In 2000, 65 percent of Nevada voters approved Question 9, a state constitutional amendment authorizing use, possession, and cultivation of cannabis by qualifying patients.  To qualify patients must be evaluated by a physician for eligibility and participate in a confidential state-operated registry that issues identification cards. Under Question 9 patients may possess up to 2.5 ounces of cannabis in a single 14-day period, cultivate up to 12 plants, and present a medical necessity defense in court if they possess cannabis in amounts above the legal limit. Unfortunately, the measure did not establish a regulated system licensing cultivators, manufacturers, testing laboratories, distributors or retailers, leaving patients without safe or legal access until such a system was authorized by SB 374 in 2014.  


SB 374 established a statewide medical cannabis distribution system, allowing for the creation of up to 66 medical cannabis dispensaries and 200 production facilities as regulated by the Department of Health and Human Services (DHHS). The law also authorized reciprocity for out-of-state patients visiting Nevada and removed authorization for patients to cultivate their own cannabis.  Patients may qualify for an exemption from this provision if the nearest licensed medical cannabis dispensary is greater than 25 miles away from the patient’s residence.  Regulations governing the operation of Nevada’s medical system were organized in 2014 and 2015, with the first medical cannabis sale occurring in July of 2015.  


In 2016, Nevada Department of Health and Human Services put patient applications online and began issuing temporary cards allowing patients to enroll and access medicine more quickly. That same year Nevada voters approved Question 2, authorizing the creation of an adult-use cannabis licensing regime and retail model in the Battle Born State.  As Nevada adopted regulations on Question 2 in 2017, the state also increased employment protections and removed the state-imposed sales tax on medical cannabis. In 2018, Nevada promulgated permanent rules for their adult-use of cannabis model.  The regulations allowed adult-use and medical cannabis establishments to be co-located and operate under the same license and strengthened testing protocols for medical cannabis.


2019 saw Governor Sisolak sign into law AB 132 and AB 192, ending the practice of denying employment predicated on a positive cannabis screening in Nevada.  The bills also allow persons convicted of a cannabis offense prior to state decriminalization efforts to have their records sealed.  The Governor also signed SB 533 into law in 2019, which created two new regulatory advisory commissions, whose role will be to coordinate and provide recommendations to the Governor and legislature on improvements to the state’s cannabis access programs.  SB 533 also authorized licensing public consumption facilities subject to local approval, but failed to specifically allow consumption of cannabis at these establishments.  The Nevada Cannabis Compliance Board was tasked with organizing a study on the viability of consumption lounges; recommendations were made to legislators who approved the new license type for 2022.


In 2020, Nevada’s response to COVID expanded several access features, including continuing delivery of medical cannabis as well as allowing for curbside pickup, and allowing for patients to secure eligibility via telehealth visits with their physicians rather than in-person visits.