The State of Medical Marijuana in Montana

2020 Grade: B

2015 2016 2017 2018-2019 2020
C- D- B- B B

2019-2020 Improvements and Recommendations

The 2020 focus on cannabis in Big Sky Country has been squarely set on authorizing adult-use via ballot initiative.38 In November voters are being offered two complimentary ballot initiatives that would permit possession, use and sale of adult-use cannabis. However Montana patients were extended important access improvements under the state’s COVID emergency response plan, which permitted medical cannabis businesses to remain open. Other program enhancements included authorization of curbside pickup to reduce patient exposure to close contact, and permission for patients to utilize telehealth for physician evaluations. ASA recommends that Montana maintain these new program elements, which improve ease of access and reduce costs for patients. ASA also encourages state lawmakers to improve civil, parental and employment rights for patients, as well as housing protections for renting patients and those in subsidized housing.


In 2004, 62 percent of Montana voters approved the Montana Medical Marijuana Allowance (I-148), allowing registered patients with a qualified condition to use, possess, and cultivate medical cannabis and designate a caregiver to assist them. In 2011, the Montana legislature passed legislation (SB 423) repealing many of the provisions of I-148. SB 423 became the subject of a lengthy court challenge, with the Montana Supreme Court ruling in 2016 to uphold most of the provisions of the law. That same year Big Sky Country voters approved I-182, which not only restored many of the rights granted to patients in I-148, but also added PTSD and removed restrictions on chronic pain for qualifying conditions.

Governor Bullock signed SB 333 into law in 2017, authorizing mandatory testing of medical cannabis products to improve patient safety, seed-to-sale tracking of all licensed cannabis plants in the supply chain, and imposing a 4 percent tax on medical cannabis that was reduced to 2 percent in 2018. The tax was later increased to 4 percent to assist with program funding. In 2019, Montana enacted SB 265, which made improvements to laboratory testing, telemedicine and removed the requirement that patients must only obtain medicine from a single dispensing facility. This is a noteworthy program improvement, offering patients much greater access flexibility and consumer choice.

Patient Feedback

Surveyed patients report that there are not enough dispensaries in the state. Surveyed patients would like to see approvals for more permits to grow and sell medical cannabis.