This report reflects a complete analysis of medical cannabis programs across the United States, in an effort to objectively evaluate how those programs serve patients. “Medical Marijuana Access in the United States: A Patient-Focused Analysis of the Patchwork of State Laws” has been updated, expanded and refined over the last three years to convey the state of medical cannabis in America, serve as a tool for comparing different laws and regulations, and assign simple letter grades.

Our grading system has not yet awarded an A grade to any state. However, in comparing year to year, we can see a general upward trend in the scores. There are medical cannabis programs of some kind in 46 states, the District of Columbia, and the territories of Guam and Puerto Rico. The highest grade awarded was an 89.8% (B+) to California and the lowest was a 23.4% (F) awarded to Wisconsin.

A development we saw over the last year that had a significant impact in scoring was the implementation of good product safety regulations. Alaska's regulatory improvements for labeling, testing and training brought their program up a letter grade. On the other hand, most drops in score were related to restrictions on access like the Florida Department of Health preventing the use of dried cannabis flowers.

Our last observation takes place in the context of America's opioid crisis. A major area most all states could improve is making medical cannabis a front-line treatment option for those living with pain. West Virginia which passed their law just this year clearly has pain and opioid use as major objectives for it's medical cannabis program. Other state's lawmakers should look to them to see how medical cannabis can help combat this public health crisis.