, and glaucoma. For many suffering these debilitating diseases, cannabis can help restore quality of life by improving cognition and mobility, relieving spasticity and rigid muscles, and more.

Although there are several different types of pain, many are approved by states as a qualifying condition. Check to make sure your state has approved the specific type of pain you experience, and note that cannabis affects each type of pain uniquely. However, many doctors and patients have found that cannabis products combining both THC and CBD tend to be most effective.

Nausea

Nausea is a commonly approved condition for medical cannabis, although there are nuances in its definition from state to state. For example, some states approve cannabis for nausea at a broad level, while others require “severe” or “intractable” symptoms. THC in particular is known to relieve nausea and vomiting—just be mindful of your dose, especially when using edibles. Too much THC can worsen nausea.

Cachexia/wasting syndrome

Cachexia, or “wasting syndrome,” is a condition that typically accompanies cancer and HIV/AIDs, and is characterized by appetite and weight loss along with weakness and fatigue. Given that cannabis—especially THC-rich varieties—has the potential to alleviate symptoms like these, it’s no surprise that so many states include cachexia in their qualifying conditions.

Post-traumatic stress disorder (PTSD)

PTSD is an anxiety disorder that is often expressed in panic episodes and hypervigilance, in addition to mood and sleep disturbances. In the right dose, and most often with high levels of CBD, cannabis can ease PTSD-related anxiety. Cannabis before bedtime has also been known to help patients fall asleep faster, stay asleep longer, and suppress nightmares.

What are the benefits of having a medical marijuana card in a legal state?

As states across the nation begin to fully legalize adult-use cannabis, many may be wondering how this impacts medical cannabis dispensaries and card holders. What does it mean to be a medical cannabis patient in a world where anyone can walk into a recreational dispensary, present their state ID, and legally purchase cannabis?

Is the hassle of visiting a doctor for a medical card still worth it? Are there any real benefits?

The answer is yes—there are many real benefits for medical cannabis card holders. From dosage to access and affordability, patients will find plenty of support for their ongoing care on the medical side of cannabis legality.

Lower costs and taxes

A major benefit offered by many states’ medical dispensaries is lower cost for patients, which is extremely important for people who rely on cannabis for medical issues. Imagine needing life-improving medication, but not having it covered by your insurance—that is the reality of medical cannabis patients all over the country.

Now imagine your medicine was also highly taxed and thus very expensive since it also doubled as a recreational joy for many people—that would be the reality of patients if they only had access to recreational dispensaries.

Medical cannabis dispensaries allow concessions for patients that recreational shops do not. An example of this can be seen in Colorado, where medical cannabis patients avoid the 10% retail marijuana tax and 15% excise tax that recreational dispensary costumers must pay.

Medical cards allow patients to have access to their medicine for lower cost, making their healthcare more affordable and accessible.

Higher potency limits

Dosage is extremely important when it comes to medical cannabis, and many patients need access to high-strength cannabis to alleviate symptoms. However, while recreational shops may have to abide by potency limits, medical dispensaries sometimes have more leeway.

For example, in California, recreational dispensaries are limited to 1,000mg of cannabinoids per package of tinctures or lotions. Medical dispensaries however, have a much higher threshold, and are legally permitted to sell tinctures or lotions with up to 2,000mg.

These potency limits vary from state to state. Colorado, California, Oregon, and Nevada all allow higher potency for MMJ patients in varying degrees of potency.

Washington state law restricts recreational edibles to 10mg per serving. However, some dispensaries offer 25mg edibles for medical patients.

Alaska, meanwhile, does not have medical dispensaries despite having a medical program. Patients access cannabis from recreational dispensaries, and currently there are no options for higher potency products for patients.

Cannabis patients under age 21

Recreational shops are permitted to sell cannabis to anyone who is over the age of 21. While this makes sense for the general populous, children who are also cannabis patients wouldn’t have access. Some medical cards allow those who are age 20 and under to legally access the cannabis medicine they need for their healthcare when treating cancer, epilepsy, or other ailments. Drawing a distinction between medical and recreational cannabis is also important in reducing stigmatization of pediatric patients.

States with medical cannabis programs typically have laws allowing minors to access medical cannabis with the assistance of a caregiver. The form of cannabis (oils, edibles, etc.), cannabinoids permitted (THC, CBD, etc.), and potency limits vary state to state.

