It is tempting to think of medical cannabis as being “legal” in the U.S., but this is not the case. Yes, certain states have medical marijuana/cannabis programs. But at the federal level, cannabis and a variety of cannabinoids (including THC and CBD, although CBD derived from hemp is technically legal in all states) is illegal and a Schedule I drug.
What does that mean? Being classified a Schedule I drug means cannabis is considered to have “no medical value”, and therefore cannot be “prescribed” in any fashion. Other drugs in this category include heroin, ecstasy, and LSD. The solution for Americans? If you can, get a medical marijuana card.
Sadly, this status means that research on the plant is restricted. This makes it extremely difficult to get information on dosing, ideal ingestion methods, which cannabinoid-terpenoid profiles are best for a particular condition, and how cannabis may react with other medications.
Because of this, doctors cannot give patients specific advice on which strain, product or cannabinoid-terpenoid profile they might benefit from most. This is partly because it is technically illegal to do so, and partly because the research is not at the stage yet where we can say for sure which cannabinoid-terpenoid profile is best for which condition (although there are certainly people working on it).
Where Medical Cannabis Is Legal In The Rest of the World
Yet, despite these problems, forward-thinking scientists, doctors and patients the world over are finding ways of trying to figure out solutions to such concerns.
Unsurprisingly, countries that have legal medical cannabis programs tend to be at the forefront of research. Two countries stand out in particular in this regard: Israel and the Czech Republic. In Israel, medical cannabis is legal, although recreational use is illegal.
Medicinal cannabis use is also legal in the Czech Republic, with possession of small amounts being considered a “misdemeanor”.
The Netherlands also stands out, due to the country’s role in the development of many of today’s cannabis strains and its lenient stance towards cannabis use (although it’s still technically “illegal” outside of licensed coffee shops).
There are also many other countries where medical cannabis is legal, including:
Argentina, Australia, Barbados, Bermuda, Brazil (for terminally ill patients), Canada, Chile, Colombia, Denmark, Ecuador, Finland (under licence), Georgia, Germany, Greece, Ireland, Italy, Jamaica, Lebanon, Lithuania, Luxembourg, Macedonia, Malawi, Malta, Mexico (with a maximum THC of 1%), New Zealand, Norway, Panama, Peru, Poland, Portugal, Romania, Saint Vincent and the Grenadines, San Marino, South Africa, Sri Lanka, Switzerland, Thailand, Turkey, Uruguay, Vanuatu, Zambia and Zimbabwe.
Places That Have Some Cannabinoid-based Prescription Medications/Medical Marijuana Programs
Austria, Belgium, Croatia, Cyprus, France and the United Kingdom have some cannabinoid-based medications available on prescription. Spain has legalized cannabis consumption in private areas, and there are some cannabinoid-based medications available upon prescription, but cannabis is still illegal in public areas.
As for the UK, cases like Alfie Dingley’s and Billy Caldwell’s could help establish an official medical cannabis program. When this will happen, we do not know, but it is part of our work to advocate for patients everywhere, to try and speed this process up wherever possible.
Places Where Recreational Cannabis Is Decriminalized
There are some countries where cannabis is “tolerated” or decriminalized to some extent, depending upon state, region, local customs and amount of cannabis the person possesses.
These countries include Antigua and Barbuda, Argentina, Australia (Northern Territory and South Australia, plus ACT), Austria, Barbados (if you’re a registered Rastafarian), Belgium, Belize, Bermuda, Bolivia, Chile, Colombia, Costa Rica, Croatia, Czech Republic, Dominica, Ecuador, Estonia, Israel, Italy, Jamaica, Luxembourg, Malta, Mexico, Moldova, Paraguay, Peru, Portugal, Saint Kitts and Nevis, Saint Vincent and the Grenadines, Slovenia, Switzerland and Trinidad and Tobago.
In some instances, the law may be poorly enforced or treated as an administrative or health rather than legal issue, but punishment is still an option. As for North Korea, nobody knows too much about how the state treats cannabis. Some say it’s illegal, others say nobody in the country even treats the plant as a “drug”.
Legalized Cannabis/Medical Marijuana
When it comes to “recreational” use, there are few countries in the world that have fully “recreationally legal” status. Many people think of the Netherlands as one such place, but as stated above, cannabis is merely “tolerated” rather than legal per sé. Some parts of Denmark also have a “tolerance” policy in place. Spain has decriminalized cannabis for personal use, and cultivation is allowed on private property – only commercial production is illegal.
Technically, the only two countries where cannabis is legal on a federal level, Canada and Uruguay. Even then, in Uruguay those who are not citizens are prohibited from buying cannabis. Canada has passed legislation to legalize cannabis federally, with provinces and territories being left to decide how they will distribute it.
In Georgia, it is legal to possess and consume cannabis but not for sale. In South Africa, it is legal to possess and cultivate cannabis but not for sale.
As for the United States, cannabis is legal both recreationally and medically in the following states:
- New Jersey
- South Dakota (goes into effect July 1 2021)
Cannabis is legal for medical use only in the following states and territories at the time of writing. We also list states where they have limits on the type of cannabinoid products that are legal:
- Alabama (non-psychoactive CBD oil only)
- Connecticut (non-medical possession decriminalized)
- Delaware (non-medical possession decriminalized)
- Florida (with a THC limit of 0.8%)
- Georgia (CBD oil with THC of less than 5% only)
- Indiana (CBD oil for patients with epilepsy only)
- Maryland (non-medical possession decriminalized)
- Minnesota (non-medical possession decriminalized)
- Mississippi (CBD oil only; non-medical possession decriminalized)
- Missouri (CBD oil only; non-medical possession decriminalized)
- New Hampshire (non-medical possession decriminalized)
- New Mexico (decriminalized in Albuquerque only)
- New York (non-medical possession decriminalized, unless in public view)
- North Carolina (CBD oil only; non-medical possession decriminalized)
- North Dakota
- Ohio (non-medical possession decriminalized)
- Oklahoma (CBD oil only)
- Puerto Rico
- Rhode Island (non-medical possession decriminalized)
- South Carolina (cannabis oil with less than 0.9% THC only)
- Tennessee (cannabis oil with less than 0.9% THC only)
- Texas (CBD oil only)
- Utah (only for terminally ill patients, and those with epilepsy have access to CBD)
- Virginia (cannabis oil with THC of less than 5% only)
- West Virginia
- Wisconsin (CBD oil only)
- Wyoming (CBD oil only)
Cannabis is legal both medically and recreationally (no recreational sales) in Washington, D.C., although cannabis is not legal on federal land.
How much will change over the next several years is anyone’s guess. We could even approach a situation where all 50 states have legalized cannabis for both medical and recreational purposes, yet is still considered federally illegal. As for the rest of the world, the evidence for establishing a well-regulated medical cannabis program is generally positive.
Let’s just hope governments the world over see sense and science, and allow for proper research into seeing how and in what way this unique plant can work for various conditions, with no demonization of any particular cannabinoid. Doing so could help usher in a new wave of very safe pharmaceutical medications for some very difficult-to-treat conditions.