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 that you don’t see here, please don’t hesitate to ask by sending your question to [email protected].

Cannabis is a flowering plant that 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. Cannabis leaves and flowers are consumed in several forms: dried flower buds or various types of concentrated, loose, or pressed resin extracted from the flowers or leaves through a variety of methods. Once mature, the plant’s leaves and flowers are covered with trichomes, tiny glands of resinous oil containing cannabinoids and terpenes that provide physical and psychoactive effects.

Cannabinoids are classified here as:

  • Phytocannabinoids – cannabinoids found in leaves, flowers, stems, and seeds collected from the Cannabis sativa plant.
  • Endogenous – cannabinoids made by the body: examples include N-arachidonoylethanolamine or anandamide (AE) or 2-arachidonoylglycerol (2-AG).  AE and 2-AG activity can be manipulated by inhibiting their corresponding hydrolases FAAH or MAGL, preventing their degradation.
  • Purified naturally occurring cannabinoids purified from plant sources:  examples include cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC),.
  • Synthetic cannabinoids synthesized in a laboratory: examples include CB1 agonists (CPP-55, ACPA), CB2 agonists (JWH-133, NMP7, AM1241), CB1/CB2 nonselective agonist (CP55940), ajulemic acid (AJA), nabilone, and dronabinol.

100+ different types of cannabinoids and terpenes.

Concentrations or percent of each type of cannabinoid ranges widely from plant to plant and cultivar (strain) to cultivar. 

The first identified and best-known cannabinoid is THC (delta-9-tetrahydrocannabinol). THC has the most significant psychoactive effect of the cannabinoids. The ratio of THC to other cannabinoids varies from strain to strain. 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 psycoactive 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, 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 of the strain). 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 can be used for medicine and to treat a number of symptoms or side effects patients experience from other treatment methods. Currently, the federal government classifies cannabis as Schedule I meaning there is “no acceptable medical use,” but advocates - and legislators - know this is not true. The federal government even holds a number of cannabis-related health patents, and in 2018 the Food and Drug Administration (FDA) approved a cannabis-derived medicine, which is yet more proof that Schedule I is wrong.

Currently there are over 6 million Americans who use cannabis as medicine in some form. Reasons for their use include pain management, seizures, muscle elasticity, anxiety, and anti-nausea, just to name a few. The medical use of cannabis can even be traced back thousands of years, and has been documented throughout history. In fact, cannabis has only been villainized and prohibited since the 20th century. Even in the early 1900s you could find over the counter medicinal cannabis products right here in the United States.

If we take a look outside of the United States, we can see more proof of cannabis as medicine today. Other countries like Canada, Mexico, many European Union countries, and Australia have all legalized cannabis for medicinal use. Researchers across the globe have published hundreds of studies on this topic in just the last few years.

It is absolutely true that cannabis is medicine, and in some cases cannabis can treat a patient even after all traditional options have failed. In these cases, cannabis medicine is literally life threatening. However, this does not mean that cannabis is only medicine. Cannabis can be used recreationally as well, but the regulatory structure for that needs to be separate from medical cannabis regulations in order to properly protect patients and their treatment choices.

For more information about cannabis medicine for specific health conditions, please see our Medical Cannabis Patient Guides.


Cannabis is illegal at the federal level. The federal government regulates drugs and medicines through the Controlled Substances Act (CSA) (21 U.S.C. § 811) placing substances deemed potentially addictive or harmful in a schedule, according to its relative potential for abuse and medicinal value. Under the CSA, cannabis is classified as a Schedule I drug, which means that the federal government views cannabis as highly addictive and having no currently accepted medical use.

Over the years, we’ve made progress in easing the severity of the enforcement of federal cannabis laws.  However, medical cannabis remains illegal federally, preventing the locally licensed cannabis businesses that serve patients from operating as other businesses do and keeping these treatments out of reach for millions of Americans.

To date, 48 states and most U.S. territories have passed laws allowing medical cannabis use in some form by qualifying patients. Of those states, some only allow access to CBD extracts of cannabis, but 37 states, the District of Columbia, and most U.S. territories have functional programs that include a range of cannabis products.

Learn more about federal cannabis laws

To date, 48 states and most U.S. territories have passed laws allowing medical cannabis use in some form by qualifying patients. Of those states, some only allow access to CBD extracts of cannabis, but 37 states, the District of Columbia, and most U.S. territories have functional programs that include a range of cannabis products. Click here to see the full range of State By State Medical Cannabis Laws.

There is no state or territory in this country with a perfect medical cannabis law. Often original legislation or regulations in state medical programs are far too narrow or strict to fully cover all patients needs and rights.

Every year, Americans for Safe Access publishes the State of the States Report, which grades each state and territory medical cannabis law on over 150 metrics. In the most recent report, the highest scoring state only received 76.14% of points possible. The average score across the country was a shocking 44.38%. This means that medical cannabis programs still have a long way to go before all patients are fully protected and served by the program.

Cannabis advocacy, in recent years, has earned a lot of wins - but our job as advocates is rarely ever done with a win. It is up to medical cannabis advocates to continue fighting for safe and legal access to cannabis therapeutics through amendments to legislation and regulations.

No two medical cannabis laws are the same from state to state, and legislators and regulators in each state often created the program from scratch. This has led to a lot of differences in how patients receive care from state to state, but it has also provided insight into which policies are most important to patients and which ones stand in the way of care. By continuing to support medical cannabis policy at both the state and federal level, advocates can continue to have an impact on programs and patients nationwide.

For over 25 years now, states have been passing individual medical cannabis bills. During those years, we have seen, and patients have experienced, varying levels of access, affordability, civil rights protections, and more in their states. Because of this piecemeal approach, every state has built their own, individual program, with different rules and regulations from state to state. This has harmed patients, especially those who live in states that do not permit access or that severely limit access.

