Medical Marijuana Laws in the United States
Federal Medical Marijuana History and Laws:
The rationale behind the legal sanctions on cannabis in the United States was a result of the heightened pressure the government was facing during the Great Depression and the Mexican Revolution of 1910. During that time, many Hispanic immigrants migrated to the US during its economic collapse, and they brought with them the recreational use of marijuana. This influx of immigration made the public fear that immigrants were taking jobs from American citizens. This negative view of immigrants influenced the way the US viewed marijuana, which was regarded to be an attack on US values. Regardless of the real motives spurring the American government at that time, in 1937, the Marijuana Tax Act passed. This statute restricted the possession, and use of marijuana to individuals or companies that paid an excise tax for the medical or industrial use of the plant, cannabis that was not used for this purpose became criminalized in the United States.
For the decades following the Marijuana Tax Act, the US would continue to switch sides on the issue of cannabis. During the 1940s and 1960s, various reports surfaced that marijuana did not contribute to the rise of violence or crimes that were reported in the ’30s leading up to the Tax Act. Furthermore, during WWII, the United States implemented the “Hemp for Victory” program that would incentivize farms across the country to grow hemp for the military, who used hemp for parachutes and Marine uniforms. Leading up to 1986 federal laws dealing with minimum and maximum sentencing were being passed and then overturned every other year; however, President Reagan’s Anti-Drug Abuse Act and Controlled Substances Act of 1970 still stands in effect today. The Anti-Drug Abuse established regulations against marijuana that were in line with “hard drugs” like heroin and put a “3-strike” system into place, where life sentences would be left against repeat drug offenders. The Controlled Substances Act took the recent legislation a step further by placing cannabis as a Schedule I drug, where it would be heavily restricted and unavailable to the public and even the medical community.
While these laws are still in place on the federal level, many states have taken action to challenge the aforementioned federal mandates. California was the first to overturn Nixon Era legislation by passing the Proposition 215 referendum, which would legally allow medical marijuana programs to exist within the state’s borders. As of 2019, 33 other states and several US territories followed California’s initiative in legalizing medical marijuana. Additionally, there are at least 12 states that have active CBD and or THC medical programs in the place of medical marijuana initiatives. Discussed below are the examples of various state laws, programs, and the qualifying conditions that encompass medical marijuana programs in the US.
State Medical Marijuana Laws:
Reviewing all of the states that currently have medical marijuana programs in effect, these are the underlying commonalities that they share when it comes to enforcing their respective programs:
All of the states who have medical marijuana programs establish a single, unified system to regulate and filter patients who want to register for a Medical Marijuana Card (MMC) in their respective state. States vary the departments in which their medical marijuana programs are run; some assert that the department of health is most suited to enforce MMC rules, while other states contend that the department of narcotics has proper authority. Additionally, all of the states with medical marijuana programs mandate that qualifying patients register themselves in their respective MMC registry, as a means of monitoring the production, distribution, and quality of medical grade marijuana, regardless of the state has legalized recreational marijuana or not. Joining a state’s MMC registry also allows patients to be excused from their state’s Schedule I drug policies regarding marijuana, which could result in hefty fines and or jail time.
The only state that differs from the trend of mandatory MMC registry in California, which does not require qualifying patients to purchase an MMC because recreational marijuana is legal in the state. California does, however, offer benefits for qualifying patients who apply for an MMC. Such as: not having to pay a state sales tax on medical cannabis, having a reduced local and/or excise marijuana tax, having exclusive access to different strains of cannabis that have higher CBD and THC levels, along with having the legal capacity to possess a higher quantity of medical cannabis and the option to cultivate their own medical marijuana.
Concerning self-cultivation, every state varies on a patients’ ability to cultivate medical marijuana. Some states, like Alaska, Hawaii, Michigan, Missouri, Montana, New Jersey, Oklahoma, Oregon, Rhode Island, and Vermont allow all of their patients to grow personal medical marijuana. However, some states like Arizona will only let MMC cardholders grow their cannabis if they face an undue burden when it comes to obtaining their prescription. In Arizona, if a patient is 25 miles or more away from a dispensary, it is unfair for them to have to pay the extra expenses to travel to pick up their prescription, and therefore they are allowed to grow their medical marijuana. With home cultivation accounted for, several other states do not allow patients to develop medical marijuana at home, such as Washington, D.C., Illinois, New York, Ohio, and Pennsylvania. In these state, patients only have the option to buy their medical cannabis from a licensed dispensary, also known as a compassion center, which is more often than not regulated by the state. While some states will go as far as to cap the number of cannabis growers and providers and will interview the cultivators and dispensary owners for their medical marijuana programs, other states like California do not. California allows any business to apply to cultivate, distribute, and or dispense medical marijuana so long as they apply and are approved for the proper medical cannabis certifications.
While states vary on allowing their residents to cultivate marijuana at home, majority of said states with medical marijuana programs cannot mandate that a landlord or employer enable a patient to grow or even consume medical cannabis on, in or near their establishment. The reason for this is that it would host a potential threat to the managements federal benefit and regulations, in addition to potentially violating Schedule I drug laws. However, some states like Arizona have particular rules in place that prevent MMC cardholders from being discriminated against when applying for jobs or housing arrangements. Arizona also protects patients from being unjustly prosecuted for failing a drug test, so long as their judgment was not impaired on the job.
