How Are Medical Marijuana and Adult-Use Marijuana Different in My State?

Good morning, afternoon, evening, or night! Recently one of our viewers wanted to know some key differences between medical and recreational programs in states where recreational use is legal. So without further ado, let’s jump right in.

In most states that have both recreational and medical cannabis programs, being a medical patient has some perks. These are not 100% guaranteed, but are generally true:

• Most medical programs have tax exemptions or tax benefits for medical patients.
• Larger dispensaries will try to prioritize the needs of patients over recreational users and have separate lines for medical users.
• Medical patients may be allowed to grow plants on their own property, typically under lock-and-key.
• There are some additional legal protections for having a medical marijuana ID card.

However, being a medical patient is not all smiles and sunshine! There are some drawbacks and hoops you will have to jump through to get a medical card:

1. In order to qualify as a medical patient, you must have one of the qualifying conditions for your state. Each state differs in what it considers a valid condition to qualify, but some common conditions to qualify for medical marijuana are glaucoma, epilepsy, and chronic pain.
2. In order to acquire a medical ID card, you must visit a doctor, get a recommendation from them, and pay a processing fee for your card. This can cost anywhere from $100 to $500, which is a lot of money to spend upfront. Additionally, you will need to renew this card annually, which has its own fee associated with it.
3. Some states medical marijuana programs are old and don’t offer as many protections against pesticide residues as their recreational programs. While this seems counterintuitive, it is an unfortunate side effect of the prohibition on cannabis.
   1. Conversely, some states are more up-to-date on their regulations regarding medical cannabis, and there may be shortages in medical cannabis as a result.

Americans for Safe Access covers Alaskan enrollment and benefits in this article, but essentially you may apply for a medical card using this form. There is a $25 processing fee payable by check or money order, and if your application is rejected for any reason, you cannot reapply for 6 months. Renewal is $20 per year, and if your card has expired, they will treat your application for renewal as though it is a new application.

Benefits for having a medical card in Alaska:

• Between you and your caregiver, you may legally possess up to 6 plants, with a maximum of 3 being mature at any given time. You may legally possess an ounce of cannabis in usable form.
• You can designate a caregiver to grow cannabis for you. They must apply with the registry as a caregiver and have a valid caregiver ID card.
• Minors can have a medical card with written permission from their legal guardian(s) and physician.
• Changes in recreational law shall not restrict the privileges granted under the medical law.

If you would like to read the rules directly, the section covering medical cannabis is covered under Alaska Statutes 17, chapter 37.

California has the oldest medical system in the United States, dating back to 1996, and a relatively new recreational system. As a result, some laws may be considered antiquated, or have changed significantly. There are a few laws that matter specifically, and these are:

• The Compassionate Care Act of 1996 (Prop 215), which established the medical marijuana program.
• California Senate Bill 420 (SB420), which further clarified the Compassionate Care Act.
• Adult Use of Marijuana Act (AUMA), which implemented recreational cannabis in California and modified the regulation of the medical program.

As you might imagine, digging through three separate laws can be a bit of a pain, and there’s the potential for unresolved legal questions. However, the Compassionate Care Act established that while you don’t need to obtain a medical card to get medical cannabis (a physician’s recommendation is enough), the medical card provides some legal protections. Additionally, a medical card allows minors to access medical cannabis.

As far as regulations go, AUMA established the regulation of all cultivation and sales of cannabis (both recreational and medical) under specific regulatory bodies.

Colorado was one of the first states to legalize recreational cannabis and was also an early adopter of medical cannabis. As a result, Colorado has had some time to work out the bugs in their system and has a pretty stable set up. In order to qualify for a medical card, you must meet certain eligibility criteria and follow a relatively simple set of steps to apply. There’s a $25 application fee, plus the cost of a doctor’s visit, and the whole process is pretty quick if the information is accurate.

