Mariana Islands

Navigating Northern Marianas Islands Laws:

Patients and Caregivers: Enrolling and Accessing Medical Cannabis

Policymakers and Advocates: Actions Needed to Improve Laws for Patients

Background on State Laws

In 2018, the first legislation authorizing medical and adult-use commercial cannabis production and access systems was established. Due to the small population size (about 55,000 residents), lawmakers decided to legalize cannabis for medical and non-medical purposes to sustain the program. CNMI’s medical program includes several important tenants for patients, such as a robust qualifying condition list, strong patient civil rights protections, and a tax exemption. As the territory implements regulations the Islands’ grade will no doubt improve. Details on how these laws apply to patients and medical professionals can be found below.

Here is a breakdown of how the Commonwealth of Northern Mariana Islands fared in ASA’s Annual State of the States Report, which evaluates the effectiveness of each state cannabis program from a patient perspective and assigns a grade using a rubric that reflects the key issues affecting patient access. Medical cannabis laws are constantly changing, ASA’s policy recommendations for the Commonwealth of Northern Mariana Islands can be found below. For policy updates Sign Up here or Take Action!

Patient Rights and Civil Protections	50/100
Arrest Protection 25/25 Affirmative Defense 20/20 Parental Rights Protections 0/20 Employment Protections 0/20 DUI Protections 0/10 Explicit Privacy Standards 5/5
Access to Medicine	55/100
Authorizes Retail Access 10/10 Alternative Accessibility Methods 10/20 - Authorizes Delivery 10/10 - Authorizes Curbside Pickup 0/10 Personal Cultivation 15/15 Collective Gardening 0/5 Sufficient Number of Licenced Retailers 0/30 Reciprocity 20/20
Program Functionality	75/100
Legal Protections Within Reasonable Time Frame 20/20 Reasonable Possession Limits 10/10 Reasonable Purchase Limits 10/10 Telemedicine for Physician Certifications 15/15 Patient and Physician Representation in Program Decision Making 0/20 Reasonable Caregiver Standards 5/5 - Background Checks 2/2 - Number of Caregivers 3/3 Reasonable Physician Standards 5/5 Access to Administration Methods 10/10 - Allows Dried Flower 5/5 - Allows Edibles, Concentrates, and Other Forms 5/5 Provides Access to Minors on School Grounds 0/5
Affordability	40/100
Sales Tax Break for Patients and Caregivers 20/20 Covered by State Insurance or Health Aid 0/20 Reasonable Registration Fees 20/20 Financial Hardship Waivers or Discounts 0/20 Donation Program 0/10 Allows Multi-Year Registrations 0/10
Health and Social Equity	45/100
State Program Protections 25/25 Housing Protections 0/25 Access for Minors 10/10 Access in Underserved Areas 0/10 List of Qualifying Conditions is Exhaustive or All Inclusive 10/10 Allows Patients to Medicate Where they Choose 0/10 Organ Transplants 0/5 Ownership or Employment Restrictions 0/5
Consumer Protection and Product Safety	59/200
Cultivation Operations 7/50 Quality Management Systems 0/10 Staff Training 5/10 Standard Operating Procedures 2/8 - Facility and Equipment Sanitation 0/1 - Workplace Safety 0/1 - Storage 0/1 - Batch and Lot Tracking 0/1 - Security 1/1 - Waste Disposal 1/1 - Water Management 0/1 - Records Management 0/1 Pesticide Usage Limitations 0/2 Environmental Impact Regulations 0/2 Required Testing 0/8 - Cannabinoids 0/1 - Terpenes 0/1 - Microbials 0/1 - Aflatoxins 0/1 - Pesticides 0/1 - Heavy Metals 0/1 - Foreign Matter 0/1 - Moisture Content/ Water Activity 0/1 Packaging and Labeling 0/3 - Cannabinoids 0/1 - Terpenes 0/1 - Pesticides 0/1 Complaints, Adverse Event Reporting, and Recall Protocol 0/7 Manufacturing Operations 18/50 Quality Management Systems 0/10 Staff Training 10/10 Standard Operating Procedures 4/7 - Facility and Equipment Sanitation 1/1 - Workplace Safety 1/1 - Storage 0/1 - Batch and Lot Tracking 0/1 - Security 1/1 - Waste Disposal 1/1 - Records Management 0/1 Environmental Impact Regulations 1/3 Required Testing 0/10 - Cannabinoids 0/1 - Terpenes 0/1 - Microbials 0/1 - Aflatoxins 0/1 - Pesticides 0/1 - Heavy Metals 0/1 - Residual Solvents 0/1 - Homogeneity 0/1 - Foreign Matter 0/1 - Water Activity 0/1 Packaging and Labeling 3/5 - Cannabinoids 0/1 - Terpenes 0/1 - Ingredients 1/1 - Allergens 1/1 - Nutritional Content 1/1 Complaints, Adverse Event Reporting and Recall Protocol 0/5 Dispensary Operations 7/50 Staff Training 5/20 Standard Operating Procedures 2/7 - Facility Sanitation 0/1 - Workplace Safety 0/1 - Storage 0/1 - Batch and Lot Tracking 0/1 - Security 1/1 - Waste Disposal 1/1 - Records Management 0/1 Product Testing 0/10 - Product Meets Requirements Before Sale 0/5 - COA Disclosure 0/5 Complaints, Adverse Event Reporting and Recall Protocol 0/13 Laboratory Operations 27/50 Independent or Third-Party 5/5 Laboratory Sampling 5/5 Method Validation 2/4 Quality Management Systems 3/5 Staff Training 10/20 Standard Operating Procedures 2/7 - Facility and Equipment Sanitation 0/1 - Equipment and Instrument Calibration 0/1 - Workplace Safety 0/1 - Sample Tracking 0/1 - Security 1/1 - Waste Disposal 1/1 - Records Management 0/1 Result Reporting 0/4
Score Penalties	20/100
Gives Regulatory Preference to Adult Use 20/20 Classifies Cannabis as a Medicine of Last Resort 0/15 Administrative or Supply Problems 0/15 Requires Vertical Integration 0/10 Creates New Criminal Penalties for Patients 0/10 Limits Patients to a Single Retailer 0/10 No System for Adding Qualifying Conditions 0/10 Imposes Bans or Limits on THC 0/5 Imposes Bans or Limits on CBD 0/5
Excerpted from ASA's 2022 State of the States Report.