Grow what you need

While not every medical state allows patients to grow their own medicine, many do. And the amount that one can grow is often higher for medical patients than it is for recreational consumers. In fact, the majority of states with both recreational and medical cannabis laws allow at least some wiggle room for patients to grow additional cannabis as needed.

For example, in Oregon, recreational growers are permitted up to four plants, while medical growers are permitted six plants. This is important for patients who, unlike recreational consumers, are dependent on the plant for their wellbeing and can better offset dispensary costs with their own homegrown supply.

Marijuana legalization map

States where medical marijuana is legal

Below is a list of states and territories that have legalized marijuana for medicinal use. Click on the name of the state or territory to navigate to more information about its marijuana laws.

State Legalization status Adult use? Medical marijuana? Decriminalized statewide?
Alaska Adult use Yes Yes Yes
Arizona Adult use Yes Yes N/A
Arkansas Medical No Yes No
California Adult use Yes Yes Yes
Colorado Adult use Yes Yes Yes
Connecticut Adult use Yes Yes Yes
Delaware Medical No Yes Yes
Florida Medical No Yes No
Georgia Medical No Yes No
Guam Adult use Yes Yes N/A
Hawaii Medical No Yes Yes
Illinois Adult use Yes Yes Yes
Iowa Medical No Yes No
Louisiana Medical No Yes No
Maine Adult use Yes Yes Yes
Massachusetts Adult use Yes Yes Yes
Michigan Adult use Yes Yes N/A
Minnesota Medical No Yes Yes
Mississippi Medical No Yes Yes
Missouri Medical No Yes Yes
Montana Adult use Yes Yes N/A
Nevada Adult use Yes Yes Yes
New Hampshire Medical No Yes Yes
New Jersey Adult use Yes Yes N/A
New Mexico Adult use Yes Yes Yes
New York Adult use Yes Yes Yes
North Dakota Medical No Yes Yes
Ohio Medical No Yes Yes
Oklahoma Medical No Yes No
Oregon Adult use Yes Yes Yes
Pennsylvania Medical No Yes No
Puerto Rico Medical No Yes No
Rhode Island Medical No Yes Yes
South Dakota Medical No Yes No
US Virgin Islands Medical No Yes Yes
Utah Medical No Yes No
Vermont Adult use Yes Yes Yes
Virginia Adult use Yes Yes Yes
Washington Adult use Yes Yes N/A
Washington, DC Adult use Yes Yes Yes
West Virginia Medical No Yes No
Maryland Medical No Yes Yes

States that accept out-of-state MMJ cards

Accepting out-of-state medical marijuana cards is not a practice that every state follows. The states and territories that demonstrate out-of-state medical marijuana card reciprocity are:

  • Arizona
  • Arkansas
  • Hawaii
  • Maine
  • Michigan
  • Nevada
  • New Hampshire
  • New Mexico
  • Oklahoma
  • Puerto Rico
  • Rhode Island
  • Washington, DC

How to buy cannabis in legal medical states

Although medical cannabis laws vary from state to state, the steps to become an authorized medical marijuana patient are generally the same. For patients who wish to use cannabis to help manage their medical symptoms and conditions, what do they need to do before visiting a medical dispensary, and what should they know once they’re at a dispensary so they feel confident about choosing the right products?

Step 1: Check your medical cannabis qualifying conditions

Note: In many states, you must be a resident to receive a medical cannabis card that is valid within that state. Some dispensaries will accept valid, out-of-state cards—check the section above to find out which states have reciprocity laws.

As with any prescribed medication, you’ll need a reason for a doctor to recommend medical cannabis. Each state has a specific set of ailments that can be legally treated with cannabis. These are called “qualifying conditions,” and you can find out which ones your state has approved by navigating to its legalization page linked in the above table.

Common approved medical conditions include cancer, pain, glaucoma, HIV/AIDS, PTSD, fibromyalgia, Crohn’s disease, and multiple sclerosis—however, in most states, the list of qualifying conditions is considerably lengthier.

Step 2: Get your medical cannabis card

Once you’ve determined that you qualify for a cannabis authorization in your state, it’s time to locate a doctor permitted to prescribe cannabis. Ask your doctor if he or she is comfortable recommending medical marijuana, or if you can receive a referral to a medical professional who issues authorizations. (You can also check Leafly’s doctor locator to see if there’s a provider nearby.)

