Published: 15 November 2011
Since 1996, 15 US states and the District of Columbia have passed laws permitting personal possession of a defined amount of cannabis for medical use. The patient must have a written recommendation from a doctor in all states except California and Maine, where the recommendation can be oral. All states except Washington have established confidential registries with patient identity cards, and in a number of states these are mandatory. While each state has its own list of conditions, most states allow cannabis use to treat pain, whether ‘chronic’, ‘severe’ or ‘intractable’.
Almost all states have adopted the caregiver model, whereby a designated person is permitted to grow a limited quantity of cannabis for the use of the patient. Depending on the state, patients may designate one or two caregivers, and caregivers may supply up to five patients. The amounts permitted range from 1 ounce — about 28 grams — (Alaska, Montana, Nevada) to 24 ounces (Oregon, Washington) of usable herbal cannabis, and from six to 24 plants, some of which should be ‘immature’. Provision of cannabis for medical use by not-for-profit dispensaries or state treatment centres is permitted in about half of the states. In all but two jurisdictions, New Jersey and Washington DC, patients are allowed to grow their own medicinal cannabis.
Federal law, in contrast, classifies cannabis as a dangerous substance with no medical use. This allows the federal government to prosecute any users and suppliers of cannabis. However, in October 2009, the Deputy Attorney General issued a memo to federal prosecutors not to prioritise the prosecution of cases relating to medical use of cannabis if authorised under state law.