Regardless if medical marijuana is homegrown or bought from a dispensary, all 34 states with medical cannabis programs have different regulations on how much marijuana a single patient can have within a select time frame. For instance, in Arizona and Maine, the maximum quantity of medical marijuana a patient can have is 2.5 ounces in 14 days, while in Massachusetts, a patient can have 10 ounces for 60 days. Additionally, states will not only regulate how much medical cannabis a patient can have, and they monitor the forms of medical marijuana available. Majority of medical marijuana states made smoking cannabis illegal and only allow editable options (such as chewable tablets and lozenges), other states will allow it in a vapor form along with topical options. Majority of states also require that any form of medical marijuana, especially smoking or vaping, be conducted on private property. There are no provisions that protect an MMC holder from facing penalties or jail time for smoking in a public space, federal land, or within the vicinity of a hospital, school, or place of worship.
In addition to limiting the areas where medical marijuana can be used, majority of states that have medical marijuana programs do not allow patients from other states to use their prescriptions or purchase more medical marijuana outside of their home state. The few states that allow for outside MMC cardholders to use or buy cannabis are Arizona, D.C., Florida, Hawaii, Maine, Maryland, Michigan, Nevada, and New Hampshire. These states also constitute the few areas that legally allow patients or their caregivers to transport their medical marijuana across state lines. The law regarding medical marijuana transportation is vague because federal laws do not allow for the transportation of cannabis via federally regulated spaces.
Furthermore, while there are clauses that help to protect patients from discrimination, all 34 states with medical marijuana programs treat operating heavy machinery or vehicles while under the influence of medical marijuana as liable for a DUI charge. Moreover, the majority of medical marijuana states do not allow for previously convicted criminals to qualify for an MMC, even if they have a qualifying condition. The only state that strays slightly from this trend is Arizona, where a convicted criminal must wait five years following their offense before they are eligible to apply for a medical marijuana program in the state.
Process to Apply for Medical Marijuana:
Concerning the age of eligible patients, the majority of states with functioning medical marijuana programs regulate that patients 18 years or older can independently apply for an MMC. The only states that have raised the age are North Dakota, where the age to apply individually is 19, and California and Alaska, where patients must be 21 years old to qualify for an MMC. However, while those are the minimum ages to apply for access to a medical marijuana program independently, anyone who qualifies as a minor may apply so long as they have a legal caregiver who can distribute the patient their medication. Most states define a caregiver as a legal parent or guardian who is over either 18 or 21 and has no past criminal offenses over a specified period. Some states allow a minor patient to have up to two caregivers, and regardless if they have one or two, they would also be exempt from any criminal penalties associated with the possession of marijuana.
After meeting the age requirement or applying for a caregiver, the patient must have a licensed physician from their state of residency, screen them for a “qualifying condition.” Some states require that both a physician and pediatrician must screen minor patients, and others require that patients with mental illnesses or who are appealing their condition have a therapist or second physician verify their illness. Depending on the state, the patient may have to make annual appointments to verify their condition to qualify for an MMC renewal. This step not only depends on the state’s guidelines for renewal but also on how long the MMC’s are valid. In reviewing all 34 states, most have their MMC’s valid for one year, and others will allow patients to pay more to have it valid for up to 3 years.
In addition to meeting the requirements of a patient or a caregiver, all states require applicants to show at least one document that can prove their residency as a part of the application process. Most states require a valid driver’s license but will allow for other forms of proof, such as mortgages, utility bills, state tax returns, voter registration card, or any other valid government ID. Should all of these requirements have been met, the last element is that the patient has a “qualifying condition” that can be treated by medical marijuana.
Qualifying Conditions for Medical Marijuana:
As previously mentioned, to participate in any state’s medical marijuana program a patient must have a “qualifying condition,” meaning that the illness they are attempting to have treated meets the state’s criteria for participating in a medical marijuana program. 2 out of the 34 states that participate in medical marijuana programs allow any condition that a physician deems reasonable, or that outweighs the potential health risks of using medical marijuana, to qualify for a Medical Marijuana Card (MMC). The remaining 32 states have excellent medical conditions outlined in their respective legislation that can be eligible for an MMC. Moreover, there are a few states that allow for a petition of appeals for potential patients without “qualifying conditions” to apply in their own right for an MMC.
Listed below is a general list of some conditions outlined in various state legislatures: Cancer, HIV, AIDS, radiation therapy, glaucoma, anxiety, chronic pain, migraine headaches, multiple sclerosis, chronic fatigue, depression, cachexia, severe nausea, epilepsy, seizures, persistent muscle spasms, hepatitis C., Crohn’s, Alzheimer’s, PTSD, ALS, Tourette’s, Lou Gehrig’s, ulcerative colitis, severe arthritis, fibromyalgia, chemotherapy side effects, peripheral neuropathy, autism spectrum disorder, Parkinson’s, nerve damage, sickle cell anemia, post laminectomy, cerebral palsy, cystic fibrosis, irreversible spinal cord damage, hydrocephalus, muscular dystrophy, terminal illnesses, osteogenesis, post-herpetic neuralgia, Arnold-Chiara malformation, CRPS, dystonia, Lupus, residual limb pain, traumatic brain injury, or any number of other persistent or chronic medical symptoms that causes serious harm to a person’s mental or physical health