The State of Medical Marijuana in Guam

2020 Grade: C

2015 2016 2017 2018-2019 2020

2019-2020 Improvements and Recommendations

Initial regulations governing Guam’s adult-use cannabis program authorized in 2019 by the Guam Cannabis Industry Act were required to be released by April 2020, however the territory’s Cannabis Control Board has requested additional time to develop these new rules and expects them to be released in the fall of 2020. In the meantime, regulators announced that cannabis consumption for persons 21 years of age or older is permitted, as is legal possession and gifting of up to one ounce of dried flower and home cultivation of up to three flowering and three non-flowering plants. All sales of adult-use cannabis and sales of manufactured cannabis products is not permitted until regulations are finalized. In the meantime the organization of a functioning medical access program continues to languish. In 2018 the head of Guam’s Department of Public Health and Social Services resigned citing a lack of staff, budget or expertise necessary to develop or implement the program.

Guam deserves credit for allowing physicians to recommend medical cannabis for any qualifying condition, but it needs to open dispensaries and address administrative delays to effectively serve patients. The territory illustrates that a good program on paper does not necessarily translate to functioning safe and legal patient access. Guam also needs to improve its staff training in cannabis cultivation, dispensing, and manufacturing and increase civil rights protections in the areas of housing, organ transplants, and employment.


In 2013, Guam passed Public Law 33-220, known as the “Joaquin Concepcion, II Compassionate Use of Cannabis Act,” which allowed for the medical use of cannabis. The Joaquin Concepcion Act has been amended twice since its enactment, once in 2016 and once again in 2017. The 2017 amendments related to the fees and taxation of medical cannabis cultivation, manufacturing, and laboratory facilities and created ownership restrictions for non-residents of Guam. Guam requires each of its dispensaries to be certified by Patient Focused Certification, a standards project of Americans for Safe Access. Patients or caregivers may possess up to 2.5 ounces of dried or prepared cannabis from a dispensary. However, administrative barriers and procedural delays have prevented the program from effectively serving patients. In 2018, rules defining qualified patients in Guam were expanded to include reciprocity for registered patients visiting Guam from other authorizing jurisdictions, such as a U.S. state.

Delays in the implementation of the medical program in Guam have frustrated patients. Due to a slow rollout, former Governor Calvo signed a bill that allows home cultivation for patients, though this will only apply until dispensaries on the island are operational. Calvo also signed a bill that provided for independent laboratory testing and allowed non-residents to participate in the territory’s medical cannabis program. In 2019, Governor Lou Leon Guerrero signed a bill that legalized cannabis on the island for non-medical use. When signing the bill, the Governor indicated that she was establishing a Medical Cannabis Regulation Commission to ensure patients were protected.

Patient Feedback

Surveyed patients again report that the lack of medical providers who are willing to recommend medical cannabis in Guam is driving many patients to seek cannabis from the illicit market.