Medical marijuana in the United States is in a precarious position. The number of certified medical cannabis patients in adult-use states has drastically declined. Many other states, meanwhile, particularly in the South and Midwest, are still trying to hash out the particulars of their programs despite ongoing opposition. There are even old, reliable medical and adult-use states like Colorado with some prohibitionist lawmakers seeking to worsen their programs for patients and providers.
Federal prohibition always throws an interesting wrench into the status of medical marijuana programs across the nation. Cannabis is federally illegal; however, states’ rights in every single state and territory still somehow miraculously supersede this status. Borders between states can be slight; however, when it comes to access to medical marijuana, the divide is often very big.
The current Republican presidential administration is going about the business of governing however it sees fit, whether that be reporting fake statistics or ignoring the sovereignty of states’ rights on many different positions.
The destructive, often anti-democratic tendencies at the federal level have now permeated down to the states. State legislators—mostly Republican—are now emboldened to carry out their personal, religious, or social agendas at the state level. These actions are embodied by some select state governors refusing to entertain any possibility of the establishment of medical marijuana or expansion, while many Republican state legislators are currently running amok to rescind and worsen many of their states’ current medical marijuana and adult-use programs.
The irony is that peer-reviewed scientific findings continue to regularly tout the potential benefits of medical cannabis. One such report analyzed over 10,000 scientific papers and concluded that “across all categories examined—health metrics, cancer treatments, and cancer dynamics—there is a consistent consensus that supports the potential of medical cannabis.” The findings also pushed for the efficacy of cannabis in treating cancer as a “scientifically validated treatment option”.
Maybe these draconian lawmakers would rather their entire electorate be hooked on harmfully addictive opioids instead of non-addictive cannabis? That’s an interesting thought, because the New York State Office of Cannabis Management survey from last year polled thousands of healthcare providers and 123,000 medical patients. The findings were remarkable:
Despite some lawmakers at the state level using the current political environment to do their dirty work—restricting access to medical and adult-use marijuana to their constituents—most states with medical marijuana and their patients continue to hold the line. Support for both adult-use and medical marijuana is still at 54% across the country, according to a 2025 Pew Research poll.
It’s time to check back in with how U.S. states are doing with their medical marijuana programs, or lack thereof. While some states wait, others continue to modify their programs for better or worse—are you in the former or the latter? Take a look and see!
Alabama has experienced a barrage of setbacks since legalizing non-smokable forms of cannabis in 2021. The AMCC awarded licenses several years ago, but licensing disputes and lawsuits continue to this day.
Licensing disputes and lawsuits continue to this day, now several years after the AMCC awarded them. According to the AMCC, investigative hearings are set to review the license applicants sometime this summer. The medical marijuana program in Alabama could begin as early as fall 2025, barring any further setbacks.
Medical cannabis is used by a small number of patients in Alaska. According to NORML, as of February 2025, there are only 113 registered medical marijuana patients in the state. The already small population of this remote state, along with an adult-use cannabis program, contributes to this small number of patients.
The Grand Canyon State is another adult-use state; however, its medical marijuana program is still going strong with a large number of active medical marijuana cardholders within its borders. The Arizona Department of Health Services reported 87,712 qualified patients in the state as of January 2025. The ADHS also reports 136 medical marijuana dispensaries in Arizona as of February 2025.
Arkansas’s medical marijuana community hoped to expand the program with the Arkansas Medical Marijuana Amendment of 2024; however, it seems as though conservative politics have thwarted any effort to move it forward.
The amendment to Arkansas’s current medical marijuana law, dating back to 2016, would’ve increased the number of recommending medical professionals available. It would also allow those professionals to recommend medical marijuana for any patients they believed could benefit from it, no matter the condition. The Arkansas Supreme Court vetoed the amendment’s placement on the ballot, citing ‘deceptive and misleading’ language.
Arkansas’s Governor Sarah Huckabee Sanders is reportedly not on board with expanding the state’s medical marijuana program. Huckabee-Sanders, however, has no problem lowering the legal age of child labor in the state, leaving open the potential for exploitation.
