Where Are We at the Moment with Medicinal Cannabis?

Stephen Andrews
23 Feb 2023

The United States has come a long way forward since 1978, when the federal government, for the first time, started to provide medicinal cannabis to a limited number of patients through the Compassionate Investigational New Drug program. The program was launched at a time when the official government policy was to deny the therapeutic and medicinal value of cannabis. More than four decades later, the story is entirely different.

Most states in the U.S. have launched their own medicinal cannabis program, allowing patients access to various cannabis-based medicines depending on the illness they struggle with. The list of health conditions for which medicinal cannabis is approved for recommendations varies from state to state, but in essence it's allowed for all diseases where it's known that cannabis has proven therapeutical benefits, including chronic pains, cancer, epilepsy, multiple sclerosis, etc. The laws and regulations also vary in terms of production, distribution, access, consumption, etc. 

Currently, 37 states in the U.S., four territories, and the District of Columbia have a comprehensive medicinal cannabis program in place. In addition, eleven other states have passed more restrictive legislation that principally limits THC-rich products and favors CBD. Still, in some of these states, CBD products are only available for very few conditions, like the treatment of rare seizure disorders, especially in children. 

In states with comprehensive programs, doctors can recommend medicinal cannabis to patients in need. The costs for cannabis medicines in most cases are non-refundable, however, registered patients with the state's program who have an MMJ card or recommendation can purchase products at dispensaries for a somewhat lower price than what you'd expect if you show up at the dispensary without a card or recommendation. 

Perhaps one of the most significant achievements is that today most of the legal states with progressive laws allow the cultivation of a limited number of cannabis plants for personal medicinal use at home. Oregon, California, and Washington were among the first to permit homegrowing medicinal cannabis, and this list has extended in the recent years to feature around two dozen states. On the other hand, around half of all states that allow cannabis for medical use prohibit homegrowing your own product. 

A few more important developments took place at the end of 2022 that will trace the path of medicinal cannabis for the future. In December, President Biden signed the first cannabis-specific reform piece of legislation into law. That is The Medical Marijuana and Cannabidiol Research Expansion Act. The primary purpose of this bill is to make life easier for cannabis scientists, enabling them to evaluate and research the medicinal benefits of the Cannabis plant without federal obstacles. 

The bill also sets the foundation for the federal government to investigate all the potential therapeutic benefits of cannabis in line with the announced rescheduling review. For medicinal cannabis, this bill is extremely important because once certain research cycles are completed, it will allow cannabis-based products to be marketed and sold using medical claims based on science without conflict with the U.S. Food and Drugs Administration, which is currently not the case. When this is achieved, it will almost certainly pull more pharmaceutical companies into the sector, and the number and availability of cannabis medicines will grow. 

In sum, medicinal cannabis in the United States is currently moving through a critical transition phase. At the end of it, hopefully, cannabis will get the all-clear from the feds and it will be removed from the list of Schedule I drugs. When this happens, there will be a cultural shift, a much significant change in the wider perception of how cannabis is viewed as a medicine. 

Stephen Andrews