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Understanding Your State’s Medical Cannabis Program

by Johnny Green

Medical cannabis policy in the U.S. has undergone quite a bit of transformation over the years.

California was the first state to legalize cannabis for medical use via the successful passage of Proposition 215 in 1996.

Other states in the Western part of the United States followed in subsequent election and legislative years.

Eventually medical cannabis reform would spread nationwide.

Medical cannabis reform has been associated with very inspiring things in states that allow it, including but not limited to a reduction in Medicaid prescriptions and lower traffic fatality rates.

You may have read about how some states have better medical cannabis laws than others, but how different are state medical cannabis really?

If you’re new to the world of medical cannabis policy, this quick guide will give you some important touch points.

What is the difference between a comprehensive medical cannabis program and a CBD-specific program?

For many years when people referred to medical cannabis states, they were referring to states that allowed all forms of cannabis.

Utah became the first state to legalize cannabis for medical use in CBD-only form in 2014. That led to a number of other states legalizing cannabis in CBD-specific form.

CBD is cannabidiol, one of dozens of cannabinoids in the cannabis plant.

CBD-only products are NOT as effective as whole-plant based medicines due to a biological concept known as ‘the entourage effect.’

Essentially, the entourage effect shows us that cannabinoids along with other components of the plant work much better together as opposed to isolating them.

Because a limited number of patients benefit from CBD-only products, the cannabis measures that legalized them are strict.

This is especially true because those states usually couple CBD-only provisions with a lack of dispensaries and no home cultivation rules.

CBD-specific versus more comprehensive medical cannabis programs are at the heart of answering the question, ‘how many medical cannabis states are there?’

To date 29 states have comprehensive medical cannabis laws, with 17 more having passed CBD-specific medical cannabis laws.

Only Idaho, Kansas, Nebraska, and South Dakota have complete cannabis prohibition in place.

What conditions can people qualify for to become a medical cannabis patient?

In order for someone to become a medical cannabis patient, the first step is determining what conditions qualify for the state’s medical cannabis program (assuming it’s not Idaho, Kansas, Nebraska, and South Dakota).

All states list the qualifying conditions on the regulating agency’s website.

An example would be in Illinois, where the medical cannabis program is administered by the Illinois Department of Public Health.

In states that only have medical cannabis, the programs are often ran by a state health agency.

But in states that have legalized cannabis for adult use, there is a push to have one regulatory agency to oversee both medical and adult-use, which is usually the agency that regulates alcohol.

You can look at the original initiative/legislation that created a state’s medical cannabis program for qualifying conditions, but the original list has likely expanded to include additional conditions.

A clear trend exists in state medical cannabis programs – the newer the medical cannabis program, the fewer qualifying conditions.

Although some states don’t have any list of qualifying conditions. Instead, they let physicians determine whether or not a patient requires cannabis.

Why should someone become a medical cannabis patient?

Deciding to become a medical cannabis patient is not a small decision.

It can be a life changing decision from a good standpoint, and potentially a negative standpoint.

Becoming a medical cannabis patient involves a lot of things, often being a part of a government database which can make some people uneasy.

However, there are a lot of benefits to being a patient:

  • Legal protections for consumption and/or possession and/or cultivation
  • Increased possession limits in states that allow adult-use possession
  • Increased cultivation limits in states that allow adult-use cultivation
  • Access to medical cannabis dispensaries, including in other states that have reciprocal agreements
  • Access to events that are only for medical cannabis patients and caregivers

Whether or not those benefits are enough to overcome any concerns that a patient may have is a personal decision that every individual needs to make on their own.

What should people expect during a medical cannabis evaluation?

Below are the steps towards becoming a medical cannabis patient:

  • Step 1 – Visit your primary physician to establish your condition
  • Step 2 – Send your primary physician records to a medical cannabis clinic
  • Step 3 – Attend an evaluation and get your required state paperwork signed by the evaluating medical professional
  • Step 4 – Submit your completed paperwork and fee to the state agency that issues medical cannabis approvals

Different states allow different people to sign medical cannabis paperwork. All medical cannabis states allow medical doctors to sign the forms, but some states allow other medical professionals to sign forms too.

Also, online medical cannabis evaluations are becoming more common, which are much more convenient and often more affordable.

Another thing to keep in mind, some doctors will not require that you see a primary physician first and others will require it.

It depends on the doctor and the state.

Communicate with the clinic/entity ahead of time to determine which it is.

For the evaluation itself, keep in mind that the evaluating medical professional is there to help you, and not to judge you or look upon you with suspicion.

Remind yourself that you are one of likely dozens of patients to go through the process that day, and that medical cannabis professionals are passionate about helping people.

Going through a medical cannabis evaluation can be an intimidating thing; going to the doctor in general can be intimidating and adding to it the decades of stigma that have surrounded cannabis, and it can be a rattling thing for many people.

Be honest with the evaluating medical professional, and anticipate being asked how cannabis helps treat your condition(s).

If you are truthful and thorough, you will do just fine!

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