A 2024 bill protects workers in California from being refused hire or fired due to cannabis use. Positive hair and urine tests for medical marijuana patients and adults over 21 are barred from being a determining factor in maintaining employment and being hired, with a few occupational exceptions. NORML had a big part in this bill, citing numerous sources that cannabis use is not correlated with high rates of accidents on the job.
Medical patients and adults 21 and over in California are now also able to enjoy Amsterdam-style cannabis cafes to socialize and enjoy a beverage or some food while consuming cannabis.
HB25-1296 allows Colorado medical marijuana registry applicants to use a state or federal tax return copy in order to receive an application fee waiver. Officials are now processing this change through rulemaking before officially transcribing it into state law.
A controversial bill looking to roll back quantity, potency, and accessibility standards for recreational consumers and medical patients was defeated in committee several months ago. The sponsors of the bill cited the public health of the children in Colorado as the primary reason for the roll-backs, while also being backed by the anti-cannabis lobby Smart Approaches to Marijuana.
Medical marijuana patients in Connecticut are flocking to adult-use in droves since full legalization began, a sharp 32% decrease since 2023. Patients in other states are also now allowed to use their medical cards in Connecticut, to entice them to shop and spend in the state.
Delaware state law protects banks, accounting firms, and transportation services from charges when they work with approved, regulated cannabis companies within Delaware, including the medical and new adult-use programs. August 1, 2025, marked the debut of the state’s adult-use market, whereby most of the medical dispensaries will convert to adult-use.
Governor Ron DeSantis of Florida continues to showcase his ignorance of the potential for cannabis in his state by supporting SB-2514, a new law that strips medical marijuana patients of their cards should they plead or be found guilty of other offenses.
The equally ignorant Florida state legislature passed the law in July of 2025, and is on record as viewing medical marijuana as “a privilege” that they have the exclusive right to revoke from patients. These lawmakers have made such hypocritical declarations while also taking contributions from pharmaceutical companies at the helm of such opposition to access to medical marijuana.
SB220 and HB227 made solid progress through the Georgia legislature this past year, but unfortunately, did not make the final grade to be passed yet. A study committee, meanwhile, has taken up the cause to discuss the potential expansion of Georgia’s very restrictive low-THC-only medical program. The hope is that input from medical professionals, patients, and supportive lawmakers will spur action to expand the program.
HB-302 was signed into law by Hawaii Governor Josh Green in June of 2025. This new law creates a boost to patient enrollment, allowing for more qualified conditions to be recommended by healthcare professionals. It also calls for the allowance of more dispensaries to be opened, including across the many rural areas of Hawaii’s several different land masses.
Primary caregivers in Hawaii are also now protected, courtesy of an executive order signed by Governor Green in January of 2025. The order protects patient access to caregivers and allows caregivers to continue to operate in good faith under the current statutes without any fear of reprisal or penalties.
Idaho has taken another giant step backward in regards to cannabis, as the only state in the country that now imposes mandatory minimum penalties for all first-time, low-level cannabis possession. A minimum fine of $300 also comes with the risk of up to one year in jail for even just minor possession of weed.
In another doozy, Idaho lawmakers are seeking to completely remove the will of the voters to pass ballot initiatives that relate to legalization, decriminalization, or any other cannabis legislation. The proposal will be up to the state’s voters to approve in the next election.
Four new medical marijuana qualifying conditions were approved by the Illinois Department of Public Health in early 2025. These conditions include
An amendment has also been introduced to classify medical cannabis as medicine and, therefore, exempt from state taxes, similar to how prescription drugs are deemed in Illinois. It also eliminates double taxation that’s found on some medical cannabis products under both the Cannabis Regulation and Tax Act and the Compassionate Use of Medical Cannabis Program Act.
Despite bipartisan support for some form of decriminalization in Indiana, at the very least, several bills did not pass the state legislature for approval this past year. The only laws passed by Indiana officials regarding cannabis recently banned any advertising of cannabis anywhere in the state and established a THC limit to determine intoxication while driving.
Iowans are still currently stuck with their restrictive, non-flower dispensing medical marijuana program. Hope, however, persists in the form of HF-105, currently under committee review in the Iowa state legislature. If passed, the bill allows for cannabis buds to be cultivated and sold to medical patients. The program only allows for capsules, vapeable oil, and tinctures in each of its five statewide medical dispensaries.
