The State of Medical Marijuana in North Carolina

2020 Grade: F

2015 2016 2017 2018-2019 2020

2019-2020 Improvements and Recommendations

In 2019, North Carolina state lawmakers introduced comprehensive medical cannabis legislation, however the bill was not provided a hearing before the legislature adjourned in 2020. Lawmakers also introduced legislation in 2019 to add autism, Crohn’s disease, multiple sclerosis, mitochondrial disease and other conditions to the state’s list of eligible conditions required to participate in the state’s limited CBD-only access model. ASA recommends that North Carolina lawmakers approve comprehensive medical cannabis legislation in 2021. Such a system should authorize robust patient access, organize patient legal protections from housing and education to parental and employment rights, and organize an in-state licensing regime for commercial cannabis cultivators, manufacturers, testing laboratories, distributors and medical retailers.


In July 2014, North Carolina enacted the North Carolina Epilepsy Alternative Treatment Act (HB 1220), creating a pilot program that allows medical use of CBD-rich oil only for registered patients diagnosed by a neurologist at one of four universities as having intractable epilepsy. The CBD-rich oil authorized by the law for patients to access must contain at least 10 percent CBD, no more than 0.3 percent THC, and must have no other psychoactive components. Patients admitted to the state’s extremely limited program must demonstrate that at least three other treatment options have not been successful in addressing the underlying health condition. The law stipulates that access is only through a registered caregiver who must be a parent, guardian, or legal custodian, and who must obtain the CBD oil in a state with reciprocity to purchase medical cannabis products. Most medical cannabis jurisdictions that honor reciprocity for other state registration cards do not allow patients/caregivers from out of state to purchase any medical cannabis products.

In 2015, Governor McCory signed HB 766 into law, legislation amending 2014’s HB 1220 to expand the types of qualified physicians who may recommend state-authorized medical cannabis products to patients to include any board certified physician certified in neurology and affiliated with any state-licensed hospital. The bill also changed the required THC/CBD percentages for medical cannabis from greater than 10 percent CBD and less than 0.3 percent THC to greater than 5 percent CBD and less than 0.9 percent THC. Finally the law enhanced patient privacy, but also included a sunset clause ending the state’s medical cannabis program in 2021 if studies fail to show therapeutic relief from CBD.

Patient Feedback

Surveyed patients report being frustrated that medical cannabis is still illegal in North Carolina, except for the limited population of patients with seizure disorders, and that the state only has a limited CBD program.