Medical cannabis

Medical cannabis refers to the use of cannabis and its derivatives under a state-authorized therapeutic program for patients with qualifying conditions, typically requiring a physician's written recommendation or certification and enrollment in a state patient registry. The first modern U.S. medical cannabis law was California's Proposition 215 (Compassionate Use Act, 1996). As of April 2026, 38 states, D.C., and four U.S. territories have comprehensive medical cannabis programs; another ~12 states permit only low-THC/high-CBD products (e.g., Texas Compassionate Use Program, Georgia's low-THC oil law). Kentucky launched medical sales on January 1, 2026; Nebraska's voter-approved program began issuing limited licenses in early 2026. Medical cannabis is distinct from FDA-approved cannabis-derived drugs (Epidiolex, Marinol/dronabinol, Cesamet/nabilone), which are prescribed under DEA schedules. Because cannabis itself remains Schedule I, physicians issue "recommendations" or "certifications" rather than prescriptions (see Conant v. Walters, 309 F.3d 629 (9th Cir. 2002)). Federal protection for state medical programs derives from the annual Joyce-Blumenauer appropriations rider, construed in United States v. McIntosh, 833 F.3d 1163 (9th Cir. 2016). *→ See also: Qualifying condition, Recommendation, Patient registry, Rohrabacher-Farr Amendment