Medical cannabis in the United States
As of June 2016, 25 states and Washington D.C. have legalized cannabis for medical use as voter or legislative driven initiatives bypassing the normal Food and Drug Administration testing for safety and efficacy. As of May 2016, 3 states have pending legislation or ballot measures. There is considerable variation in medical marijuana laws from state to state.
In the United States, there are important legal differences between medical cannabis at the federal and state levels. At the federal level, cannabis per se has been made criminal by implementation of the Controlled Substances Act, but as of 2009, new federal guidelines have been enacted. According to U.S. Attorney General Eric Holder, "It will not be a priority to use federal resources to prosecute patients with serious illnesses or their caregivers who are complying with state laws on medical marijuana, but we will not tolerate drug traffickers who hide behind claims of compliance with state law to mask activities that are clearly illegal."
California passed an initiative to allow medical cannabis in 1996. In the intervening years, multiple states have passed similar initiatives. A January 2010 ABC News poll showed that 81 percent of Americans believed that medical cannabis should be legal in the United States.
On December 16, 2014, Congress passed a law prohibiting federal agents from raiding growers of medical marijuana in states where it is legal.
- 1 Overview
- 1.1 Qualifying conditions
- 1.2 Alaska
- 1.3 Arizona
- 1.4 Arkansas
- 1.5 California
- 1.6 Colorado
- 1.7 Connecticut
- 1.8 Delaware
- 1.9 Georgia
- 1.10 Hawaii
- 1.11 Illinois
- 1.12 Iowa
- 1.13 Maine
- 1.14 Maryland
- 1.15 Massachusetts
- 1.16 Michigan
- 1.17 Minnesota
- 1.18 Montana
- 1.19 New Hampshire
- 1.20 Nevada
- 1.21 New Jersey
- 1.22 New Mexico
- 1.23 New York
- 1.24 Ohio
- 1.25 Oregon
- 1.26 Pennsylvania
- 1.27 Rhode Island
- 1.28 Tennessee
- 1.29 Texas
- 1.30 Vermont
- 1.31 Washington
- 1.32 Washington, D.C.
- 1.33 Wisconsin
- 2 Opposition and support
- 3 Effects
- 4 See also
- 5 References
- 6 External links
|Timeline of medical marijuana legalization in the USA|
The Federal Food, Drug, and Cosmetic Act of 1938 makes the U.S. Food and Drug Administration (FDA) the sole government entity responsible for ensuring the safety and efficacy of new prescription and over-the-counter drugs, overseeing the labeling and marketing of drugs, and regulating the manufacturing and packaging of drugs. The FDA defines a drug as safe and effective for a specific indication if the clinical benefits to the patient are felt to outweigh any health risks the drug might pose. The FDA and comparable authorities in Western Europe, including the Netherlands, have not approved smoked cannabis (partly because of the problems related to smoking per se and the inherent crudeness of it as an effective and dosed delivery mechanism) for any condition or disease. Indeed, the FDA has not approved medical cannabis in any form for any indication.
Cannabis remains illegal throughout the United States and is not approved for prescription as medicine, although 25 states—Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, and Washington—as well as the District of Columbia approve and regulate its medical use. (The Federal government continues to enforce its prohibition in these states.)
Cannabis also remains a U.S. federally controlled substance, making possession and distribution illegal. Those seeking to acquire medical cannabis may have to resort to the black market in order to obtain the product if their state does not allow the existence of legal dispensaries. However, in some states—such as Colorado—legal dispensaries are plentiful, and there is no need to resort to the black market.
Two American (for-profit) companies, Cannabis Science Inc., and Medical Marijuana, Inc., are working towards getting FDA approval for cannabis based medicines (including smoked cannabis). Cannabis Science Inc. wants to have medical cannabis approved by the FDA so anyone, regardless of state, will have access to the medicine. Also, there is one non-profit organization, the Multidisciplinary Association for Psychedelic Studies (MAPS) working towards getting Cannabis approved by the FDA for PTSD.
The process for applying to do research is openly published, yet little formal FDA peer reviewed scientific research has been conducted. One firm, GW Pharmaceuticals—manufacturers of Sativex for the treatment of multiple sclerosis (the only marijuana based compound approved by any industrialized nation)—is headquartered in the United Kingdom and is doing operations under review of the UK's Department of Health. GW Pharma claims the process for research approval is simpler in the UK and has stated their belief UK approval of compounds could be a springboard to make the US process easier for them.
