Cannabis is legal to possess to all adults over 21; however, the Cannabis Control Board of Guam has yet to release the rules governing sales within the territory. Registered patients or caregivers may possess up to 2.5 ounces of dried or prepared cannabis from a dispensary. Reciprocity is available to patients visiting Guam as a result of the expansion of rules defining qualified patients in Guam in 2018, to include reciprocity for registered patients visiting Guam from other authorizing jurisdictions, such as a U.S. state. Most recently in 2019, Governor Lou Leon Guerrero signed a bill that legalized cannabis on the island for non-medical use. When signing the bill, the Governor indicated that she was establishing a Medical Cannabis Regulation Commission to ensure patients were protected. Details on how these laws apply to patients and medical professionals can be found below.

Navigating Guam Territorial Laws:

Patients and Caregivers: Enrolling and Accessing Medical Cannabis

Medical Professionals: Procedures for recommending Medical Cannabis

Policymakers and Advocates: Actions Needed to Improve Laws for Patients

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Here is a breakdown of how Guam 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 Guam can be found below. For policy updates sign up here.

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	25/100
Authorizes Retail Access 10/10 Alternative Accessibility Methods 0/20 - Authorizes Delivery 0/10 - Authorizes Curbside Pickup 0/10 Personal Cultivation 15/15 Collective Gardening 0/5 Sufficient Number of Licensed Retailers 0/30 Reciprocity 0/20
Program Functionality	95/100
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 20/20 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	20/100
Sales Tax Break for Patients and Caregivers 0/20 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	144/200
Cultivation Operations 33/50 Quality Management Systems 10/10 Staff Training 10/10 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 2/2 Environmental Impact Regulations 1/2 Required Testing 7/8 - Cannabinoids 1/1 - Terpenes 0/1 - Microbials 1/1 - Aflatoxins 1/1 - Pesticides 1/1 - Heavy Metals 1/1 - Foreign Matter 1/1 - Moisture Content/ Water Activity 1/1 Packaging and Labeling 1/3 - Cannabinoids 1/1 - Terpenes 0/1 - Pesticides 0/1 Complaints, Adverse Event Reporting, and Recall Protocol 0/7 Manufacturing Operations 36/50 Quality Management Systems 10/10 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 2/3 Required Testing 7/10 - Cannabinoids 1/1 - Terpenes 0/1 - Microbials 1/1 - Aflatoxins 1/1 - Pesticides 1/1 - Heavy Metals 1/1 - Residual Solvents 1/1 - Homogeneity 0/1 - Foreign Matter 1/1 - Water Activity 0/1 Packaging and Labeling 3/5 - Cannabinoids 1/1 - Terpenes 0/1 - Ingredients 1/1 - Allergens 1/1 - Nutritional Content 0/1 Complaints, Adverse Event Reporting and Recall Protocol 0/5 Dispensary Operations 32/50 Staff Training 20/20 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 10/10 - Product Meets Requirements Before Sale 5/5 - COA Disclosure 5/5 Complaints, Adverse Event Reporting and Recall Protocol 0/13 Laboratory Operations 43/50 Independent or Third-Party 5/5 Laboratory Sampling 5/5 Method Validation 4/4 Quality Management Systems 3/5 Staff Training 20/20 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 4/4
Score Penalties	15/100
Gives Regulatory Preference to Adult Use 0/20 Classifies Cannabis as a Medicine of Last Resort 0/15 Administrative or Supply Problems 15/15 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.