Frequently Asked Questions on Medical Cannabis

Let’s face it, medical cannabis issues are complicated! The following is a list of frequently asked questions we receive at Americans for Safe Access. If you have a question you don’t see here, please don’t hesitate to ask by sending your question to [email protected] or search ASA's Glossary of Terms.

Cannabis (commonly referred to as marijuana) is a versatile plant used for medicinal, industrial, and nutritional purposes. This flowering plant has fibrous stalks used for paper, clothing, rope, and building materials; leaves, flowers, and roots used for medicinal purposes; and seeds used for food and fuel oil.

The leaves and flowers can be consumed in several forms: dried flower buds or various types of concentrated, loose, or pressed resin (sometimes called “hash”) extracted through various methods. These flowers are covered with trichomes, tiny glands of resinous oil containing cannabinoids (such as THC and CBD), and terpenes (which contribute to the aroma and additional therapeutic effects).

These terms refer to products, laws, regulations, and markets surrounding the versatile Cannabis Sativa plant. The term marijuana is a slang term that usually refers to cannabis varieties that contain higher levels of THC (delta-9-tetrahydrocannabinol), the psychoactive compound responsible for the "high" associated with cannabis use. Hemp is a legal distinction of cannabis cultivars that contain minimal THC (less than 0.3%) and are primarily cultivated for industrial purposes, such as producing textiles, paper, and CBD (cannabidiol) products.

In a legal context, medical cannabis (marijuana) is used under the supervision of a healthcare professional to treat specific medical conditions. Patients must obtain a medical cannabis card and adhere to state regulations to access a variety of cannabis products tailored to their therapeutic needs. These products may include oils, tinctures, edibles, and other forms designed to alleviate symptoms such as chronic pain, anxiety, and seizures.

On the other hand, recreational cannabis (marijuana) is used for personal enjoyment without a medical necessity. Recreational use is subject to different state regulations, typically including age restrictions, possession limits, and designated consumption areas. While both medical and recreational cannabis originate from the same plant, their legal frameworks and intended uses differ significantly to address the distinct needs of patients and recreational users.

Cannabinoids are chemical compounds found in cannabis (marijuana) that interact with the human body’s endocannabinoid system. They are classified into:

Phytocannabinoids: Found in the Cannabis sativa plant.

Endogenous Cannabinoids: Produced naturally by the body, such as anandamide (AE) and 2-arachidonoylglycerol (2-AG).

Purified Naturally Occurring Cannabinoids: Extracted from the plant, including cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC).

Synthetic Cannabinoids: Created in laboratories, like nabilone and dronabinol.

There are over 100 different types of cannabinoids and terpenes, with concentrations varying widely between different cannabis varieties (strains). THC (delta-9-tetrahydrocannabinol) is the most well-known cannabinoid, responsible for the plant’s psychoactive and therapeutic effects, while CBD is recognized for its therapeutic benefits without psychoactive properties. While THC has been the focus of breeding and research due to its various psychoactive and therapeutic effects, non-psychoactive cannabinoids have physiologic effects that can be therapeutic.

Cannabidiol (CBD) relieves convulsions, inflammation, anxiety, and nausea—many of the same therapeutic qualities as THC but without psychoactive effects. It is the main cannabinoid in low-THC cannabis strains, and modern breeders have been developing strains with greater CBD content for medical use.

Cannabinol (CBN) is mildly psychoactive and decreases intraocular pressure and seizure occurrence.

Cannabichromene (CBC) promotes the analgesic effects (pain relief) of THC and has sedative (calming) effects.

Cannabigerol (CBG) has sedative effects and antimicrobial properties, as well as lowers intraocular pressure.

Tetrahydrocannabivarin (THCV) is showing promise for type 2 diabetes and related metabolic disorders.

In addition to cannabinoids, other cannabis plant molecules are biologically active. A few other molecules known to have health effects are flavonoids and terpenes or terpenoids (the flavor and smell). Cannabinoids, terpenoids, and other compounds are secreted by the glandular trichomes found most densely on the floral leaves and flowers of female plants.