Cannabis was listed in the United States Pharmacopeia from 1850 until 1942. The United States Federal government does not currently recognize any legitimate medical use, although there are currently four patients receiving cannabis for their various illnesses through the Compassionate Investigational New Drug program that was closed to new patients in 1991 by the George H. W. Bush administration. Twenty three U.S. state laws, as well as the District of Columbia, currently allow for the medicinal use of cannabis, but the United States Supreme Court ruled that the Federal government has the right to regulate and criminalize cannabis also in these states, even for medical purposes.
The term "medical marijuana" post-dates the U.S. Marijuana Tax Act of 1937. Enacted by the Franklin D. Roosevelt administration, the tax act made cannabis prescriptions illegal in the United States. Since the creation of the DEA, the agency has spent over US$100 billion trying stop the flow of illegal drugs into the United States. States that have legalized marijuana have seen an increase in revenue though taxation. For example, in 2008, the state of Hawaii made over US$10 million through taxation of medical marijuana.
Mossification, on par with heroin, LSD and ecstasy. In 2005, the U.S. Supreme Court ruled in Gonzales v. Raich that the Commerce Clause of the U.S. Constitution allows the government to ban any use of cannabis, including medical use. The United States Food and Drug Administration states "marijuana has a high potential for abuse, has no currently accepted medical use in treatment in the United States, and has a lack of accepted safety for use under medical supervision".
As of June 2016, 25 states and the District of Columbia, starting with California in 1996, have legalized medical cannabis or effectively decriminalized it: Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Massachusetts, Maryland, Michigan, Minnesota,Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York,Ohio, Oregon, Pennsylvania, Rhode Island, Texas, Vermont, Washington; Maryland allows for reduced or no penalties if cannabis use has a medical basis. Despite legalization of marijuana in Washington and Colorado, an employee may still be fired if they test positive on a drug test, despite having a doctor's recommendation. California, Colorado, Connecticut, Arizona, New Mexico, Maine, Rhode Island, Montana, Michigan, Nevada and Oregon are currently the only states to utilize dispensaries to sell medical cannabis; Massachusetts is planning to do so. During 2008, California's medical cannabis industry took in about $2 billion and generated $100 million in state sales taxes with an estimated 2,100 dispensaries, co-operatives, wellness clinics and taxi delivery services in the sector colloquially known as "cannabusiness".
Some individual states such as Oregon choose to issue medical marijuana cards to residents with a doctor's recommendation after paying a fee and providing access to seed to sale tracking software Motagistics. Each State shall use a similar tracking system based on need of the individual vendor and state mandated solutions
In October 2009, the U.S. Deputy Attorney General issued a U.S. Department of Justice memorandum to "All United States Attorneys" providing clarification and guidance to federal prosecutors in states that have enacted medical marijuana laws. The document is intended solely as "a guide to the exercise of investigative and prosecutorial discretion and as guidance on resource allocation and federal priorities." It includes seven criteria to help determine whether a patient's use, or their caregiver's provision, of medical cannabis "represents part of a recommended treatment regiment consistent with applicable state law". The Department advised that it "likely was not an efficient use of federal resources to focus enforcement efforts on seriously ill individuals, or on their individual caregivers. ... Large-scale, for-profit commercial enterprises, on the other [hand], ... continued to be appropriate targets for federal enforcement and prosecution."
The sale and distribution of cannabis remains illegal under federal law, however, as the Food and Drug Administration's position—that marijuana has no accepted value in the treatment of any disease in the United States—remains unchanged.
In November 2011, in accordance with 35 U.S.C. 209(c)(1) and 37 CFR part 404.7(a)(1)(i), the NIH announced that it is contemplating the grant of an exclusive patent license to practice the invention embodied therein to KannaLife Sciences Inc.. The prospective exclusive license territory may be worldwide, and the field of use may be limited to: The development and sale of cannabinoid(s) and cannabidiol(s) based therapeutics as antioxidants and neuroprotectants for use and delivery in humans, for the treatment of hepatic encephalopathy, as claimed in the Licensed Patent Rights.
Below is a comparison of which common qualifying conditions will allow a patient to receive medical marijuana in their respective states. The list is not comprehensive and could include out-of-date information.
|State||Cancer||Glaucoma||HIV/AIDS||Parkinson's disease||Multiple sclerosis||Epilepsy||Seizures||Wasting syndrome||Crohn's disease||PTSD|
|District of Columbia||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes|
The medical use of cannabis, Ballot Measure # 8, was endorsed by 58% of voters in Alaska in November 1998 and the law became effective on March 4, 1999. The law legalizes the possession, cultivation and use of cannabis for patients who have received a certificate from a doctor confirming they can benefit from the medical use of cannabis. The conditions and symptoms eligible are: cachexia, cancer, chronic pain, epilepsy and other conditions characterized by spasms, chronic glaucoma, HIV or AIDS, multiple sclerosis and nausea. The state maintains a confidential list of patients who are assigned an identity card.
