North Dakota

A health care provider such as a physician, advanced practice registered nurse (APRN) or physician assistant (PA) may recommend medical cannabis under North Dakota’s Medical Marijuana Program following the guidelines below:

• Physicians and physician assistants must be licensed through the North Dakota Board of Medicine and have a license in good standing.
• APRN’s must be licensed through the North Dakota Board of Nursing and have a license and good standing.

Written certification, a mandatory form that must be part of a patient's application, can only be signed if a bona fide provider-patient relationship exists. To determine a bona fide provider-patient relationship:

• The healthcare provider has reviewed the patient's relevant medical records and completed a full assessment of the patient's medical history and current medical condition, including a relevant, in-person medical evaluation of the patient.
• The healthcare provider has created and maintained records of the patient's condition in accordance with medically accepted standards.
• The patient is under the healthcare provider's continued care for the debilitating medical condition that qualifies the patient for the medical use of marijuana.
• The healthcare provider has a reasonable expectation that they will continue to provide follow-up care to the patient to monitor the medical use of marijuana as a treatment of the patient's debilitating medical condition.
• The relationship is not for the sole purpose of providing written certification for the medical use of marijuana.

Under state law, a healthcare provider is not subject to arrest or prosecution, or denial of any right or privilege solely for providing a written certification or for refusing to provide a written certification. A healthcare provider is also not required to provide a written certification. A healthcare provider who holds a financial interest in a Compassion Center may not issue a written certification, refer a patient to a Compassion Center, refer a patient to a designated caregiver, or advertise in a Compassion Center.

• cancer;
• positive status for human immunodeficiency virus (HIV);
• Acquired Immune Deficiency Syndrome (AIDS);
• decompensated cirrhosis caused by hepatitis C;
• amyotrophic lateral sclerosis;
• post-traumatic stress disorder;
• agitation of Alzheimer's disease or related dementia;
• Crohn's disease; fibromyalgia; spinal stenosis or chronic back pain,
• including neuropathy or damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity;
• glaucoma; epilepsy; anorexia nervosa; bulimia nervosa;
• anxiety disorder;
• Tourette syndrome;
• Ehlers-Danlos syndrome; endometriosis;
• interstitial cystitis; neuropathy;
• migraine; rheumatoid arthritis;
• autism spectrum disorder;
• a brain injury;
• a terminal illness;
• or a chronic or debilitating disease or medical condition or treatment for such disease or medical condition that produces one or more of the following: (1) cachexia or wasting syndrome; (2) severe debilitating pain that has not responded to previously prescribed medication or surgical measures for more than three months or for which other treatment options produced serious side effects; (3) intractable nausea; (4) seizures; or (5) severe and persistent muscle spasms, including those characteristic of multiple sclerosis.

More information, patient instructions, and applications can be found on the North Dakota Medical Marijuana Program website.

Medical professionals have a legal right to recommend cannabis as a treatment in any state, as protected by the Medical Marijuana and Cannabidiol Research Expansion Act (Title III section 301) which became law on December 2, 2022, and the First Amendment (established by a 2004 United States Supreme Court decision to uphold earlier federal court rulings that doctors, and their patients have a fundamental Constitutional right to freely discuss treatment options).

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