Becoming a Patient in North Carolina

Only patients with intractable epilepsy (epilepsy that does not respond to three or more other treatments) and that are recommended for treatment by a state-licensed neurologist are eligible.  North Carolina’s limited-use law does not apply to those who suffer from debilitating medical conditions like cancer, AIDS, ALS or multiple sclerosis. Patients are also prohibited from using cannabis with THC and CBD ratios that do not conform to the law.  Patients must have a caregiver who is their parent, legal guardian, or custodian and has registered with the North Carolina Department of Health and Human Services (“DHHS”).  

What's Legal

Under the strict terms of the law, patients and their caregivers may only possess “hemp extracts,” which are defined as cannabis extractions that contain less than 0.9% THC and at least 5% CBD and contain no other psychoactive substance. The patient or caregiver in possession of the hemp extract must have a certificate of analysis that indicates the exact ingredients of the hemp extract, including the percentages of THC and CBD. There is no mechanism for cultivation, distribution, or possession of cannabis products other than hemp extracts. 

Eligible Conditions

The only qualifying condition under the North Carolina law is intractable epilepsy, which is defined as "a seizure disorder that, as determined by a neurologist, does not respond to three or more treatment options overseen by the neurologist." No other conditions are eligible for legal protections under North Carolina law.


The law requires that patients be under the care of a neurologist that has attempted at least three other treatment options without success. The neurologist must be board-certified in neurology, licensed to practice in the state, and affiliated with a state-licensed hospital. A neurologist recommending or approving hemp extract, must provide a written statement that:

  1. the patient has been examined and is under the neurologist’s care,
  2. the patient suffers from intractable epilepsy (epilepsy that has not responded to three or more treatments), and
  3. the patient may benefit from treatment with hemp extract.


Only caregivers are allowed to acquire hemp extract, patients are not allowed to directly acquire the medicine regardless of whether or not the patient is an adult. The law does not provide for a clear means for caregivers to acquire hemp extract. Seemingly, caregivers will have to travel out of state to a medical cannabis state that has hemp extract for sale and allows sales to non-resident caregivers.

To become a caregiver, the following requirements apply:

  • Must be at least 18 years of age
  • Must be a resident of North Carolina
  • Must be patient’s parent, legal guardian, or custodian
  • Must register with DHHS by completing the Caregiver Registration Application
  • Must possess a written statement from the patient’s neurologist recommending hemp extract (see above description).

Caregiver Registration

The patient’s caregiver, who must be their parent, legal guardian, or custodian, must register with DHHS by completing and submitting a Caregiver Registration Application, which includes the name and address of the patient and name, address and hospital affiliation of the recommending neurologist.  If the neurologist’s name, address, or hospital affiliation change, the caregiver must notify DHHS and provide the updated information. There is no separate registration process for the patient.    


The law imposes no limits on where patients may consume their medicine.

Age Limits

There are no age limits for patients.


The law explicitly states that the identities of patients, caregivers, and neurologists reported to DHHS with the registration application are confidential.  However, law enforcement agencies may contact DHHS to confirm a caregiver’s registration.


There are no housing discrimination protections under the law.


There are no employment discrimination protections under the law.


Health insurers are not required to pay for hemp extract.

Out of State Patients

The law does not recognize out of state patients.

For More Information

NC Department of Health and Human Services