Medical Marijuana 2020

What are other states doing?

Frequently Asked Questions 

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What are other states doing?

47. What other states have implemented medical marijuana programs? 
A total of 33 states and Washington, D.C. have made medical marijuana available (17 through ballot initiatives, and 16 through legislative action), allowing more than 2.8 million Americans with a proper diagnosis to use medical marijuana. These include Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Utah, Vermont, Washington, Washington D.C., West Virginia.  

48. On average, how many people in each state become medical marijuana patients? 
For the states with medical marijuana programs, the numbers range from between 0.01% to 3.15% of each states’ respective total population. For example, Arizona’s total population is approximately seven million people and there are approximately 153,000 patients enrolled in its medical marijuana program, which is 2.2% of the total population. 

49. What has been the experience of other states that have made medical marijuana available? 
No state that has made medical marijuana available has repealed it. Medical marijuana patients report reduced pain and symptoms of their debilitating medical conditions, and increased quality of life.  

50. How are medical marijuana programs regulated in other states? 
Every state’s programs are implemented and regulated by each state’s and Washington D.C.’s respective Department of Health; require Medical Marijuana ID Cards to identify patients who are approved to purchase medical marijuana; authorize the use of caregivers to assist patients who need help purchasing and using medical marijuana (i.e. a caregiver for an elderly person or a child); require a physician examination and certification before a patient is authorized to obtain a Medical Marijuana ID Card and then purchase medical marijuana; requires a renewal of the physician certification and the Medical Marijuana ID Card to keep the patient status current (most programs require a renewal annually; Mississippi will require an annual renewal unless the physician chooses a shorter time period); regulate and provide licenses to the businesses that produce and dispense medical marijuana to qualifying patients; and regulate the amount of medical marijuana that can be sold to patients within the allowable time period.

51. How do the medical marijuana programs work in the nearby states of Louisiana, Florida, Arkansas, and Oklahoma?

LOUISIANA
Louisiana’s medical marijuana law was originally enacted by the state legislature in 2015, then amended in 2016, and expanded in 2018 to include more debilitating medical conditions like PTSD, severe autism, and chronic pain. Louisiana’s program requires patients to obtain a doctor’s recommendation to purchase certain medical marijuana products such as tinctures, oils, salves, patches, edibles, capsules, and other concentrated forms of the medicine. The program is regulated by the Louisiana Department of Agriculture and Forestry, the Louisiana Board of Pharmacy, and the Louisiana State Board of Medical Examiners.

Louisiana’s medical marijuana program originally included regulations that restricted patient access to medical marijuana, such as a cap established in 2016 limiting physicians to only 100 medical marijuana patients as well as a requirement that patients see their doctor after 90 days in order to continue treatment. The Louisiana Board of Medical Examiners has since removed both restrictions in order to allow patients greater access to medical marijuana. 

Unlike the Mississippi proposal, which creates a free market for regulated businesses to provide medical marijuana, the Louisiana proposal stipulates that medical marijuana can only be grown and provided to pharmacies by the agricultural centers at Louisiana State University and Southern University, which are both partnering with national corporations to grow the state’s medical marijuana; and, the Louisiana’s program only allows up to ten pharmacies where medical marijuana can be sold throughout the state. The pharmacies will be regulated by the Louisiana Board of Pharmacy. It is projected that patients will be able to begin purchasing medical marijuana in 2019; no patients have yet been served by Louisiana’s medical marijuana program. 

Due to regulatory hurdles, Louisiana’s program has experienced delay and patients have not received access to medical marijuana. Louisiana’s regulators have taken years to determine the program’s regulations related to choosing and licensing a limited number of pharmacies and limiting medical marijuana to only be grown at two places, which are both state universities. 

Mississippi’s proposal does not limit the number of Medical Marijuana Treatment Centers (where medication can be cultivated, processed, and dispensed) and requires the Mississippi Department of Health to have the program up and running no later than August 15, 2021, just nine months after the vote will take place on the November 2020 ballot. 

FLORIDA
Florida’s medical marijuana program was overwhelmingly passed in November 2016 by voters in favor of medical marijuana by more than 71% after a successful state-wide ballot initiative campaign. Although Florida’s program became official in January of 2017, the state government has been slow to enact the necessary regulations for patients to get access, and the process has been mired in legal red tape. Florida’s program allows qualified patients to obtain a medical marijuana ID card and purchase their medicine after being examined by and receiving a recommendation for medical marijuana from their doctor. The program is regulated by the Florida Department of Health.

Unlike the Mississippi proposal, which creates a free market for regulated businesses to provide medical marijuana, Florida’s program only allows a limited number of licenses to Medical Marijuana Treatment Centers (medical marijuana businesses authorized to cultivate, process and dispense medical marijuana), with preference given for up to two licenses to applicants that own one or more facilities that are or were used for processing citrus fruit or citrus molasses in some way and will convert the facility or facilities for the processing of medical marijuana. These regulatory stipulations, among others, have led to lawsuits and caused delay to Florida’s program implementation.

Although Florida’s program is still being implemented to a fuller extent, the program is functioning and patients are being served. Florida’s program stipulated that once the medical marijuana statewide database reached a 100,000-patient threshold, four additional licenses would be issued within six months; the database reached the 100,000 threshold in May 2018. As of September 2018, Florida’s database accounts for more than 166,000 total patients. 

Mississippi’s proposal does not limit the number of Medical Marijuana Treatment Centers (where medication can be cultivated, processed, and dispensed) and requires the Mississippi Department of Health to have the program up and running no later than August 15, 2021, just nine months after the vote will take place on the November 2020 ballot. 

