Question of the Month: What states permit the use of medical marijuana, and in those states, how is use of the drug regulated?

Stateline Midwest ~ May 2013

Medical marijuana is now legal in 18 states and the District of Columbia. Only one of those states — Michigan — is in the Midwest, though several bills were introduced in the region this year (see map) to legalize medical marijuana, which is used to relieve severe pain, control nausea and stimulate appetites.

Michigan voters approved a ballot measure legalizing medical marijuana in 2008, and since then, policymakers have grappled with how to best regulate its use and distribution.

Under Michigan law, a physician can authorize marijuana use for certain illnesses — such as cancer, glaucoma and AIDS — and for certain chronic, debilitating conditions such as wasting disease, chronic and severe pain, and nausea (usually resulting from treatment for another illness).

Patients, or their caregivers, who have written documentation from their physician can possess and grow up to 12 plants or possess 2.5 ounces of marijuana. In other states, the amount of marijuana a registered user can possess ranges from one to 24 ounces (or a 60-day supply in Massachusetts), and the number of plants a user can possess ranges from four to 24.

Michigan does not have marijuana dispensaries. In contrast, most of the other 18 medical-marijuana states permit pharmacies or for-profit dispensaries, or require the marijuana to be sold by nonprofit dispensaries. These dispensaries are licensed and regulated; in some cases, too, states allow localities to ban dispensaries.

This year, several laws took effect in Michigan clarifying and expanding some of the rules regarding medical marijuana. For example, HB 4834 extends the period a patient’s registry card is valid from one year to two years and also requires proof of state residency. 

According to the Michigan Department of Licensing and Regulatory Affairs, the number of new or renewed applications (since the law took effect) had reached nearly 379,000 as of April. There are more than 130,000 active, registered patients in the state system as well as 27,000 active, registered primary caregivers. The department has denied about 10 percent of the applications, mostly due to incomplete applications or missing documentation.

Another new law in Michigan (the result of HB 4851) requires a “bona fide physician-patient relationship”: Doctors must see the patient in person, review his or her medical records, and follow up to ensure that the marijuana is helping the patient.

Legislation has been or is being considered in several other states in the Midwest this year. One of those states is Illinois, where the House passed HB 1 in mid-April. If enacted into law, the measure would limit possession to 2.5 ounces, require a patient and doctor to have a previous doctor-patient relationship, and require a patient to get a state ID. Use would be limited to patients with specific conditions.