Step 3: Find a cannabis dispensary near you

Note: Remember to bring your medical cannabis card with you to every dispensary visit. Most shops will need to check it upon entry, even if they have your authorization already on file.

With your medical card in hand, you’re now ready to explore dispensaries near you. Use Leafly’s dispensary locator tool for a bird’s eye view of stores nearby—just be sure to filter for medical dispensaries if you live in a state with separate recreational and medical licensed stores.

Every patient has unique needs and deserves an experience that caters to them specifically. Shop around a bit until you’ve found a store with a staff, atmosphere, and product selection that really appeals to you. Peruse Leafly’s dispensary reviews for some crowd-sourced opinions, and consider adding your own after you’ve finished shopping.

You can also take our word for it and subscribe to Leafly’s newsletter, where we drop recommendations for shops, strains, and other products.

Step 4: Learn the cannabis basics

Once you’ve surveyed the neighborhood for local dispensaries, it’s a good idea to educate yourself on some of the different strains and products they have available. When treating a medical condition, it’s particularly important to learn about strains, delivery methods, and dosing.

Luckily, Leafly has an answer to almost every cannabis question you might have. Here are a few of the most common, along with a resource chock-full of answers.

  • Learn about cannabis consumption methods
  • Product tips and recommendations for cannabis newcomers
  • Strain recommendations for new consumers
  • What does “indica,” “sativa,” and “hybrid” mean?
  • How will THC and CBD affect me?
  • Edibles dosing guidelines

Budtenders are there to take your questions, but when shops are bustling, you may feel pressured to get through your questions quickly. Get to know the very basics and you’ll have a better chance of a positive experience and effective symptom relief.

You can also run a quick Leafly search of your condition to learn more about what strains and cannabinoids are best suited for your symptoms.

Legalization guide

For a closer look at the types of legalization, check out our dedicated guides for each.

Medical Marijuana

Medical marijuana is the medical use of the Cannabis sativa or Cannabis indica plant to relieve symptoms of or treat diseases and conditions. The Cannabis plant was used medically for centuries around the world until the early 1900s. Medical marijuana facts can be difficult to find because strong opinions exist, both pros and cons. Medical uses and emerging research on off-label uses are summarized in this article.

What are THC and CBD?

THC or tetrahydrocannabinol is the psychoactive compound in marijuana. It is responsible for the "high" people feel. There are two man-made drugs called dronabinol (Marinol) and nabilone (Cesamet) that are synthetic forms of THC. They are FDA-approved to prevent nausea and vomiting in people receiving chemotherapy.

CBD or cannabidiol is another compound in marijuana that is not psychoactive. CBD is thought to be responsible for the majority of the medical benefits.

Epidiolex is a CBD oil extract that is undergoing clinical trials for epilepsy.

THC:CBD: Nabiximols (Sativex) is a specific plant extract with an equal ratio of THC: CBD. It is approved as a drug in the UK and elsewhere in Europe for the treatment of multiple sclerosis, spasticity, neuropathic pain, overactive bladder, and other indications.

Medical marijuana products are available with a huge range of THC and CBD concentrations. The expert opinion states that 10mg of THC should be considered "one serving" and a person new to medical marijuana should inhale or consume no more until they know their response.

SLIDESHOW

What are the uses for medical marijuana?

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Medical uses of marijuana include both studied and approved uses and off-label uses. In a recent research survey, the most common reasons people use medical marijuana are for

    , ,
  • depression,
  • muscle spasticity, and such as Crohn’s disease.

More research has been conducted on the compound CBD. Medical CBD is anti-inflammatory, anticonvulsant, antioxidant, neuroprotective, and anxiolytic, antipsychotic, and anti-emetic. The CBD compound in medical marijuana appears to be neuroprotective in Huntington’s, Parkinson’s, and Alzheimer’s disease, fetal hypoxia, and other neurodegenerative conditions and movement disorders.

What are the health benefits of medical marijuana?

There are over 60 peer-reviewed research studies examining the benefits of medical marijuana. Sixty-eight percent of these studies found benefit while 8% found no benefit. Twenty-three percent of the studies were inconclusive or neutral. Most research has been conducted on the compound CBD. The benefits of medical marijuana can be attributed to binding to the endocannabinoid system. This has many effects including

  • modulating the immune system,
  • promoting neuroplasticity,
  • emotional and cognitive modulation including learning and motivation, appetite, vascular function, and digestive function.