ARKANSAS
Arkansas passed Amendment 98 to their State Constitution by more than 53% after a successful state-wide ballot initiative campaign in 2016. Regulations were established in May of 2017, but the implementation of the medical marijuana program has been delayed due to legal challenges and licensing delays. Arkansas’ program requires patients to be certified by a licensed physician, and to provide the certification to the Arkansas Department of Health to obtain a medical marijuana ID card. The program is regulated by Arkansas Department of Health.

 Unlike the Mississippi proposal, which creates a free market for regulated businesses to provide medical marijuana, Arkansas’ program only allows a limited number of licenses to Medical Marijuana Treatment Centers (medical marijuana businesses authorized to cultivate, process and dispense medical marijuana), which has caused delay to the program’s implementation due to lawsuits over the available licenses. 

The Arkansas program allows five growers and 40 dispensaries statewide. No patients have yet been served by Arkansas’ medical marijuana program. Medical marijuana business cultivators hope to begin growing in spring of 2019, with medical marijuana products becoming available to patients in summer of 2019.

Mississippi’s proposal does not limit the number of Medical Marijuana Treatment Centers (where medication can be cultivated, processed, and dispensed) and requires the Mississippi Department of Health to have the program up and running no later than August 15, 2021, just nine months after the vote will take place on the November 2020 ballot. 

OKLAHOMA
Oklahoma voters approved medical marijuana in June of 2018 by passing Question 788 with 56% approval following a successful ballot initiative. Oklahoma’s program requires patients to be certified by a licensed physician, and to provide the certification to the Oklahoma Medical Marijuana Authority to obtain a medical marijuana ID card. The program is regulated by the Oklahoma Medical Marijuana Authority, which operates under the Oklahoma Department of Health.

The Oklahoma Medical Marijuana Authority began issuing licenses to medical marijuana businesses in September 2018. As of November of 2018, Oklahoma’s program has more than 13,000 patients and more than 600 licensed businesses to grow and dispense medical marijuana. Oklahoma is experiencing lawsuits against the state on behalf of Oklahoma dispensary owners and growers who are currently looking to reduce the number and size of fees faced by medical marijuana businesses. Even so, patients already have access to medical marijuana in Oklahoma. 

Oklahoma’s program allows individuals to grow up to six medical marijuana plants in their own homes. Mississippi’s medical marijuana program will not allow home grow and requires the Mississippi Department of Health to have the program up and running no later than August 15, 2021, just nine months after the vote will take place on the November 2020 ballot.

GEORGIA
Georgia became the 34th state to legalize some form of medical marijuana when Republican Governor Brian Kemp signed Georgia’s “Hope Act” (House Bill 324) into law in April of 2018.  The Georgia Legislature approved the “Hope Act” so that Georgia residents with specific debilitating medical conditions could obtain low-THC medical marijuana oil, tinctures, patches, lotions, and capsules.  The law created a commission, Georgia Access to Medical Cannabis Commission, to regulate and license medical marijuana producers, and allows patients registered with the Georgia Department of Health to obtain a medical marijuana ID card to purchase up to 20 fluid ounces of low-THC medical marijuana products.  

Since 2015, Georgia has allowed patients suffering from severe seizures and other illnesses to use CBD oil, but the state did not allow in-state cultivation and sales of any medical marijuana products. This expanded legislation through the “Hope Act” for medical marijuana allows legal cultivation and sale of low-THC medical marijuana oil, tinctures, patches, lotions, and capsules in Georgia. The bill stipulates that medical marijuana can only be cultivated by six private growers and two designated universities, and Georgia patients will be allowed to purchase low-THC medical marijuana products from licensed treatment centers or specially licensed pharmacies. Some of Georgia’s debilitating medical conditions include cancer, ALS, seizure disorders, multiple sclerosis, Crohn’s disease, sickle cell disease, Alzheimer's disease, and Parkinson’s disease – most of which require that the patients’ diagnosis be “severe or end stage.”

While Mississippi’s initiative is broader and more comprehensive, the Georgia Legislature and the Georgia Governor recognized the medicinal value of medical marijuana and took a substantial first step in helping Georgia citizens with debilitating medical conditions.

52. Do medical marijuana businesses operating in states with legal medical marijuana programs face any business roadblocks?
Unfortunately, yes. Banks and other financial institutions face significant hurdles in serving the financial needs of businesses operating under legal state medical marijuana programs. The American Bankers Association (ABA) provides a summary of the issues that banks and other financial institutions are facing in dealing with medical marijuana companies:  

  • “Currently, thirty-three states, the District of Columbia, Guam and Puerto Rico have all legalized the use of marijuana to some degree. Yet the possession, distribution or sale of marijuana remains illegal under federal law, which means any contact with money that can be traced back to state marijuana operations could be considered money laundering and expose a bank to significant legal, operational and regulatory risk.

  • In addition to growers and retailers, there are vendors and suppliers, landlords and employees that are indirectly tied to the cannabis industry, thus posing legal risk for banks serving such entities and individuals, as indirect connections to marijuana revenues are hard, if not impossible, for banks to identify and avoid.  The rift between federal and state law has left banks trapped between their mission to serve the financial needs of their local communities and the threat of federal enforcement action.

  • ABA believes the time has come for Congress and the regulatory agencies to provide greater legal clarity to banks operating in states where marijuana has been legalized for medical or adult use. Those banks, including institutions that have no interest in directly banking marijuana-related businesses, face rising legal and regulatory risks as the marijuana industry grows. Current proposals in both the Senate and the House that seek to provide greater clarity and bridge the gap between state and federal law provide a solid starting point for discussion.”

The issues that the ABA illustrated will be a challenge for medical marijuana businesses intending to operate in Mississippi under a legal state program until the federal government amends laws and regulations related to the banking industry that permit banks to conduct business with such companies.  Fortunately, these issues are being addressed in Congress, which will provide clarity prior to Mississippi’s medical marijuana program.