Yes, cannabis (marijuana) is used medicinally to treat a variety of symptoms and conditions, including pain management, seizures, muscle spasms, anxiety, and nausea. Despite being classified as a Schedule I substance federally, which indicates no accepted medical use, over 6 million Americans utilize medical cannabis. Historical use dates back thousands of years, and modern research supports its efficacy for various medical conditions.

For more information, explore ASA’s Cannabis Therapeutics Webpages and Guides for Patients & Caregivers.  

At the federal level, cannabis (marijuana) remains illegal under the Controlled Substances Act (CSA), classified as a Schedule I drug. However, as of now, 49 states and most U.S. territories have enacted laws permitting medical cannabis use for qualifying patients. These state programs vary, with some allowing only CBD extracts and others offering a broader range of cannabis products.

Learn more about federal cannabis laws here.

Currently, 49 states and most U.S. territories have passed legislation allowing medical cannabis use in some form. Among these, 39 states, the District of Columbia, and most territories offer comprehensive programs that include a variety of cannabis products. For a detailed list of state medical cannabis laws, visit our State Medical Cannabis Laws.

Reasonable patient rights and protections ensure that medical cannabis (marijuana) patients can access and use their medicine without facing legal or social repercussions. Key protections should include:

  • Arrest Protection: Prevents law enforcement from arresting compliant medical cannabis patients.
  • Affirmative Defense: Allows patients to defend themselves in court based on medical necessity.
  • Parental Rights Protections: Safeguards parents using medical cannabis from child welfare interventions.
  • DUI Protections: Ensures medical cannabis use does not automatically imply impairment.
  • Employment Protections: Prevents employment discrimination based solely on medical cannabis use.
  • Explicit Privacy Protections: Keeps patient information confidential.
  • Access for Minors on School Grounds: Allows minors with medical needs to use cannabis without disrupting their education.
  • State Program Protections: Protects medical cannabis patients from losing state benefits.
  • Housing Protections: Prevents eviction based on medical cannabis use.
  • Access for Minors: Facilitates access to medical cannabis for minors with parental consent.
  • Access in Underserved Areas: Ensures equitable access regardless of geographic location.
  • List of Qualifying Conditions: Supports an exhaustive list of conditions treatable with cannabis.
  • Patients Can Medicate Where They Choose: Allows use in appropriate locations without unnecessary restrictions.
  • Organ Transplants: Protects medical cannabis patients from being excluded from organ transplant lists.
  • Ownership or Employment Restrictions: Removes barriers for individuals to work at cannabis businesses.
  • Sales Tax Break for Patients and Caregivers: Exempts medical cannabis from sales taxes to reduce costs.
  • Covered by State Insurance or Health Aid: Encourages insurance coverage for medical cannabis.
  • Reasonable Registration Fees: Ensures registration fees are affordable for patients.
  • Financial Hardship Waivers or Discounts: Provides financial assistance to patients in need.
  • Donation Programs: Facilitates donations of medical cannabis to qualified patients.
  • Multi-Year Registrations: Simplifies the registration process for long-term patients.
  • Reasonable Possession Limits: Allows patients to possess amounts necessary for their treatment.
  • Reasonable Purchase Limits: Ensures patients can consistently obtain their medicine.
  • Telemedicine for Physician Certification: Enables remote medical cannabis certifications.

For a comprehensive overview of which rights and protections are included in your state, read ASA’s State of the States report.

Becoming a medical cannabis (marijuana) patient involves several steps:

Determine Eligibility: Check if your medical condition qualifies under your state’s medical cannabis laws.

Consult a Healthcare Provider: Obtain a recommendation or certification from a licensed physician. Here are some tips on talking to your doctor about medical cannabis.

Register with Your State (if required): Submit the necessary documentation and fees to your state’s medical cannabis program.  Once approved, you will receive an ID card that allows you to purchase cannabis from licensed dispensaries.

For detailed guidance, visit ASA’s state pages, which include details on medical conditions, how to register with your state and other state requirements.

Traveling with medical cannabis (marijuana) involves navigating both state and federal laws:

Within States: Generally allowed if traveling within a state where medical cannabis is legal.

Across State Lines: Illegal federally, even if both states permit medical cannabis.

International Travel: Strictly prohibited, as many countries have severe penalties for cannabis possession.

