POST 2020 ELECTION UPDATE: As of Nov. 4 2020, voters in Mississippi and South Dakota approved a measure to regulate cannabis for medical use, bringing the total to 36 states and 4 territories. However, Mississippi's measure is being challenged as of February 2021.

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ADULT-USE UPDATE: As of March 31, 2021, 15 states have enacted legislation to regulate cannabis for adult-use.

• Voters in Arizona, Montana, New Jersey and South Dakota approved measures to regulate cannabis for adult-use.
• On February 8, 2021 South Dakota Circuit Judge Christina Klinger ruled that the measure was unconstitutional. Decision is being appealed as of March 31, 2021.
• New Jersey's governor signed enacting legislation on March 1, 2021.
• New York's legislature and governor enacted AB 1248/SB 854 on March 31, 2021.
• The Virginia legislature passed legislation on February 27 and sent the bill to the governor- pending signature as of March 31, 2021.
• New Mexico legislature passed legislation on March 31 and sent the bill to the governor- pending signature as of April 5, 2021.
• If signed, Virginia's law will bring the total to 16 states, two territories and the District of Columbia.
• This total does NOT include South Dakota's court-over-turned measure, which is pending appeal.

A total of 36 states, District of Columbia, Guam, Puerto Rico and U.S. Virgin Islands have approved comprehensive, publicly available medical marijuana/cannabis programs.

Approved measures in 11 states allow use of "low THC, high cannabidiol (CBD)" products for medical reasons in limited situations or as a legal defense. Low-THC programs are not counted as comprehensive medical marijuana programs. NCSL uses criteria similar to other organizations tracking this issue to determine if a program is "comprehensive":

1. Protection from criminal penalties for using marijuana for a medical purpose.
2. Access to marijuana through home cultivation, dispensaries or some other system that is likely to be implemented.
3. It allows a variety of strains or products, including those with more than "low THC."
4. It allows either smoking or vaporization of some kind of marijuana products, plant material or extract.
5. Is not a limited trial program. (South Dakota and Nebraska have limited, trial programs that are not open to the public.)

Medical Uses of Marijuana

In response to California's Prop 215, the Institute of Medicine issued a report that examined potential therapeutic uses for marijuana. The report found that: "Scientific data indicate the potential therapeutic value of cannabinoid drugs, primarily THC, for pain relief, control of nausea and vomiting, and appetite stimulation; smoked marijuana, however, is a crude THC delivery system that also delivers harmful substances. The psychological effects of cannabinoids, such as anxiety reduction, sedation, and euphoria can influence their potential therapeutic value. Those effects are potentially undesirable for certain patients and situations and beneficial for others. In addition, psychological effects can complicate the interpretation of other aspects of the drug's effect."

Further studies have found that marijuana is effective in relieving some of the symptoms of HIV/AIDS, cancer, glaucoma, and multiple sclerosis.1

In early 2017, the National Academies of Sciences, Engineering, and Medicine released a report based on the review of over 10,000 scientific abstracts from marijuana health research. They also made 100 conclusions related to health and suggest ways to improve cannabis research.