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Are there any side effects of medical marijuana?

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Medical marijuana side effects are minimal when used at low doses and include

At higher doses, side effects include

    , , and
  • psychoactive effects including mood changes and hallucinations.

There are concerns about the adverse effects of cannabis among adolescents because the risks are greater to the immature brain and neurological system. Concerns include increased risk of schizophrenia and loss of IQ.

There are public health concerns about the safety of driving under the influence of medical marijuana. A JAMA study found lower rates of opioid overdose deaths in states with legal medical marijuana.

Is medical marijuana legal?

At the time this article was written, 23 states have legalized medical marijuana with varying restrictions. However, it is classified as a Schedule I substance by the Federal Drug Administration (FDA) and thus is illegal at the Federal level. In most states with legal medicinal marijuana, a prescription, authorization, or medical recommendation is required, and a card or license is issued. This allows a person to buy medical marijuana.

How do you get medical marijuana?

In states where medical marijuana is legal, shops, often called dispensaries, sell marijuana products in a variety of forms. Medical marijuana is available in

  • edible forms (candies or cookies),
  • oils, and extracts, and
  • as the plant which can be smoked or otherwise inhaled.

Dispensaries require a medical marijuana card before they will sell products. How people can get a medical marijuana card varies by state. It requires a prescription from a licensed healthcare professional.

Is medical marijuana “addictive?”

Most research suggests a very low risk of addiction and very low toxicity of medical marijuana when taken as recommended in low therapeutic doses. There is concern about psychological dependence in heavy users and whether this constitutes marijuana abuse. Some research has suggested CBD oil might be useful in the treatment of marijuana addiction or marijuana abuse.

What research is being done for medical marijuana?

There are numerous studies underway on medical marijuana, but research is challenged by limited access given the FDA classification. A search of the National Institutes of Health-funded projects list in 2016 revealed 165 studies related to cannabis and 327 studies related to the search term marijuana. The majority of these studies are surveyed into use patterns. Many are also basic science studies investigating how the endocannabinoid system in the brain and immune system works. Survey studies that anonymously assess users' habits and reported benefits may provide insight into the effects of real-world use patterns. There are over 60 peer-reviewed research studies that have been published about medicinal cannabis. Sixty-eight percent of these studies found benefit while 8% found no benefit. Twenty-three percent of the studies were inconclusive or neutral. The most promising areas of research appear to be in the use of CBD for neuroprotection.

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Teesson, M. et al. “The relationships between substance use and mental health problems: evidence from longitudinal studies.” In: Stockwell, T. et al. “Preventing harmful substance use: the evidence base for policy and practice.” Chichester, UK: John Wiley; 2005. p. 43-51.

Fernández-Ruiz, J. et al. “Cannabidiol for neurodegenerative disorders: important new clinical applications for this phytocannabinoid.” Br J Clin Pharmacol. 2013 Feb;75(2):323-33.

Sexton, M., et al. “A Cross-Sectional Survey of Medical Cannabis Users: Patterns of Use and Perceived Efficacy.” (Under Review 2016: Cannabis and Cannabinoid Research).

Murnion, B. “Medical Cannabis.” Aust Prescr. 2015 Dec; 38(6): 212–215.
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4674028/>

Bachhuber, MA., et al. “Medical cannabis laws and opioid analgesic overdose mortality in the United States.” 1999-2010. JAMA Intern Med. 2014 Oct;174(10):1668-73. Erratum in: JAMA Intern Med. 2014 Nov;174(11):1875.

Allsop, DJ., et al. “Nabiximols as an agonist replacement therapy during cannabis withdrawal: a randomized clinical trial.” JAMA Psychiatry 2014;71:281-91.

Brunt, TM., et al. “Therapeutic satisfaction and subjective effects of different strains of pharmaceutical-grade cannabis.” J Clin Psychopharmacol. 2014 Jun;34(3):344-9.

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Nausea and Vomiting

Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. There are numerous cases of nausea and vomiting. Some causes may not require medical treatment, for example, motion sickness, and other causes may require medical treatment by a doctor, for example, heart attack, lung infections, bronchitis, and pneumonia.

Some causes of nausea and vomiting may be life-threatening, for example, heart attack, abdominal obstruction, and cancers.