Always check the specific laws of your destination before traveling. For more information, refer to our Traveling with Medical Cannabis.

Medical cannabis (marijuana) can be purchased from licensed dispensaries in states where it is legal, and some states allow patients and adults 21 and older to cultivate cannabis. For more information on obtaining medical cannabis. To find a licensed dispensary near you, use our Dispensary Locator.

This question continues to be a point of significant debate in the U.S. For individuals using cannabis (marijuana) to manage a medical condition, many experts note that cannabis is less addictive than certain other medications, such as opioids. Nonetheless, people who stop using cannabis after a prolonged period may experience withdrawal symptoms similar to those linked with caffeine cessation, including irritability, disrupted sleep, depressed mood, and reduced appetite. Infrequent reports of chills, headaches, physical tension, sweating, and stomach pain also exist.

The National Institute on Drug Abuse (NIDA) reports that around one in ten people who use cannabis may develop what is termed “cannabis use disorder.” However, many in the medical and research communities point out that daily use, tolerance, and dependence alone are not necessarily sufficient grounds to label cannabis consumption as “abuse,” especially considering that self-medication can be a motivation for consistent use. Furthermore, numerous other medications create similar tolerance or dependence but are not separately classified as “use disorders.” These complexities underscore the need for education, more profound research, and more nuanced discussions rather than blanket assumptions.

While cannabis use disorder remains controversial, overuse can negatively impact daily life. Using cannabis responsibly and in consultation with a healthcare professional is key, especially if you have concerns about potential dependency or adverse effects. Keeping a cannabis log and maintaining open communication with friends and family can help with self-monitoring and offer additional support.

Delta-8-tetrahydrocannabinol (Delta 8 THC) is a cannabinoid found in cannabis (marijuana) that has psychoactive effects similar to Delta-9 THC but is typically less potent In a medical application, it is used for anxiety relief and pain management, but it only occurs naturally in cannabis at trace levels. Although Delta-8 THC is widely considered to have a safety profile similar to other cannabinoids, this assumption rests largely on its chemical similarity to Delta-9 THC rather than comprehensive clinical studies. Novel cannabinoids such as Delta-10 THC, Synthetic Delta-9 THC, THC-O Acetate, and Delta-8 do not have a long record of safe use or extensive scientific research.

To create high levels of Delta-8 THC, producers use isomerization—a chemical conversion of CBD or Delta-9 THC. All Delta-8 THC products thus involve some form of chemical conversion, and only a few human studies have examined Delta-8 THC’s long-term safety, high-dose effects, or full medicinal benefits.

Quality testing is critical for Delta-8 THC products because extracts often contain elevated amounts of Delta-9 THC and other impurities that can be difficult to remove. The isomerization process used to convert CBD into Delta-8 THC can also introduce additional contaminants. In some jurisdictions, Delta-8 THC products sold in state-regulated dispensaries undergo the same testing and purity requirements as other cannabis products. However, many Delta-8 THC items come from hemp-based CBD and appear in unregulated outlets such as convenience stores, smoke shops, and gas stations, where they are not reliably tested.

As for legality, many states have taken steps to ban or regulate Delta-8 THC products. In 2022, the Ninth Circuit Court of Appeals ruled that federal law does not explicitly prohibit manufacturing or selling Delta-8 THC products, as long as they come from hemp or hemp-derived cannabinoids, acknowledging a loophole in the 2018 Farm Bill. The court deferred to Congress for clarification. In 2023, the Drug Enforcement Administration (DEA) maintained that Delta-8 THC products fall outside the Farm Bill’s scope because they do not occur naturally in cannabis and are obtained synthetically. This discrepancy will likely be addressed in the next version of the Farm Bill.

Medical cannabis (marijuana) can be used to treat a wide range of conditions, including:

  • Chronic Pain
  • Epilepsy
  • Multiple Sclerosis
  • Cancer
  • HIV/AIDS
  • Anxiety
  • Nausea
  • Seizures
  • For a comprehensive list of qualifying conditions, see our Qualifying Conditions Chart, and for more information on its medical use, use these tools provided by ASA

Medical cannabis (marijuana) interacts with the body’s endocannabinoid system, which regulates various physiological processes such as pain, mood, and appetite. Cannabinoids like THC and CBD bind to cannabinoid receptors, producing therapeutic effects that can alleviate symptoms associated with various medical conditions.

