Missouri

Navigating Washington State 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

NOTICE: It can be challenging for patients to determine which businesses offering cannabis products are licensed and approved by the state. Review this list of medical cannabis retailers and/or a list of adult use retailers to find out where to purchase regulated cannabis in Missouri. 

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Home cultivation is allowed in Missouri, for medical cannabis patients and caregivers. Six flowering marijuana plants, six non-flowering marijuana plants (over fourteen inches tall), and six clones (plants under fourteen inches tall) at any given time in a single enclosed facility. Growers must apply for a separate Patient Cultivation Card and pay a $53 fee. The card is separate from a medical marijuana card.

Background on State Laws

Medical cannabis is legal in Missouri, any registered patient or caregiver may possess up to 4 ounces of cannabis. A registered patient or caregiver over the age of 18 may apply for a home cultivation license. Patients may also purchase up to 4 ounces of cannabis, or its equal in other forms, per 30 day period from state licensed retailers. Missouri does not recognize out of state medical cannabis cards. Over the years, Missouri has continued to show flexibility in regard to their qualifying conditions list, allowing doctors to use their professional judgment as to whether or not medical cannabis may assist a patient. Details on how these laws apply to patients and medical professionals can be found below.

Although cannabis expungement has not occurred in Missouri, Amendment 3 was passed in 2022 to legalize marijuana use for adults. This prevents individuals from being subject to criminal prosecution and began movements towards cannabis expungement in the state of Missouri.

Here is a breakdown of how Missouri 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 Missouri can be found below. For policy updates Sign Up here or Take Action!

Patient Rights and Civil Protections	60/100
Arrest Protection 25/25 Affirmative Defense 20/20 Parental Rights Protections 10/20 DUI Protections 0/10 Employment Protections 0/20 Explicit Privacy Standards 5/5
Access to Medicine	65/100
Authorizes Retail Access 10/10 Alternative Accessibility Methods 10/20 - Authorizes Delivery 10/10 - Authorizes Curbside Pickup 0/10 Personal Cultivation 15/15 Collective Gardening 0/5 Sufficient Number of Licensed Retailers 30/30 Reciprocity 0/20
Program Functionality	83/100
Legal Protections Within Reasonable Time Frame 10/20 Reasonable Possession Limits 10/10 Reasonable Purchase Limits 8/10 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	40/100
Sales Tax Break for Patients and Caregivers 20/20 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	60/100
State Program Protections 25/25 Housing Protections 0/25 Access for Minors 10/10 Access in Underserved Areas 5/10 List of Qualifying Conditions is Exhaustive or All Inclusive 10/10 Allows Patients to Medicate Where they Choose 0/10 Organ Transplants 5/5 Ownership or Employment Restrictions 5/5
Consumer Protection and Product Safety	148/200
Cultivation Operations 36/50 Quality Management Systems 10/10 Staff Training 10/10 Standard Operating Procedures 5/8 - Facility and Equipment Sanitation 1/1 - Workplace Safety 1/1 - Storage 0/1 - Batch and Lot Tracking 1/1 - Security 1/1 - Waste Disposal 1/1 - Water Management 0/1 - Records Management 0/1 Pesticide Usage Limitations 0/2 Environmental Impact Regulations 0/2 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 3/7 Manufacturing Operations 38/50 Quality Management Systems 10/10 Staff Training 10/10 Standard Operating Procedures 5/7 - Facility and Equipment Sanitation 1/1 - Workplace Safety 1/1 - Storage 0/1 - Batch and Lot Tracking 1/1 - Security 1/1 - Waste Disposal 1/1 - Records Management 0/1 Environmental Impact Regulations 0/3 Required Testing 8/10 - 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 1/1 Packaging and Labeling 2/5 - Cannabinoids 1/1 - Terpenes 0/1 - Ingredients 1/1 - Allergens 0/1 - Nutritional Content 0/1 Complaints, Adverse Event Reporting and Recall Protocol 3/5 Dispensary Operations 29/50 Staff Training 20/20 Standard Operating Procedures 4/7 - Facility Sanitation 1/1 - Workplace Safety 1/1 - Storage 0/1 - Batch and Lot Tracking 1/1 - Security 1/1 - Waste Disposal 0/1 - Records Management 0/1 Product Testing 5/10 - Product Meets Requirements Before Sale 5/5 - COA Disclosure 0/5 Complaints, Adverse Event Reporting and Recall Protocol 0/13 Laboratory Operations 45/50 Independent or Third-Party 5/5 Laboratory Sampling 5/5 Method Validation 4/4 Quality Management Systems 10/5 Staff Training 10/20 Standard Operating Procedures 7/7 - Facility and Equipment Sanitation 1/1 - Equipment and Instrument Calibration 1/1 - Workplace Safety 1/1 - Sample Tracking 1/1 - Security 1/1 - Waste Disposal 1/1 - Records Management 1/1 Result Reporting 4/4
Score Penalties	0/100
Gives Regulatory Preference to Adult Use 0/20 Classifies Cannabis as a Medicine of Last Resort 0/15 Administrative or Supply Problems 0/15 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.