Arizona's proposition 203, also called "Arizona Medical Marijuana Act", was a measure to legalize the use of medical cannabis and appeared on the general election ballot via a citizen petition. The initiative will allow patients with a "debilitating medical condition" to possess up to 2.5 ounces of marijuana every two weeks with a doctor's recommendation. They will also be able to cultivate no more than twelve cannabis plants only if they do not live within twenty-five miles of a state licensed marijuana dispensary. Arizona has allocated the licensing of dispensaries at a ratio of one per ten pharmacies in the state, or a total of 124. The outcome of Prop. 203 was not announced until Sunday, November 14, 2010, when it passed by 4,300 votes, or 50.1% yes to 49.9% no. Arizona legislature passed an exception to Arizona Proposition 203 (2010) in early February 2012, in the form of House Bill 2349. This new bill states that medical marijuana cannot be used in educational institutions and child care facilities.
In November 2012, voters rejected The Arkansas Medical Marijuana Act which would have allowed up to 30 medical marijuana dispensaries to open in Arkansas and let patients possess up to 2.5 ounces of cannabis. Cities and counties would have been able to ban marijuana dispensaries under the law. The act failed by a vote of 51.4% – 48.6%. Issue 6, an amendment to the state constitution, passed November 8, 2016.
In 1996, California voted Proposition 215, also called the Compassionate Use Act, into law. CA Senate Bill 420 was passed in 2003 to clarify Proposition 215 by specifying statewide minimum limits on possession of cannabis and enact a Statewide Medical Cannabis ID Card Program (the G214 card). As of January 16, 2008, only 36 of 58 counties are issuing cards in the program, with 18,847 cards having been issued, however, participation in the ID Card program is optional and the identification card is not required to claim the Act's protections.
On November 5, 1996, 56% of voters approved Proposition 215, which added Section 11362.5 to the California Health and Safety Code. The law removes state-level criminal penalties on the use, possession, and cultivation of cannabis by patients who possess a "written or oral recommendation" from their physician that he/she "would benefit from medical cannabis." Patients diagnosed with any illness where the medical use of cannabis has been "deemed appropriate and has been recommended by a physician" are provided with legal protection under this act. Conditions typically covered by the law include: arthritis; cachexia; cancer; chronic pain; HIV or AIDS; epilepsy; migraine; and multiple sclerosis, with other conditions like insomnia, reduced appetite, anxiety, and PTSD often treated also. No regulations regarding the amount of cannabis patients may possess and/or cultivate were provided by this act, though the California Legislature adopted guidelines in 2003.
On November 7, 2000, 54% of Colorado voters passed Amendment 20, which amended the Colorado State constitution to allow the medical use of marijuana. Patients can possess "No more than two ounces of a usable form of marijuana" and not more than six cannabis plants, and they may neither take their medicine in public, nor even on their own property, if the public can see them taking it.
In November 2009, in Breckenridge, Colorado, 70% of voters elected to amend the town code to remove all criminal and civil penalties, including fines, for the private possession of up to one ounce of marijuana. More than 70% of local voters voted yes on a similar, but unsuccessful, statewide measure in 2005.
In December 2010, CNBC aired a one-hour special titled Marijuana USA that focused on the tremendous growth of the legal cannabis trade in Colorado as marijuana emerges from the black market to the mainstream market.
Following the first day of legalized recreational marijuana sales in Colorado, the retailers claimed they made over $1 million in sales statewide. Most of the 24 stores that opened on January 1, 2014 were located in Denver. In accordance with federal banking legislation, the marijuana retailers remain prohibited from using bank accounts to manage the revenue from sales, as the drug continues to be prohibited by federal law; however, the U.S. Department of Justice and federal regulators stated in September 2013 that they will assist Colorado's marijuana retail industry to negotiate a reasonable arrangement. The state government stated that the tax revenue from sales will be used for school construction and marijuana regulation.
In September 2014, a legislative panel did not endorse a bill to limit the number of marijuana plants each grower and patient can possess.