Several bills related to cannabis possession, legalization, and veterans were rejected in 2025 by a primarily Republican state legislature. Kansas is one of just a small handful of states in the
U.S., without a medical or adult-use program.
A regulatory audit is still investigating the Kentucky medical marijuana program’s lottery system that allocated licenses for cannabis businesses earlier in 2025. Despite the wait, sales will hopefully launch at some point in 2025 once the audit is resolved. Over 8,000 patients have already been issued their cards. Governor Andy Beshear is steadfast in his desire to “reduce Kentuckians’ reliance on addictive opioids and provide them with relief from severe and chronic pain”.
The state of Louisiana enacted a series of new laws aimed at its medical marijuana program. Reciprocity is now allowed for out-of-state patients in Louisiana who meet the right qualifying criteria. Protection from prosecution is provided by HB-137 for medical marijuana patients as well as visiting patients in regards to cannabis violations. Medical and health professionals of varying degrees can also now recommend medical marijuana to qualifying patients.
Law enforcement can no longer use the odor of cannabis as probable cause to search a residence without a warrant, thanks to HB-629. Other laws passed include those to improve production and testing systems, and a new fee establishment for producers of medical marijuana. Another law prohibits and penalizes drivers and passengers who smoke or vape weed while operating an automobile.
A state representative from Maine introduced legislation that would ensure testing for potency and contaminants in medical marijuana meets the same standards as the current Maine adult-use program. Maine is the only state with a medical marijuana program that doesn’t test for contaminants such as residual pesticides, fungal contaminants, and toxic metals.
Maine’s Office of Cannabis Policy found that 42% of randomly tested medical marijuana strains and products contained contaminants..
State senators from Maryland passed a bill in March of 2025 that protects firefighters, emergency, and rescue workers in Maryland from termination, suspension, or any disciplinary penalties for using cannabis while off-duty. The bill applies to any of those types of workers in Maryland who are card-carrying medical marijuana patients. State senate committees are currently reviewing the bill before it hopefully reaches the desk of Governor Wes Moore (D).
The Massachusetts Cannabis Control Commission has taken some serious heat over the years for its vertical integration requirement for medical marijuana operators that doesn’t apply to adult-use operators. Medical marijuana operators in the state must meet the requirements of having a dispensary, cultivation center, and manufacturing center, along with about $40,000 more in licensing fees upfront compared to adult-use.
This large disparity has caused many medical marijuana operators to bail on owning and operating a strictly medical facility, which has also deeply affected patient access to medical-only products and dispensaries. State representatives hoping to modify the rule recently introduced legislation in the state’s House of Representatives.
Michigan is the country’s second-largest cannabis market, with $3.29 billion in adult-use and medical marijuana sales, with medical weed only accounting for about $18 million of that enormous figure. Average prices for recreational cannabis often dip below the price of medical cannabis, causing Michiganders to opt for adult-use weed instead. Legislators in the state have discussed combining both markets; however, there is no current legislation to do so.
In the wake of Minnesota’s fresh adult-use cannabis market, legislators in Minnesota are in the process of ironing out a bill that would improve patient access to medical marijuana. According to the bill, caregivers and patients would be allowed to grow up to 8 plants apiece, along with improvements for native operators and patients, as well as reciprocity rules for visiting patients.
Lawmakers in Minnesota have also solidified protections for medical marijuana patients in the workplace. Employers must now be more forthcoming as to why they are disciplining or firing a registered patient in the state. Current laws protect all legal consumers of cannabis from discrimination during a job candidacy, while most workplaces are already barred from testing for cannabis.
Mississippi bans medical marijuana operators from using any sort of advertising, including basic information like where they are located and how much their products cost. One state-based operator appealed this injustice to the U.S. The Supreme Court, which, to nobody, declined to hear the case.
Mississippi medical patients and operators must also now comply with new units of measurement for concentrates and infused products that correlate one unit with one gram total of THC. A recent update to the program removes the requirement for homebound patients to undergo in-person assessments for medical marijuana.
