The State of Medical Marijuana in Rhode Island

2020 Grade: C+

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

2019-2020 Improvements and Recommendations

In 2019, RI issued guidance and began accepting applications from licensed medical cannabis dispensaries to begin delivery services, of which 17,994 are currently enrolled in the state’s program. The state also authorized a lottery system for awarding licenses to new medical cannabis dispensaries, a strategy that runs the risk of licensing operators who may not be capable of running a functional operation. In 2020, the state expanded its number of licensed retailers, adding six new licenses to improve patient access.50 The state also introduced proposals for state-run cannabis retail facilities in 2020, an effort proposed by a few other states in previous years that were unsuccessful due to the conflict of federal and state cannabis laws.

Rhode Island was thorough in the state’s expansion of cannabis provisions responding to COVID-19. The state’s emergency plans maintained operations of medical cannabis businesses, authorized curbside pickup and delivery, and is permitting current and prospective patients to utilize telehealth for physician evaluations related to enrollment.

For 2021, ASA encourages lawmakers to focus on many of the reforms outlined in H 7621, program improvement legislation introduced in 2020. Specifically legislators should work to pass provisions of the measure addressing the high cost of cannabis products, discrimination against patients who are state employees, and state discrimination against persons seeking employment in the cannabis industry with prior drug convictions. Lawmakers are also encouraged to approve legislation extending patient protections to parents and veterans, and improve laboratory testing and labeling standards. ASA recommends that Rhode Island permanently maintain the enhancements added to the state’s medical program under COVID.


In 2006, Rhode Island enacted the Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act, allowing in-state patients with a Rhode Island registry ID card to use, possess and cultivate cannabis. Under the law registered patients may possess up to 2.5 ounces of usable cannabis and may cultivate up to 12 plants. Patients may appoint up to two primary caregivers for assistance or designate a compassion center as one of the caregivers, and qualified patients and caregivers are entitled to an affirmative defense at trial or dismissal of charges. Authorized patient eligibility is determined by physician certification that the patient suffers from one or more of eight qualified conditions provided for by the state, and language in the law provides access for patients with chronic pain.

Legal patient access became a little more realistic in 2009 when the Rhode Island Department of Health was authorized to license not-for-profit compassion centers to retail medical cannabis. However the state failed to provide licensed medical retail access for nearly seven years from the date it enacted authorizing legislation. In 2011, Governor Chafee suspended licensing of compassion centers in response to threats from federal prosecutors, though licensing resumed in January 2012 after background checks and additional plant limits were added to the licensing requirements. By 2013 compassion centers were serving patients.

In 2014, the General Assembly approved legislation removing caps on cultivation for compassion centers, and allowing patients and caregivers to sell excess medical cannabis to compassion centers. Product shortage issues were addressed again in 2016 when the state created a new cultivation licensing category, the same year the state added PTSD as a qualifying condition to its list of eligible conditions. Rhode Island also deserves credit for protecting patient employee rights through the courts in Callaghan v. Darlington Fabrics Co. et. al., (R.I. Super. Ct. 2017).

In 2016, Rhode Island approved a number of changes to its medical access program, which include requirements for patients to affix a tracking tag to each medical cannabis plant grown and pay $25/tag unless financial hardship can be demonstrated. The location of registered patient and caregiver cultivation sites must also be disclosed. Additional reforms were organized for dispensing facilities, including more stringent product testing and safety standards, inventory tracking and the removal of a requirement that patients designate a single dispensary as their source of cannabis medicine. Cultivators were finally provided a separate licensing category as well, offering patients improved product volume to mitigate shortages and potentially driving down the high cost of medical cannabis. Finally, the changes sunsetted in 2019 a patient and caregiver’s authority to cultivate cannabis collectively, requiring patients to either choose to grow their own medical cannabis or defer the responsibility to a designated caregiver.

In 2018, Rhode Island approved several program improvements, including reciprocity access for out-of-state patients, criminal records expungement legislation, and adding autism spectrum disorder as a qualifying condition.

Patient Feedback

Surveyed patients report frustration that there are not enough dispensaries in the state, causing many to have to drive long distances for access. In addition, some surveyed patients would like to do away with the qualifying conditions list in the state, preferring instead to empowering doctors rather than lawmakers or regulators to decide if and when medical cannabis should be recommended. Surveyed patients would like to see the curbside pickup, delivery services and telehealth COVID response measures maintained in the future.