The State of Medical Marijuana in Oklahoma

2020 Grade: B

2015 2016 2017 2018-2019 2020

2019-2020 Improvements and Recommendations

Oklahoma has quickly organized an operational medical access program since the 2018 voter approval of Question 788, the state ballot initiative authorizing the creation of a state-operated medical cannabis policy framework. By May of 2020, Oklahoma had issued 2,428 dispensary licenses, 6346 grower licences, and 1,611 processor licences, which have been instrumental in forming the medical cannabis industry backbone required to provide functional patient access. Though not all of these licenses are currently operational, the ratio of one licensed dispensary for every 116 patients produced by this configuration is an excellent monitor for overall patient accessibility which patients in other states are left to envy.47 Patients in Oklahoma now represent 8.33 percent of Oklahoma’s population, the most significant representation of registered cannabis patients of any state.

Beyond making significant progress on medical cannabis industry buildout and patient enrollment, Oklahoma has also improved laboratory testing requirements. As of April of 2020, all cannabis products cultivated or processed must be tested by a state-licensed laboratory per legislation approved in 2019 and 2020 Oklahoma Medical Marijuana Authority guidance. OMMA also demonstrated a commitment to ensuring product safety when the regulatory body began recalling products deemed unsafe for patient use.48

Oklahoma also moved quickly to maintain and improve access for medical cannabis patients and keep them safe during the COVID pandemic. Key measures organized in 2020 included a declaration of medical cannabis dispensaries as essential, authorization of curbside pickup and delivery of cannabis medicine to patients and allowing patients to utilize telehealth for physician evaluations required for patient re-enrollment. As state lawmakers and regulators look to 2021, ASA recommends permanently maintaining these measures.


In 2015, Governor Fallin signed HB 2154, Katie and Cayman’s Law, which allows physicians in Oklahoma to recommend a high-CBD cannabis oil (less than 0.3 percent THC) to minors suffering from a severe epilepsy disorder such as Lennox-Gastaut or Dravet Syndrome. In 2016, the state adopted HB 2835, which expanded legal protections to patients of all ages and added several new qualifying conditions including spasticity due to Multiple Sclerosis or paraplegia, intractable nausea and vomiting, and appetite stimulation with chronic wasting diseases. In March of 2017, a lawsuit was resolved allowing Question 788 - the Medical Marijuana Legalization Initiative to appear on the June 2018 Ballot, where voters approved the initiative by 57 percent.

Under Question 788 registered patients may possess up to three ounces of medical cannabis flower and one ounce of concentrated medical cannabis, and may also cultivate up to six mature plants with another six vegetative plants. Regulations governing the operation of the new law were approved quickly in 2018, which also removed the ban on smoking cannabis as a treatment method, the requirement that all dispensaries have a pharmacist on staff and the patient eligibility condition list. That same year the Oklahoma Court of Civil Appeals ruled that the presence of an intoxicating substance in the blood does not automatically mean impairment, which is a victory for those patients who may be drug tested in the workplace. The Oklahoma Medical Program grew rapidly in 2019, as no licensing caps were imposed on medical retail facilities. By the beginning of the fourth quarter of 2019, state regulators had issued almost 7,000 licenses to cannabis businesses and registered over 200,000 patients.

2019 saw Oklahoma implement a number of new reforms to the state’s medical access program. Included in these reforms were reduced application fees for low income patients, an expansion of the type of licensed physicians who may recommend medical cannabis and organization of guidelines for inventory testing, tracking, advertising, packaging and labeling. Lawmakers also approved HB 2612, which establishes a Medical Marijuana Authority within the state Department of Health, outlines the rights of patients who are firearm owners, allows patients to have 2-year registrations, permits veterans to participate in the program and creates a medical cannabis research licensing category.

Patient Feedback

Surveyed patients report that there is an adequate number of dispensaries in the state, creating a very competitive market for the benefit of patients in the state that helps reduce costs to patients and provides for ease of access. Surveyed patients would like to see Oklahoma’s pre ordering, curbside pickup, and telehealth program enhancements organized under COVID maintained in the future.