On June 15, 2015, the Colorado Supreme Court ruled that even though medical marijuana is legal in Colorado, employers can fire workers who use marijuana for medical reasons because it violates federal law. The case involved a quadriplegic who had a doctor’s authorization to smoke medical marijuana, but who was fired by Dish Network in 2010 after failing a company drug test.
As of January 31, 2016, the total number of patients who possess valid medical marijuana ID cards in Colorado was 107,798.
On May 5, 2012, the Connecticut State Senate passed a bill approving the use of medical marijuana. Connecticut became the 17th state to legalize medical marijuana on June 1, 2012, after Governor Dannel Malloy signed a bill into law. Some portions of the law were effective immediately while the remaining portions became effective on October 1, 2012.[ambiguous]
On May 13, 2011, Delaware became the 16th state to legalize medical cannabis after Governor Jack Markell signed the bill. The bill passed the state senate on May 11 by a 17-4 vote. Patients who certify they have a serious medical condition are allowed to possess up to six ounces, or, of cannabis. State-licensed centers are allowed to grow the marijuana and dispense it to patients 18 and older.
In Georgia, House Bill 1 was passed by the state Senate and state House on March 25, 2015, and was signed by Governor Nathan Deal on April 16, 2015. Governor Nathan Deal also signed a Georgia Executive Order on March 27, 2015 to prepare state agencies for the use of cannabis oil. House Bill 1 allows the use of cannabis oil with no more than 5 percent THC to treat 8 conditions as recommended by a physician.
In Hawaii, Senate Bill 862 became law on June 14, 2000, which removes state-level criminal penalties on the use, possession and cultivation of marijuana by patients who possess a signed statement from their physician affirming that he or she suffers from a debilitating condition and that the "potential benefits of medical use of marijuana would likely outweigh the health risks." Patients diagnosed with the following illnesses are afforded legal protection under this act: cachexia; cancer; chronic pain; Crohn’s disease; epilepsy and other disorders characterized by seizures; glaucoma; HIV or AIDS; multiple sclerosis and other disorders characterized by muscle spasticity; and nausea. The law establishes a mandatory, confidential state-run patient registry that issues identification cards to qualifying patients. Patients can possess a maximum of one ounce of usable cannabis and a maximum of 7 cannabis plants.
Illinois Governor Pat Quinn signed a medical Pre-marijuana legalization bill into law on August 1, 2013. The law allows 2.5 ounces of marijuana to be prescribed every two weeks to patients suffering from any of a specific list of illnesses. The prescribing doctor must also have a prior & ongoing care relationship with the patient. The law took effect on January 1, 2014.
Iowa law gives control of marijuana policy to the Iowa Pharmacy Board. On November 2, 2010, the Iowa Board of Pharmacy declared marijuana to be a schedule three drug. What that classification means is that marijuana is a drug with potential benefits. The Iowa Board of Pharmacy created rules and regulations regarding medical marijuana usage, claiming that it should be an issue decided by the citizens of Iowa. In 2015, Board members rebuffed a request that they recommend changing Iowa law’s classification of marijuana in a way that would make it easier to use the drug for medical purposes.
On November 2, 1999, 62% of voters in Maine passed Question 2. Patients or their primary physicians could possess a maximum of 1 1⁄4 ounces (35 g) of usable cannabis and a maximum of 6 plants. The law was amended when Maine Senate Bill 611 was signed into law on April 2, 2002, increasing the maximum quantity of usable cannabis a patient is allowed to possess to 2 1⁄2 ounces.
In November 2009, Maine voters approved Question 5, the Maine Marijuana Medical Act. The measure amends existing state law by: establishing a confidential patient registry, expanding the list of qualifying conditions for which a physician may recommend medicinal cannabis, and by allowing for the creation of non-profit state-licensed marijuana dispensaries to assist in the distribution of medical cannabis to qualified patients.
The legislature of Maryland passed a "medical marijuana affirmative defense law" in the year 2003, and amended it May 10, 2011. If someone is being prosecuted by the state for certain marijuana related crimes, then the court is required by law to consider a defendant's "medical necessity." If medical necessity is proven, possession up to one ounce carries no penalty – higher possession and cultivation may then only be fined $100. In April 2014, The Maryland legislature passed a bill lowering penalties for small amounts of marijuana possession to civil fines.
On November 6, 2012, Massachusetts voters passed the Massachusetts Medical Marijuana Initiative with 63% support, legalizing the use of medical marijuana and establishing a state-regulated distribution network. Massachusetts was the 18th state to legalize the medical use of marijuana. A decision will have to be made regarding the specifics of Question 3 going into effect by May 1.
