The 5 States Most Likely to Legalize Medical Marijuana By December

Only 12 states have not enacted laws legalizing medical marijuana, with that number likely to shrink by the end of the year.

medical marijuana states

Since California became the first state to legalize medical marijuana in 1996, 37 others states have followed suit, although with varying approaches. Nine other states have passed laws allowing the medical use of low-THC / high-CBD products.

Among the 12 states that have not legalized medical marijuana, a handful have serious efforts underway to change that.

With that in mind, below are the states most likely to legalize medical marijuana by December:

  • Nebraska

Nebraskans for Medical Marijuana is currently pursuing the goal of placing a medical marijuana legalization initiative on the November, 2024 ballot. The group has been collecting signatures for their initiative since July, with them needing 125,000 signatures from registered Nebraska voters by July 1 to make the November ballot.

Recently Campaign Manager Crista Eggers said “We’re feeling very good”, saying he’s “confident” their initiatives will appear on the November ballot.

The initiative would “enact a statute that makes penalties inapplicable under state and local law for the use, possession, and acquisition of limited quantities of cannabis for medical purposes by a qualified patient with a written recommendation from a health care practitioner, and for a caregiver to assist a qualified patient in these activities.”

The proposal would create the Nebraska Medical Cannabis Commission to provide the necessary “registration and regulation of persons that possess, manufacture, distribute, deliver, and dispense cannabis for medical purposes.”

The group is also collecting signatures on a second initiative that would provide legal protections for doctors who recommend marijuana to their patients.

  • Idaho

Like Nebraskans for Medical Marijuana, a group called Kind Idaho is working to put a medical marijuana legalization initiative on this November’s ballot. The proposal would legalize medical marijuana for those with a qualifying condition who receive a recommendation from a physician. The possession limit would be set at four ounces, with patients allowed to grow up to six plants for personal use. The initiative would also establish a licensed and regulated system of medical marijuana dispensaries.

The initiative campaign is funded in part by the Marijuana Policy Project, a group that has led successful initiatives to legalize medical and recreational marijuana in numerous states.

The group has until May 1, 2024 to collect 62,896 signatures from registered Idaho voters in order to place the measure on the 2024 ballot.

Qualifying conditions for the initiative would include cancer, glaucoma, positive status for human immunodeficiency virus, acquired immune deficiency syndrome (AIDS), hepatitis C, amyotrophic lateral sclerosis, Crohn’s disease, Alzheimer’s disease, post-traumatic stress disorder, inflammatory bowel disease, Huntington’s disease, Tourette syndrome, a chronic or debilitating disease or medical condition or its treatment that produces cachexia or wasting syndrome, severe pain, chronic pain, severe nausea, seizures, including those characteristic of epilepsy, or severe and persistent muscle spasms, including those characteristic of multiple sclerosis, as well as “Any terminal illness with life expectancy of less than twelve months as determined by a licensed medical physician”.

You can find the initiative’s title, long ballot title and full text by clicking here.

  • North Carolina

In March of last year the North Carolina Senate voted 36 to 10 to pass the “Compassionate Care Act”, which would allow patients with a “debilitating medical condition” such as cancer, epilepsy, Parkinson’s disease, multiple sclerosis and post-traumatic stress disorder to possess and consume medical marijuana if they receive a recommendation from a licensed physician.

The law would allow 10 medical marijuana suppliers to control the cultivation and sale of cannabis, with each allowed to operate up to eight dispensaries. The measure would also establish a Medical Cannabis Production Commission to regulate and oversee the medical marijuana industry.

Last year the measure failed to be approved by the House of Representatives prior to the end of the legislative session. However, proponents of the proposal are hopeful that when the new legislative session begins in April, the House will take a closer look at the bill, which passed with wide bipartisan support in the Senate.

According to polling released in February, 78% of North Carolina voters support legalizing medical marijuana.

  • South Carolina

Legislation (Senate Bill 423) to legalize medical marijuana was approved last month through the South Carolina Senate by a vote of 26 to 17. Earlier this month the measure was assigned to the House Committee on Medical, Military, Public and Municipal Affairs.

The bipartisan billwould establish the South Carolina Medical Cannabis Program, creating “a seed-to-sale system to provide for the sale of medical cannabis to treat a qualifying patient’s debilitating medical condition or to alleviate symptoms.”

The law would allow patients to possess an “Allowable amount of medical cannabis” or “allowable amount of cannabis products”, defined as:

  • cannabis products for topical administration including, but not limited to, patches for transdermal administration or lotions, creams, or ointments, that contain a total of no more than four thousand milligrams of tetrahydrocannabinol;
  • cannabis products for oral administration including, but not limited to, oils, tinctures, capsules, or edible forms, that contain a total of no more than one thousand six hundred milligrams of tetrahydrocannabinol;
  • cannabis products that consist of oils for vaporization that contain a total of no more than eight thousand two hundred milligrams of tetrahydrocannabinol; or
  • for any other modes of delivery, an equivalent amount as determined by the department.

The measure would establish a licensed and regulated system of marijuana dispensaries, able to supply the medicine to any qualified patient. The Department of Health and Environmental Control and Board of Pharmacy would be tasked with establish rules and handling licensing for marijuana businesses.

Qualifying conditions under the proposed law include:

  • cancer;
  • multiple sclerosis;
  • neurological diseases or disorders, including epilepsy;
  • post-traumatic stress disorder (PTSD), subject to evidentiary requirements;
  • Crohn’s disease;
  • sickle cell anemia;
  • ulcerative colitis;
  • cachexia or wasting syndrome;
  • autism;
  • severe or persistent nausea unrelated to pregnancy, associated with end-of-life or hospice care, or bedridden/homebound due to a condition;
  • chronic medical conditions causing severe and persistent muscle spasms;
  • any chronic or debilitating disease or medical condition for which opioids are prescribed or could be prescribed by a physician, subject to specific requirements.
  • A terminal illness with a life expectancy of less than one year, as determined by the treating physician.
  • Any other serious medical condition or its treatment added by the Medical Cannabis Advisory Board.

If the measure is advanced through the House committee process and passed by the full House it will be sent to Governor Henry McMaster for consideration.

The full text of SB 423 can be found by clicking here.

  • Tennessee

Legislation filed in January by Senator London Lamar (D) was “Passed on First Consideration” on January 31, and referred to the Senate Judiciary Committee the following day. The proposed law would legalize medical marijuana for those with a qualifying condition who receive a recommendation from a licensed physician. Currently Tennessee is one of just 10 states that have not legalized any form of medical marijuana. 24 states have legalized marijuana for recreational use, while 40 have done so for medical purposes.

Senate Bill 1829 – the Medical Autonomy Related to Cannabis Act – would legalize the medical use of marijuana and marijuana products for those 18 and older. The measure would establish a system of licensed and regulated medical marijuana dispensaries, with regulations overseen by the Department of Agriculture.

If passe into law, patients would be allowed to possess up to one ounce of dried marijuana, eight grams of marijuana concentrates and marijuana-infused edibles with up to 8,000 mg of THC.

Patients would be allowed to possess and use “oils, tinctures, flower, edibles, pills, topical forms, gels, creams, vapors, patches, suppositories, liquids, and forms administered by a nebulizer”.

For the full text of Senate Bill 1829, click here.


For a look at the four states likely to legalize recreational marijuana by December, click here.

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