cannabis with American flag
Medical cannabis programs are never final, but rather a step in the right direction. Let's keep pushing!

California was the first state in America to legalize medical cannabis in 1996. Since that time many other states have followed California's lead.

More work needs to be done, but the spread of medical cannabis reform across America the last two decades has been truly inspiring

According to a recent poll conducted by CBS News, 88% of Americans support the legalization of medical cannabis. With people suffering all over the country, that level of support is tremendously encouraging.

Obviously not all states have a legal medical cannabis program. How many do?

What makes a state a 'medical cannabis' state?

Newer medical cannabis programs tend to be stricter than others.

If you follow mainstream media cannabis coverage, you have likely noticed that the number of medical cannabis states in America referenced varies.

That's because the definition of a 'medical cannabis state' is subjective, and constantly evolving. Below are some of the factors at play:

  • Can patients cultivate their own medicine?
  • Are all forms of cannabis allowed, or just CBD?
  • What conditions can patients qualify for?
  • Does the state allow dispensaries?
  • Are all forms of consumption allowed, or is smoking banned?

If you look at the first state to legalize medical cannabis (California) and compare it to West Virginia's model, you will see that they are very, very different.

As medical cannabis reform has spread, it has become undeniably more restrictive, especially in states that have legalized via legislative action.

A general rule of thumb is that the newer the medical cannabis state, the stricter the program. The stricter the state program, the less likely it will be considered a 'medical cannabis state' by cannabis advocates and pundits.

How do CBD-specific states factor in?

Even CBD-only states still have a lot of work to do as citizens continue to lobby for more expansive programs.

Where a lot of the debate surrounding medical cannabis state designations occurs is when it's regarding 'CBD-specific' states.

These are states have the following characteristics:

  • Only all-CBD or extremely low-THC forms of medical cannabis are allowed
  • Patients can only qualify for the program via a limited number of conditions 
  • Patients are not allowed to cultivate their own medicine
  • Medical cannabis dispensaries are either very limited or not allowed

The argument against states like these is that if there are no legal safe access points to acquire medical cannabis from, and protections only apply after the cannabis is obtained, then that state does not have a 'real' medical cannabis program.

For many cannabis activists, only states that allow high-THC forms of cannabis are considered to be 'true medical cannabis states.'

That standard is how organizations like the Marijuana Policy Project arrive at the tally of West Virginia being considered as the 29th medical cannabis state.

If CBD-specific states where added to that count, there would be 46 medical cannabis states in America. Only Idaho, South Dakota, Nebraska, and Kansas still completely prohibit cannabis in all forms.

States are in various stages of implementation

When a state passes a medical cannabis legalization measure, whether it be by citizen initiative or legislative action, that is just the first phase of the public policy change process.

The next phase is the rule-making process, followed by the implementation phase, which then and only then results in the program being administered and maintained.

Old states like California, Oregon, and Washington have had medical cannabis programs operating and functional for quite some time. because they had a number of years to get things off the ground.

But newer states are somewhere else on the timeline, with some states struggling to get things going.

Rule creation and the implementation of a brand new government program involves politics and bureaucracy, which are obviously two of the most notoriously slow things on earth.

Why medical cannabis programs are still needed in adult-use states

Eight states have legalized cannabis for adult use. They are Colorado, Washington, Oregon, Alaska, Maine, Massachusetts, Nevada, and California. All of those states have medical cannabis programs. 

Some lawmakers and members of the public may ask why a medical cannabis program is still needed if cannabis is legal for adult use in a particular state?

Medical cannabis programs are still needed in adult-use states because patients need extra protection via extra possession and cultivation limits.

Also, products designed for patients can be much different than products designed for adult use, both from a demand and regulatory standpoint. Medical cannabis programs allow that industry product distinction framework to exist.

Medical patients have a medical need for products that are designed to treat certain conditions and provide very specific wellness benefits. That's why industry regulations in legal states allow higher potency levels for medical cannabis products.

Another reason why medical cannabis programs are still needed in an adult-use era is that there needs to be a way to distinguish patients from other customers for the purpose of taxation.

Patients should not be forced to pay taxes on their medicine, cannabis-derived or otherwise. Legal states like Oregon exempt medical cannabis purchases from being taxed, which would be nearly impossible to do if Oregon didn't have a medical cannabis registration program.

How to change your local laws

We have to keep educating each other that this plant is good -- not bad.

I have always felt that any movement on cannabis reform is worthwhile, as long as it's seen as a step in the right direction and not seen as a permanent public policy change.

Cannabis policy, as with virtually all areas of politics, is an incremental process. The main thing is to keep pushing for reform until every person that is suffering has safe access to all forms of cannabis that helps them.

Always hold your politicians accountable, even after (and especially after) reform victories. This should be especially true in CBD-specific states.

State health agencies typically oversee and administer medical cannabis programs. Find out which state agencies are in charge of your state's program and become familiar with them.

Learn their administrative rules on the books currently, and also learn about the public hearing process for how they are changed.

Keep fighting to move the needle where you live to help ensure that your state has a comprehensive, implemented medical cannabis program that is helping patients in a meaningful way.

To find out your state's status, check out NORML's website which has an amazing database and action tools that will help you as a cannabis advocate.

Want to learn more about how medical cannabis is helping people live healthier lives? Check out our latest online class "How to Use Cannabis as Substitute for Rx Drugs and Alcohol" with Amanda Reiman from Drug Policy Alliance – only on Green Flower!

Click here for details.

Do you live in a state that has legalized medical cannabis?

Do you live in a state that has legalized medical cannabis?