Advocates for patient access to medical marijuana are hoping to overturn a confusing policy in Missouri that doesn’t allow medical patients to buy any adult-use weed once their medical allotment is reached. The state limits patients to purchasing only 6 ounces monthly, while recreational consumers can purchase up to 3 ounces every single day.
Fear-mongerers in the Montana state senate are hoping to remove high-potency products “to send a message” that there are negative health risks associated with cannabis, especially for the youth. This change would apply to recreational and medical products.
There was no mention by the same lawmakers of the fact that alcohol-impaired driving caused 34% of all fatalities in Montana during 2023, a large total that far exceeds the national average.
Governor Jim Pillen has approved the roll-out of the licensing process for medical cannabis facilities to begin by October 1, 2025. The Nebraska Medical Cannabis Commission has received public feedback and is looking to stave off opposition, specifically from the Nebraska Attorney General. Nebraska voters approved legalized medical weed in November of 2024.
Nevada is taking the federal government to task with a resolution seeking to get Congress to reschedule the status of psilocybin, psilocin, DMT, ibogaine, mescaline, and MDMA. They argue that these natural medicines provide therapy while not leading to overdoses and addiction under medical supervision.
State legislators in New Hampshire are working on reducing the penalties for a first offense of psilocybin possession. A Republican-led state senate excluded the home cultivation provision for medical patients and caregivers in a revised bill.
The New Jersey Cannabis Regulatory Commission recently approved several cannabis consumption lounges in the state, where both recreational consumers age 21 and over and medical patients can purchase weed to smoke inside. The lounges are a safe space that can hopefully bring engagement and community to the experience. Medical patients can bring their own weed to enjoy at the lounges, provided it is sealed and labeled.
In another milestone, city employees of Trenton, along with employees of the cities of Orange and Teaneck, are now eligible to receive discounted telehealth appointments and discounted medical marijuana from several healthcare providers and dispensaries, provided they are currently registered patients. This passage is the first time a non-cannabis industry employer in the U.S. has ever offered medical cannabis as an employee healthcare benefit.
HB-230 in the New Mexico legislature is currently under review. This bill will potentially shield medical marijuana patients in the state from employment discrimination while eliminating the majority of employment-related drug testing.
Despite efforts from other New Mexico legislators, a federal court shot down a separate bill seeking to get health insurance companies to cover medical marijuana in April 2025.
New York State Senate Bill SB-3689 is currently working its way through the legislative process in the hope of protecting tenants from being evicted by a landlord for using medical marijuana.
As an affront to consumers and patients alike, Assembly Bill 977 is currently being chaired in a committee. This restrictive bill will keep maximum THC flower potency at 15%, along with a 25% THC potency restriction for all other cannabis products in the adult-use program. How does this affect medical patients? Many products can’t be found in medical dispensaries, so patients must often frequent adult-use dispensaries. Removing safe, tested, readily available products will only force some consumers and patients to the unregulated black and gray markets.
As one of the few states without a medical marijuana program, the hope in 2025 was that SB-350 would change that unfortunate status; however, as of now, lawmakers have stalled the bill, and it isn’t currently under consideration.
On the bright side, North Carolina Governor Josh Stein signed an executive order mandating the creation of the North Carolina Advisory Council on Cannabis. He hopes to bring both sides of the aisle together to iron out a plan with input from state officials to provide safe access to potential medical cannabis patients in the state.
As of August 1, 2025, North Dakota medical marijuana patients can now access low-dosage THC edibles, while also extending the expiration of medical cards to two years after being issued or recertified. Telehealth screenings and out-of-state reciprocity are also now options for medical patients.
Ohio’s Republican-led supermajority in its state legislature is at it again–this time looking to overturn the will of the voters who voted for adult-use legalization. The state senate has already passed SB-56, and it’s making its way through the House. This affront to consumers and patients alike seeks to:
The medical marijuana program in Oklahoma used to be somewhat of an oasis of hope within a desert of midwestern and southern cannabis contempt. Once the program was in operation, starting in 2021, almost 10,000 cannabis grows were licensed with the state.
Officials eventually put caps in place on the number of operators, as well as several new laws for the program that went into effect in 2025. Most of these laws involved licensing and testing rules and standards, but also the banning of deli-style dispensing of weed for patients; all flower must now be pre-packaged.
