In November 2004, Montana voters by a significant margin (62 percent) passed Initiative I-148, allowing certain patients with specific medical conditions to alleviate their symptoms through the limited use of marijuana under medical supervision. Montana issues registry ID cards allowing qualified patients who are Montana residents to use cannabis legally. Patients may designate licensed providers to assist them with obtaining their medicinal cannabis. Registry ID cards are to be carried by the patient or provider at all times. 

SB 423, which went into effect on July 1, 2011, changed the application process to require a Montana driver's license or state issued ID card.  SB 423 also required confirmation from a second physician when the patient's debilitating condition was chronic pain (the second physician requirement was repealed by I-182 (described below)).

The Montana Marijuana Program has undergone several drastic changes in recent years. Several of the original regulations were repealed in 2011 by SB 423, which prohibited dispensaries and caregivers. New regulations have been issued in 2011 and 2012, which established the rules for “providers,” who could supply a limited number of patients with medicine, and could not be reimbursed for their services.

Most of SB 423's provisions remained on hold following its passage due to constitutional challenges against it. The Montana Supreme Court, after hearing arguments in November of 2015, issued its opinion in February 2016..  The Montana Supreme Court upheld most of the provisions of SB 423 as constitutional, although it did strike down the restriction against medical marijuana providers receiving compensation.  In response to a petition for rehearing and a motion to stay, the Montana Supreme Court delayed the effectiveness of its February 2016 opinion until August 31, 2016.

However, on November 8, 2016, the Montana Medical Marijuana Initiative, also known as I-182, was approved by the voters of Montana (58% - 42%).  I-182, among other things, renamed the governing statute as the “Montana Medical Marijuana Act” and added post-traumatic stress disorder as a qualifying condition.  Furthermore, I-182 repealed several certain aspects of SB 423, including the three patient limit put into effect by SB 423, the restrictions on compensation for medical marijuana providers, as well as the requirement of a second physician’s confirmation of a chronic pain condition.  Certain parts of I-182 went into effect immediately while others will be effective on June 30, 2017.

Montana Supreme Court opinion issued on February 25, 2016 in Montana Cannabis Industry Association et al v. State of Montana, which upheld all but one provision of the 2011 Montana Marijuana Act (SB 423), which was subsequently amended in November 2016 as a result of the passing of Initiative I-182.  


Montana Voter Initiative I-148

Montana Senate Bill 423

Montana Voter Initiative I-182


Chapter 46. Use of Marijuana for Debilitating Medical Conditions