Maryland’s first legal protections for patients were established in 2003 with the Darrell Putman Compassionate Use Act, which created an affirmative defense for patients possessing less than one ounce of cannabis that reduced convictions to a misdemeanor offense with a maximum $100 fine. Free State lawmakers expanded this work in 2011, when Maryland passed SB 308 to recognize specific medical conditions and remove the misdemeanor possession penalty but maintain the $100 fine. In 2013, Maryland lawmakers secured passage of HB 180 and HB 1101, which expanded the affirmative defense to caregivers, allowed “Academic Medical Centers” to conduct medical cannabis research studies and established the Natalie M. LaPrade Medical Marijuana Commission to create regulations. 


In 2014, the Maryland legislature approved HB 881/SB 923, a comprehensive medical cannabis program that expanded and clarified legal protections for patients, caregivers, and physicians and created a distribution system. Under the law registered patients and their designated caregivers are allowed to obtain and possess a 30-day supply of cannabis, but personal cultivation is prohibited. There are no explicit qualifying conditions in Maryland under HB 881.  Instead, physicians must apply for permission to write recommendations for conditions they specify, though the Commission may add conditions through rulemaking.  


In 2016, Maryland enacted HB 104, legislation expanding the type of healthcare practitioners authorized to recommend cannabis. Under the law dentists, podiatrists, nurse midwives and nurse practitioners may recommend cannabis for treatment in addition to physicians.  After nearly four years since the state approved sweeping medical cannabis reforms, patients in Maryland finally had access to medicine through a total of 21 dispensaries in December of 2017. 


In 2019, Governor Hogan signed HB 17 into law, legislation authorizing the manufacturing and medical sale of cannabis edible products.  In 2020 Maryland saw HB 671/SB 604 become law.  This important measure permits administration of medical cannabis to qualified minor patients to medicate on school grounds and on the school bus, and state regulators are expected to have guidelines in place for this new system feature before the end of the year.  Legislation to expand Maryland decriminalization laws was tabled in 2020, and a state working group assembled to consider a state approach to adult-use cannabis opted against recommending any approach for 2020. COVID emergency measures included permission for licensed retailers to deliver to patients, curbside pickup and the use of telehealth for system reenrollment rather than in-person physician visits.