Although cannabis is legal in more than half of the United States, it’s still inaccessible to many individuals for a number of reasons. These reasons include restrictive legislative policies in their state, geolocation, age, and the costs of medical cannabis.
Such barriers allow the black market to thrive even in legal cannabis states. While you may think the black market solely serves underground recreational cannabis users, plenty of individuals with medical conditions are pushed into black market cannabis sales due to the accessibility hurdles.
So, what can be done to improve cannabis patient access?
Medical Cannabis in States without Medical Cannabis Regulation
The biggest hurdle for cannabis patients is living in a state without a medical or adult use cannabis program. In such cases, these individuals may have to visit another state to purchase and use cannabis.
However, returning to their home state with their medicine becomes a state and a federal offense.
Even in states where medical cannabis is legal, some individuals don’t feel comfortable getting certified for a medical card. They may fear their employer would find out and discriminate against them. Or they’re intimidated by consulting a doctor for medical cannabis.
Furthermore, some medical cannabis programs specify that individuals must have at least one of a very limited set of conditions to qualify for a medical card. They may have another underlying ailment, but if it isn’t on the list, they won’t qualify for a medical marijuana card.
The penalties for using and possessing illegal cannabis — even for medicinal purposes — vary across each state and municipality. These penalties can range from fines to imprisonment, depending on the quantity of cannabis within your possession.
In states without medical or adult use cannabis programs, hemp-derived products are your only legal and closest option to cannabis products. These products include hemp-derived CBD, CBN, etc…
Hemp-derived delta-8 THC is also legal in some states, though a handful have already made moves to prohibit it.
Caregiver Liability in Medical Use Cannabis States
A caregiver is an individual certified by the state’s regulatory department to purchase cannabis products for a medical marijuana patient. A caregiver may be the parent of a child, or a loved one/nurse for a patient who can’t physically go to the dispensary.
One individual may be a caregiver for several patients, but each patient may only have one caregiver.
In most states, caregivers are only authorized to purchase and deliver cannabis products to the medical cannabis patient in their care. Though, in Michigan, caregivers are allowed to grow cannabis plants for their patients.
Caregivers are liable for ensuring the products they purchase are solely delivered to and used by the patient they were purchased for. It is illegal for a caregiver to buy products for themselves under a patient’s name.
Likewise, it is illegal for a caregiver to purchase products under a patient’s name and distribute them to another individual.
Caregivers are also liable for ensuring they and their patient(s) keep their medical cannabis card certifications up to date. Otherwise, neither party can legally access cannabis (unless the state has an adult-use cannabis program).
Crossing State Lines with Medical Cannabis
Crossing state lines with medical cannabis is a state and a federal offense. Even if cannabis is legal in both states that you are traveling between, it is still a crime.
According to an article by HG Legal Resources, this is illegal for two big reasons:
- It becomes an issue of interstate commerce, which the federal government regulates. Cannabis is still federally illegal.
- Medical cannabis laws vary in each state. For example, states where cannabis is legal generally denote the cannabis products purchased must be grown locally. Products purchased in another state would not qualify as “grown locally.”
When flying to other states with medical cannabis in your possession, the TSA says their officers are required to “report any suspected violations of law to local, state, or federal authorities.”
“TSA’s screening procedures are focused on security and are designed to detect potential threats to aviation and passengers,” the TSA website explains. “Accordingly, TSA security officers do not search for marijuana or other illegal drugs, but if any illegal substance is discovered during security screening, TSA will refer the matter to a law enforcement officer.”
Ultimately, the “final decision rests with the TSA officer on whether an item is allowed through the checkpoint.”
Thus, it’s up to the officer who screens you whether to report you to law enforcement for having medical cannabis in your possession.
On that note, some states accept medical marijuana cards that were certified in other states at their dispensaries. The states with medical marijuana reciprocity include:
- Arizona: “Limited reciprocity.” Individuals must be visitors or have lived in Arizona for less than 30 days. The condition they qualified for must also be on the list of Arizona’s qualifying conditions for medical cannabis.
- Hawaii: Yes, however, they must also have one of the qualifying conditions listed in Hawaii’s legislation. They must also pursue a temporary patient registration with Hawaii’s Department of Health.
