The State of Medical Marijuana in Illinois

2020 Grade: B+

2015 2016 2017 2018-2019 2020
B+ B+ B+ A- B+

2019-2020 Improvements and Recommendations

The most significant 2019 cannabis policy reforms were focused establishing an adult-use commercial cannabis marketplace that opened in January 2020. Some patient-focused reforms to the state’s medical program were also adopted, including making the state’s medical cannabis access program permanent, initially authorized as a pilot in 2014, as well as the addition of 11 new qualifying conditions, including chronic pain. The state also passed Ashley’s Law, which allows students to use medical cannabis under the supervision of certain school personnel while on school property.

Included in legislation authorizing commercial adult-use cannabis business licensing are provisions requiring existing medically licensed stores to maintain an adequate supply of cannabis and cannabis products for patients. ASA was pleased to see this provision included, as too often states fail to ensure the functionality of existing medical access systems and patient access prior to shifting focus to adult-use.

Under COVID emergency rules Illinois declared medical cannabis dispensaries essential, authorized curbside pickup and permitted patients to utilize telehealth screenings for program eligibility determinations rather than in-person visits with physicians.

ASA applauds the state for mandating geographic distribution of the original 55 medical cannabis facilities and hopes to see patient access expanded through the licensing of additional retail storefront in 2020. ASA also recommends reforming requirements for retail storefronts to maintain an ongoing and adequate supply of specific products to respond to frustration raised by patients over the inconsistency of product availability.18


In 2013, the Compassionate Use of Medical Cannabis Pilot Program Act (HB 1) was enacted to create a temporary statewide distribution program for qualifying patients. The measure specified 35 qualifying conditions to secure patient access, but excluded chronic pain, the leading indication for the use of medical cannabis. HB 1 allowed patients to purchase up to 2.5 ounces of cannabis every two weeks from a dispensing organization. Cultivation by patients or their caregivers is permitted for up to five plants only from seeds purchased from licensed cannabis retailers. Public safety officials, school bus and commercial drivers, police and correctional officers, firefighters, and those convicted of a drug-related felony are not eligible for the program.

The Joint Committee on Administrative Rules approved final rules for the pilot program on July 15, 2014 with input from the Departments of Agriculture, Financial and Professional Regulation, Public Health, and Revenue. The state’s first dispensaries began serving patients in November 2015. In 2016, the legislature passed SB 10, which extended the sunset clause for the program to 2020, added PTSD and terminal illness as qualifying conditions, established a petition process for adding new conditions, amended the process by which physicians certify patients, and extended the registration identification card validity period from one year to three years.

In 2018, Illinois instituted significant reforms to the state’s medical cannabis program improving patient access. Designed to respond to the state’s opioid crisis, the reforms removed requirements for patients to be fingerprinted and undergo a criminal background check before qualifying for access. These modifications also addressed regulatory delays to patient access by allowing online patient applications accompanied by a doctor’s recommendation to secure temporary legal access until regulators can formally review patient registry applications. As a result the number of registered patients in the state grew quickly from roughly 42,000 to over 100,000 patients since these regulations were adopted in late 2018. In 2018, the state also began to allow medical cannabis in schools and allowed for anyone with a prescription for opioids to trade in that prescription for medical cannabis.

In 2019, Illinois became the first state to legalize the non-medical use of cannabis through the legislature. This legislation allows patients to cultivate up to five plants at home and will exempt patients from taxes once Illinois’ adult-use market is in place. The Illinois legislature also made the medical program permanent, added new qualifying conditions, and allowed nurse practitioners and physician assistants to issue recommendations. As of February 1, 2019, patients who submit Medical Cannabis Registry Card applications online receive provisional access to a licensed dispensary within 24 hours of completing the application process.

Patient Feedback

Surveyed patients report being frustrated that medical cannabis products are still expensive. Surveyed patients are struggling to find consistent product availability in dispensaries. They blame the recreational market for the decrease in supply and the increase in cost of cannabis products.