Every year, Americans for Safe Access publishes the State of the States Report, which grades each state and territory medical cannabis law on over 150 metrics. In the most recent report, the highest scoring state only received 76.14% of points possible while the lowest scoring states earned 0%. The average score across the country was a shocking 44.38%. Just one look through the report demonstrates the drastic differences between the level of care and access patients receive from one state to another. There is also no uniformity among these laws. Without federal oversight and coordination among these programs, patients are left bearing the burden of legal research just to make sure they have their medicine without risking prosecution or discrimination.

Beyond those issues, cannabis for any use remains illegal on the federal level. This has many negative repercussions for patients. Patients are not legally allowed to travel from state to state with their cannabis medicine, minor patients are not allowed to access their cannabis medication near their school, patients face eviction from Housing and Urban Development (HUD) for medicating, and employers can discriminate against cannabis patients. These are only a few of the issues patients face in our current system.

By stepping in and providing national oversight over these programs, the federal government can set minimum safety standards and protections for patients, and can help ensure that patients have adequate access across the country. Not only that, but this office would also be responsible for overseeing cannabis-related policies at other federal agencies or in federal programs, and would help facilitate more research for medical cannabis. All of these are things that are not getting done now. And even if the government did want to start doing all these things tomorrow, it is not equipped to because agencies lack the proper staff and resources. This is why ASA is advocating for the creation of an Office of Medical Cannabis and Cannabinoid Control.

ASA’s model legislation would create a federal cannabis program through two major actions: 1) The creation of the Office of Medical Cannabis and Cannabinoid Control (OMCCC) housed in HHS and 2) The creation of a new schedule for cannabis, Schedule VI. The mission of the OMCC would be to facilitate access to medical cannabis for therapeutic use and research, regulate the production of medical cannabis products, and oversee the new schedule VI.

The simplest analogy to use: medical cannabis and recreational cannabis are cousins, not siblings. Medical and recreational come from the same family - legal use of cannabis - but have their own distinct DNA not shared between the two as well. While there are similarities, there are enough differences that require separate legislation to address the two. This is important because simply legalizing recreational use leaves out critical patient rights and protections, and even prohibits some patients from accessing cannabis at all. 

Medical cannabis is used by patients to treat a medical condition, and should be treated as such under law. In the same way that a person cannot be evicted from public housing for using a prescribed pharmaceutical medication, cannabis patients deserve those rights as well. Unlike recreational cannabis use, patients require cannabis to treat their conditions and do not simply have the option of abstaining like a recreational user has. This means that patient protections like affordability and no sales or excise taxes are extremely vital aspects of medical cannabis regulations that are often not featured in recreational regulations. 

Perhaps the biggest oversight in the misconception that medical patients’ needs are covered under recreational cannabis laws are children with debilitating diseases. Recreational adult use programs are designed for those 21 years of age or older. This automatically cuts access off from those who are younger and often rely on cannabis to treat very serious or life threatening conditions. These patients deserve access too. 

However, it is not enough to have recreational cannabis regulations with a simple exemption for minor patients. Below is just a partial list of protections and rights that patients deserve, in line with any other treatment option they may choose. Some, if not all, of these issues are often forgotten while focusing on recreational regulations because that program has other distinct needs. This is why separate laws are required for the two: while they are related by the topic of cannabis, the programs and the consumers are very different. 

For a more detailed look at these issues and more, read our State of the States Rubric.

  • Custody rights 
  • Housing protections 
  • Employment protections 
  • 30 day supply limits 
  • Accessibility options 
  • Access for minors 
  • Protections for medicating 
  • Tax-free purchases 
  • Financial hardship discounts/programs

Unfortunately, just because CBD products can be found on shelves of many stores and gas stations, that does not necessarily mean the product is safe.

To be clear: CBD itself is completely safe. The problem, however, is that there are little to no regulations on the CBD market. This means there are no safety standards in place, and no one monitoring if companies are acting in good faith - which includes providing accurate labels and test results.

In 2018, the Farm Bill was signed into law, which separated hemp and hemp-based products from the definition of “cannabis” under the Controlled Substances Act. This made hemp and products like “hemp-derived CBD” legal. While the Farm Bill provided for the regulation of the cultivation of cannabis, it left the question of product regulation open and instructed the Food and Drug Administration (FDA) to create these rules. FDA promised CBD product regulations by Fall 2019 to ensure that products on the market were safe. Unfortunately, FDA has still not published any kind of guidance for manufacturers or retailers.

Because of this, CBD products - specifically ones you can buy online, at retail stores like wellness shops and pharmacies, or at gas stations - exist in a gray area legally.

Not all CBD products are the same! CBD products purchased at dispensaries are produced under the safety guidelines and regulations of the state.

Absolutely! And not in some “wish upon a star” or “when pigs fly” kind of way. The momentum is on our side and cannabis policy is getting more and more attention - and congressional support - by the day. 

In fact, on November 16, 2022, Congress sent the first ever standalone cannabis reform bill to the President’s desk. This bill, the Medical Marijuana and Cannabidiol Research Act, is just one of many cannabis reform bills that have been introduced in Congress. 

Medical cannabis continues to have support from the vast majority of Americans. And in a time when policymakers seem divided on every aspect of policy, medical cannabis remains a bipartisan issue, and one that is still important to members of both parties. 

Cannabis patients have been left behind for too long. With the current momentum and support for medical cannabis, it is time for the federal government to do away with the archaic prohibition policies that actively harm patients. Because patient needs are distinct from recreational consumer needs, Congress should use this time to pass the much needed patient protections while their conversations and debates around recreational use continue. Patients cannot afford to be left behind any longer.