Cannabis was decriminalized for first-time offenders in Nebraska in 1979, with possession of one ounce or less punishable by a $300 fine. However increased fines and levels of criminal offense classifications as well as jail time can result for subsequent possession of larger volumes of cannabis. Beyond these laws Nebraska has organized no cannabis policy reform improvements to provide patients with safe and legal access, or organize associated affirmative defense laws to protect patients.

In 2014, Nebraska and Oklahoma filed suit against Colorado, arguing that Colorado's authorization of adult-use cannabis access in 2012 was leading to cross-border business practices occurring affecting surrounding states. The suit's aim to strike down key provisions of the 2012 Colorado law was unsuccessful, with the U.S. Supreme Court in 2016 declining to hear Nebraska and Oklahoma's case by a 6-2 margin. Several legislative attempts to organize a fully functional legal medical cannabis access and licensing regime have been introduced in the Cornhusker state, however these measures have failed to secure sufficient support to get to the Governor's desk.