- Louisiana: Not currently. But Louisiana passed legislation that will allow out-of-state patients to purchase cannabis with their qualifying medical cards starting August 1, 2022.
- Michigan: Yes — but your home state must also have reciprocity with Michigan.
- New Hampshire: Not yet, though the state is working on enacting legislation that would allow qualifying out-of-state cannabis patients to purchase products in NH.
- New Jersey: Out-of-state patients may “legally bring their marijuana into NJ for up to six months.” But this is somewhat confusing, as crossing state lines with cannabis would technically still be a federal crime.
- New Mexico
- Pennsylvania: No. However, parents are allowed to “lawfully obtain medical marijuana from another state, territory of the United States or any other country” for their child, so long as the child is a minor. The cannabis obtained in another territory must exclusively be given to the minor.
- Rhode Island
- Washington D.C.
- West Virginia: Yes, but only for terminally ill patients with cancer.
Key Takeaways: There Are Still Barriers to Cannabis Patient Access
Despite cannabis being legal in more than half of the United States, there are still many barriers to cannabis access for patients. Such barriers include restrictive legislation, geolocation, physical disabilities, age, and the costs of medical cannabis.
By far, the biggest hurdle is accessing medical cannabis in states where cannabis is still prohibited. Although some individuals may purchase and use cannabis in other states, it becomes a state and federal crime as soon as they go home with their out-of-state cannabis products.
Cannabis caregivers are also liable for ensuring the products they purchase on behalf of their patients are solely delivered to and used by the patient they have purchased for. Furthermore, caregivers must ensure they and their patients update their medical marijuana card certifications annually.
Even when traveling with cannabis between two states where it is legal, it is still considered a federal and possible state crime. However, some states offer medical marijuana reciprocity, allowing patients with out-of-state medical cards to make purchases at their dispensaries.
- Think About Cannabis. (2022, April 4). What is Delta-8 THC? https://www.thinkaboutcannabis.com/cannabis-science/what-is-delta-8-thc
- HG.org. (n.d.). Can You Travel Across State Lines with Legally Obtained Marijuana? HG.Org Legal Resources. https://www.hg.org/legal-articles/can-you-travel-across-state-lines-with-legally-obtained-marijuana-31789
- Transportation Security Administration. (n.d.). Medical Marijuana | Transportation Security Administration. TSA. https://www.tsa.gov/travel/security-screening/whatcanibring/items/medical-marijuana
- NORML. (2022, June 15). Arizona Medical Marijuana Law. https://norml.org/laws/medical-laws/arizona-medical-marijuana-law/
- NORML. (2022, June 15). Hawaii Medical Marijuana Law. https://norml.org/laws/medical-laws/hawaii-medical-marijuana-law/
- Louisiana State Legislature. (2022). HB135. https://legis.la.gov/legis/BillInfo.aspx?i=239940
- NORML. (2022, June 15). Maine Medical Marijuana Law. https://norml.org/laws/medical-laws/maine-medical-marijuana-law/
- NORML. (2022, June 15). Michigan Medical Marijuana Law. https://norml.org/laws/medical-laws/michigan-medical-marijuana-law/
- NORML. (2022, June 15). Nevada Medical Marijuana Law. https://norml.org/laws/medical-laws/nevada-medical-marijuana-law/
- NORML. (2022, June 15). New Jersey Medical Marijuana Law. https://norml.org/laws/medical-laws/new-jersey-medical-marijuana-law/
- NORML. (2022, June 15). New Mexico Medical Marijuana Law. https://norml.org/laws/medical-laws/new-mexico-medical-marijuana-law/
- NORML. (2022, June 15). Pennsylvania Medical Marijuana Law. https://norml.org/laws/medical-laws/pennsylvania-medical-marijuana-law/
- NORML. (2022, January 18). Rhode Island Medical Marijuana Law. https://norml.org/laws/medical-laws/rhode-island-medical-marijuana-law/
- NORML. (2022, June 15). District of Columbia Medical Marijuana Law. https://norml.org/laws/medical-laws/district-of-columbia-medical-marijuana-law/
- NORML. (2022k, June 15). West Virginia Medical Marijuana Law. https://norml.org/laws/medical-laws/west-virginia-medical-marijuana-law/