The State of Medical Marijuana in Missouri

2020 Grade: C-

2015 2016 2017 2018-2019 2020
F F F C C-

2019-2020 Improvements and Recommendations

Since approving rules in 2019 governing the state’s medical cannabis program approved by voters in 2018, Missouri has been successful at licensing a population of cultivators, processors and dispensaries that are expected to begin serving patients as soon as this fall36. By the end of 2020 the state hoped to have 192 dispensaries open to serve patients, with 60 cultivators and 86 processors licenced to provide a sufficient supply of medical cannabis products. However state attention to COVID may disrupt facility licensing, inspection and opening. The state currently maintains a population of 22,706 registered patients, who are permitted to apply for home cultivation licences in order to grow their own medical cannabis.37 Responding to COVID, Missouri authorized patients to utilize telemedicine for physician evaluations.

ASA is excited for the initiation of the state’s medical program this fall, and encourages lawmakers to focus in 2021 on improving patient protections covering civil, parental and employment rights, as well as protections for renters and those in subsidized housing.


In 2014, Missouri passed HB 2238, which created a legal right for eligible patients to obtain, possess, and use hemp extracts in limited circumstances. The law defines a hemp extract as a preparation of cannabis that contains at least 5 percent CBD and no more than 0.3 percent THC, and only allows access to these extracts for patients with severe seizure disorders who have a recommendation from a neurologist and state hemp registration card. Patients are allowed to purchase hemp extracts from two state-regulated “cannabidiol oil care centers”, which were licensed by the Department of Agriculture in 2015 and began serving patients in 2016.

In 2018, Show-Me State voters did just that, approving Amendment 2 and authorizing the creation of a comprehensive medical cannabis framework. The measure allows for home cultivation and personal possession limits of up to four ounces for a 30 day period (no more is allowed without demonstrating a medical necessity). Though the program created by Amendment 2 contains a patient condition list to obtain eligibility, it also allows doctors to use their professional judgement as to whether or not medical cannabis may assist a patient. This flexibility is notable and something for other states with limited condition lists to consider. Rules governing program operation were released in May of 2019, and state regulators began accepting applications for medical cannabis dispensaries in August of that year. Initial Missouri medical cannabis sales are expected in 2020.

Patient Feedback

Even though a medical cannabis law was passed, surveyed patients express frustration that they do not currently have access to medical cannabis, as there are still no dispensaries open at this time.