Cannabis cafes in Oregon are hopefully a reality after the 2026 election. A state-wide coalition is in the second round of signatures needed to further the option for consumption lounges similar to those in Amsterdam to be in the state.
A bill is currently making its way through committees in the Pennsylvania state legislature to protect parents who are medical marijuana patients during custody battles. SB-926 establishes legal use of medical marijuana by a Pennsylvania-registered patient is not grounds enough to be a determining factor when deciding on child custody during a legal dispute.
The Rhode Island Cannabis Control Commission recently finalized and put into effect regulations for the state’s adult-use and medical markets. The Rhode Island Cannabis Control Commission is now the state’s governing and oversight committee for all things cannabis. Regulations include improvements for enforcement, licensing, operators, and homegrow.
Residents of South Carolina will have to wait another year for their rights to access medical marijuana. Previous efforts to pass a medical marijuana bill in the South Carolina House of Representatives have continued to fail over the last decade, including earlier in 2025.
Medical marijuana patients and advocates in South Dakota celebrated the defeat of a bill seeking to eliminate the state’s voter-approved medical marijuana program earlier this year. Legislators narrowly defeated the bill—rife with mischaracterizations and falsehoods—7-6 in committee.
Tennesseans looking for legal and safe access to medical marijuana will also have to wait longer. Another bill to establish a medical marijuana program in the state failed in 2025, continuing the state’s reluctance to do so.
Texas medical marijuana patients can rejoice–the state’s notoriously restrictive medical marijuana program will now include more products and qualifying conditions. The governor has signed House Bill 46, which will go into effect starting September 2025.
Registered medical marijuana patients in Utah now total over 100,000–a sign that the often restrictive western state’s residents and health professionals are seeing the value of medical marijuana more and more each year.
Adult-use retailers in Vermont can now select a medical-use designation for their dispensaries. State officials believe the designation can help sustain a severely diminished medical dispensary industry in Vermont that recreational dispensaries have all but put out of business. Vermont retailers that opt for the designation can sell medical-quality cannabis and products, as well as provide curbside pickup and higher allotment caps.
READ: The Rise of Cannabis Beverages: Are They a Healthier Alternative?
Medical cannabis in Virginia, along with an adult-use program passed several years ago, is just another unfortunate victim of Governor Glenn Youngkin and his crusade to exert his beliefs over the will of the people of Virginia.
While he continues to obstruct the initiation of a voter-approved adult-use program, he has also interfered with potential laws seeking to help medical cannabis patients in the state. State legislators intended HB-1989 to improve labeling safety and patient delivery access, but the governor vetoed it due to personal bias.
Patients in Washington state are no longer on the hook for excessive taxation when purchasing specific Department of Health-approved products. Products with this designation have higher safety and compliance testing compared to adult-use products–they’re also not subject to the state’s absurd 37% cannabis tax. While the removal of excessive taxes is a great win for medical marijuana patients in Washington state, adults over 21 and patients still await the legalization of homegrown.
Despite its non-statehood status, Washington, D.C. has allowed for decriminalization and legal “gifting” sales for well over a decade now. The Washington D.C. Council passed a framework expanding the medical marijuana program in 2023, allowing stores that “gift” weed to get licensed. Cannabis stores must now sell all compliant products or risk closure.
West Virginia lawmakers introduced HB-2765 in February 2025; it still awaits further review. The bill, if passed, will greatly expand the state’s medical marijuana program. These improvements include the allowance of any medical condition to qualify, as per a physician, and more leeway to recommend cannabis to patients, also determined by a physician.
A Republican-led legislature has again stood in the way of adult-use and medical marijuana programs being established in Wisconsin. The prohibitionist Republican majority in the budget committee removed Governor Tony Evers’ designation to establish adult-use and medical programs in May 2025. Wisconsin is one of the few states in the country that has no adult-use or medical programs.
Despite having many surrounding states with medical and adult-use programs, Wyoming continues to hold steady as another prohibitionist state with no signs of letting up. The Wyoming House of Representatives decided not to consider a bill in 2025 seeking to decriminalize and reduce sentences for low-level cannabis possession.
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