According to some sources, the benefits of a medical card in Colorado are pretty obvious. You get lower taxes, reduced prices, and some legal bonuses, such as being allowed to carry more cannabis at any given moment. Regulations that cover recreational production are governed by the Marijuana Enforcement Department (MED), and generally the same protections are in place for medical production that are in place for recreational production.

Yes, yes. DC is not a state. It’s a district. There’s a whole slew of political problems surrounding that unique issue. But ignoring that, we’re looking at cannabis. The DC cannabis market is super strange, given the political significance of the district. Essentially you cannot “buy” or “sell” cannabis, but you can “gift” it.

Medical cannabis users have unique benefits, especially since they are allowed to visit dispensaries, while recreational users can only get “gifts” or grow their own cannabis. If you want to learn more about the process for applying for a medical card, the Leafly link above will explain in more detail. There’s a $100 application fee on top of a doctor’s visit.

Maine was an early adopter of medical marijuana, and only recently legalized recreational cannabis, much like California. Maine has a department specifically to cover medical cannabis, abbreviated as the MMMP. They are still in the process of rolling out their recreational system, so medical users have the UPPER HAND.

Just kidding of course. Maine’s medical system follows a caregiver-style of system, and as such you must have a medical recommendation to qualify. Patients may grow their own cannabis or designate a caregiver.

Massachusetts legalized medical cannabis in 2012, and recreational cannabis in 2016. Medical cannabis use is regulated by their MMMP, and the application process has been streamlined to be doable online. An excellent article on wbur.org covers the main differences for medical and recreational patients. It even has a helpful table!

Michigan just legalized recreational cannabis in 2018, so their recreational system is not online yet. Medical marijuana is currently the only way to access cannabis. In order to learn more about their medical system, you can learn about their MMMP here.

Nevada’s recreational and medical systems are online. Famously, Nevada declared a state of emergency when they first legalized. In Nevada, both adults and minors can enroll in the medical program, and must have one of the qualifying conditions. Patients must apply online and pay a $25 application fee.

Patients are given several legal exemptions from prosecution. Patients and caregivers may also grow cannabis with certain restrictions, depending on location and availability. Medical cardholders can also possess 2.5x as much cannabis at any given time as a recreational user. They are also not subject to sales tax on their cannabis.

Oregon was an early adopter of medical marijuana, and legalized recreational back in 2012. Since then, the recreational program rolled out with only a few hitches, and things have been chugging along ever since. In order to have a medical card in Oregon, you have to apply online or by mail. You need a physician’s statement, a photo ID, and $200 application fee. It’s cheaper under specific exceptions.

Medical sales in Oregon are plummeting as dispensaries shift towards serving recreational customers over medical ones. However, many of the benefits that medical patients see in other states apply to Oregon as well. Additionally, medical users can have higher concentrations of cannabinoids per individual serving, and can carry significantly more usable cannabis at any given time.

Vermont legalized medical cannabis in 2004, and recreational in 2018. Vermont’s medical program requires patients to have a valid photo ID, qualifying medical condition, doctor’s visit, and $50 application fee. There are some benefits to being a medical patient in Vermont (like in other states), but there’s a weird conflict between the two laws. Basically the newer recreational law has fewer restrictions, leaving many medical patients wondering why they should bother getting a medical card in the first place.

And finally we come to Washington. The state legalized medical marijuana in 1998 and the first to legalize recreationally in 2012. Today, both programs continue on. The medical marijuana program is managed by Washington’s Department of Health. In order to become a medical marijuana card holder, you need to have a qualifying condition and a doctor’s authorization. Then you can go to a medically-endorsed store to get your card.

According to Leafly, registered patients don’t have to pay sales tax, are protected from prosecution based on the amount they consume, and can participate in cooperatives. If your doctor determines you may need more cannabis than the standard amount, you may also be eligible to grow your own plants.

So tell us what you think about this kind of article. Would you like to see more of these research articles comparing and contrasting? Or are there other subjects you’d like us to cover? Let us know in the survey below or on the forum!