Learn more about How Medical Cannabis Works.

Medical cannabis (marijuana) can be administered in several forms, including:

  • Smoking or Vaping: Inhaling cannabis directly into the lungs.
  • Edibles: Consuming cannabis-infused foods and beverages.
  • Tinctures and Oils: Using drops placed under the tongue.
  • Topicals: Applying cannabis-infused creams or balms to the skin.
  • Capsules and Pills: Swallowing cannabis in pill form.

Each method offers different onset times and durations of effect. Choose the method that best suits your medical needs and lifestyle.

For more information, visit Administration Methods.

While medical cannabis (marijuana) can provide therapeutic benefits, it may also cause side effects such as:

  • Dizziness
  • Dry Mouth
  • Fatigue
  • Changes in Appetite
  • Mood Changes
  • Impaired Memory and Concentration

More information on managing and mitigating potential side effects can be found here. 

While it is virtually impossible to fatally overdose on medical marijuana (cannabis), excessive consumption can lead to uncomfortable side effects like severe anxiety, paranoia, dizziness, and impaired motor function. Always use cannabis responsibly and as directed by a healthcare professional. For more information on adverse effects and overconsumption, use these resources.

While recreational markets have emerged from medical cannabis advocacy, they do not address the specific rights and needs of patients. Unlike a robust medical model, the recreational framework lacks essential protections, such as those guaranteed under the Americans with Disabilities Act (ADA), the Fair Housing Act, or insurance coverage for prescribed treatments. Additionally, the recreational market doesn’t incentivize the development of specialized cannabis medicines, leaving patients without tailored therapeutic options.

Patients need more than just access to dispensaries; they require a healthcare framework that recognizes cannabis as medicine. This distinction is crucial for establishing coverage and legal protections that support patients in their daily lives.

The duration cannabis (marijuana) remains detectable in your system varies based on factors such as frequency of use, metabolism, and the type of test administered. Generally:

Urine Tests: Detectable for up to 30 days with chronic use.

Blood Tests: Detectable for up to 7 days.

Saliva Tests: Detectable for up to 72 hours.

Hair Tests: Detectable for up to 90 days.

Yes. No state or territory currently has a perfect medical cannabis law. Original legislation often lacks comprehensive protections and may not fully address all patient needs. By staying involved, you can help advocate for improvements to ensure safe and legal access for all patients.

Learn more about our advocacy efforts in the State of the States Report.

Relying solely on state regulations has led to a patchwork of laws, creating disparities in access, affordability, and patient protections across the country. Federal oversight would:

Standardize Regulations: Ensure consistent safety and quality standards nationwide.

Enhance Patient Protections: Provide uniform rights and safeguards for all medical cannabis patients.

Facilitate Research: Promote comprehensive studies on medical cannabis benefits and safety.

Simplify Legal Access: Allow patients to travel and access medical cannabis without legal complications.

ASA advocates for the creation of an Office of Medical Cannabis and Cannabinoid Control (OMC) within the Department of Health and Human Services (HHS) to achieve these goals.

ASA’s model federal legislation proposes:

Creation of the Office of Medical Cannabis and Cannabinoid Control (OMC): Housed within HHS, responsible for regulating medical cannabis production, distribution, and safety.

Reclassification of Cannabis to Schedule VI: A new classification that recognizes medical use and facilitates research and access.

For detailed proposals, visit our Federal Medical Cannabis Legislation.

Absolutely! There is growing momentum and bipartisan support for medical cannabis reform. Recent legislative efforts, such as the Medical Marijuana and Cannabidiol Research Act, demonstrate progress toward federal recognition and regulation.

ASA remains committed to advocating for comprehensive federal legislation to ensure safe, legal, and equitable access to medical cannabis for all Americans.

Additional Patient Support

ASA provides a range of resources and support for medical cannabis (marijuana) patients, including:

Educational Materials: Comprehensive guides and information on medical cannabis.

Advocacy Tools: Resources to help you advocate for better access and protections.

Community Support: Connect with other patients and caregivers for shared experiences and support.