Recommending Cannabis in Maryland

Certifying Providers

Maryland healthcare providers are required to register online with the Commission. Physicians must provide their Maryland physician’s license number and controlled dangerous substance number to complete the form.  In addition, physicians must specify the conditions or diseases that they plan to treat, as well as any criteria for including or excluding patients. This form must be renewed every two years.

Physicians must have a “bona fide physician-patient relationship”, which is a treatment or counseling relationship between a physician and a patient in which the physician reviews the patient’s medical records, completes an in person assessment of the patient’s medical history and current medical condition, creates and maintains standard medical records, expects to monitor patient’s program, and takes any medically required actions to follow up with the patient.

If a physician determines that a patient’s condition, treatment or disease qualifies him/her for medical cannabis, the physician must go to the Commission website to issue the patient a written certification. The written certification must have the patient’s name, address, date of birth, physician’s name, date of patient qualification and medical condition. At a minimum, the physician must also perform an in person evaluation at least once every year in order to continue to issue a written certification for the patient.

The Commission is encouraged to approve of physician applications for the following medical conditions:

(1) a chronic or debilitating disease or medical condition that results in a patient being admitted into hospice or receiving palliative care; or

(2) a chronic or debilitating disease or medical condition or the treatment of a chronic or debilitating disease or medical condition that produces:

 (i) cachexia, anorexia, or wasting syndrome;

 (ii) severe or chronic pain;

 (iii) severe nausea;

 (iv) seizures; or

 (v) severe or persistent muscle spasms.

The Commission may also approve of applications that include any other conditions that are severe and for which other medical treatments have been ineffective if the symptoms reasonably can be expected to be relieved by the medical use of cannabis.

The physician registration form and written certification form is available on the Commission website:

Starting June 2017, the list of healthcare providers that may provide a written certification recommending the medical use of cannabis will be expanded to include dentists, podiatrists and nurse practitioners.

Affirmative Defense

Maryland allows for an affirmative defense for possession and use of medical cannabis or paraphernalia, if the patient has a debilitating medical condition diagnosed by a physician with whom the patient has a bona fide physician-patient relationship, the debilitating medical condition is severe and resistant to conventional medicine, and marijuana is likely to provide the patient with therapeutic or palliative relief from the debilitation medical condition.  In addition, with respect to caregivers, they may put forth an affirmative defense for possession of drug paraphernalia, if it is related to cannabis for medical use of a patient with a debilitating condition for whom the defendant is the caregiver.

The affirmative defense may not be asserted by any defendant if the defendant was using cannabis in a public place or if the defendant was assisting a patient in using cannabis in a public place (if the defendant is a caregiver), or if the defendant was in possession of more than the legally allowed amount of cannabis.