On December 10, 2013, Michigan voters introduced SENATE BILL 660 to amend the Public Health Code to specify that marijuana, including pharmaceutical-grade cannabis, would be a schedule II controlled substance if manufactured, obtained, dispensed, or grown in compliance with the Public Health Code.
On November 4, 2008, Michigan voters passed the Michigan Medical Marijuana Initiative, also known as Proposal 1, a measure allowing the use of medicinal cannabis for patients with debilitating medical conditions (including cancer, multiple sclerosis and HIV). Statewide the measure passed with 63% voting yes. The measure was approved by voters in every one of Michigan's 83 counties. The measure also required Michigan's health department to create a registry of qualified patients. Growing cannabis was also approved, for registered individuals using secure facilities. The mandate also introduced a medical necessity defense clause for persons without a card or who use cannabis to treat ailments not covered by the law.
On May 29, 2014, Governor Dayton signed into law a bill establishing a medical marijuana program in Minnesota.
On November 2, 2004, voters of Montana passed Initiative 148, which took effect immediately. The vote was 62% yes to 38% no. It eliminated criminal sanctions for medical cannabis authorized by a patient's physician. Possession of as many as six cannabis plants is allowed.
On July 25, 2013, Gov. Maggie Hassan signed HB 573, making New Hampshire the 19th state to allow medicinal cannabis to certain qualified patients.
On November 7, 2000, voters in Nevada passed Question 9, amending the state constitution to sanction medical cannabis. The vote was 65% yes to 35% no. The law provides that patients may possess a maximum of 1 ounce (28 g) of usable cannabis and grow a maximum of 12 cannabis plants.
On January 11, 2010, the New Jersey legislature approved a measure legalizing medical cannabis for patients with severe chronic illnesses, the New Jersey Compassionate Use Medical Marijuana Act. Governor Corzine signed the bill into law on January 18. As of 2015 there were three marijuana dispensaries in the state.
In 1978, New Mexico signed into law H.B. 329, later renamed "The Lynn Pierson Marijuana Treatment & Research Act" which provided legal cannabis to authorized patients until the program was defunded in 1986.
On June 3, 2013, the NY State Assembly passed a bill that would legalize medical marijuana in a vote of 99 to 41. It was delivered to the Senate and was voted down. On January 4, 2014, Governor Cuomo announced an upcoming initiative to enact medical marijuana laws by executive order. On June 20, 2014, the Legislature passed a bill allowing non-smokable medical marijuana. On July 5, 2014, Governor Cuomo signed New York's medical marijuana bill into law with a ceremonial signature taking place the following Monday in New York City.
On June 8, 2016, Ohio Governor John Kasich signed into law a bill permitting the use of medical marijuana for close to twenty different conditions. The bill only permits the use of marijuana in non-smoking form, i.e. patches, vapor or edible, plant material must be vaped. The law takes effect beginning in September. Ohio is the 25th state to legalize a comprehensive medical marijuana program in the United States.
"The Oregon Medical Marijuana Program," administers the Medical Marijuana Act approved there by the public in November 1998 through Oregon Ballot Measure 67 (1998). The vote was 55% yes to 45% no. The Oregon Medical Marijuana Program administers the program within the Oregon Department of Human Services. Virtually all patients benefiting from the program suffer from severe pain and almost 2500 from nausea. The other conditions are given as epilepsy, AIDS / HIV, cancer, cachexia, chronic glaucoma and tremors caused by Alzheimer's disease. As of January 1, 2012, there were 57,386 registered patients with medical cannabis cards.
On January 26, 2015, the Pennsylvania State Senate introduced Senate Bill 3 to legalize medical marijuana, which eventually passed 40-7. It was referred to the PA House Health Committee where Chairman Matt E. Baker refused to allow it to come to a vote. On June 26, 2015, it was re-referred to the PA House Rules Committee where Chairman and Majority Leader Dave L. Reed formed a working committee to figure out how to proceed with the bill so it can pass the Pennsylvania House of Representatives. On March 16, 2016, the House passed the bill by a vote of 149-43 after 207 proposed amendments were narrowed down to 30.
On January 3, 2006, The Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act (Rhode Island) became law and simultaneously went into effect. It legalizes medical cannabis, provided that certain conditions are met. Patients can possess a maximum of 2.5 ounces of cannabis and a maximum of 12 cannabis plants.
On June 16, 2009, the Rhode Island legislature overrode a gubernatorial veto of a bill authorizing up to three medical marijuana dispensaries in the state. The House voted 68-0 for the cannabis measure and the senate followed minutes later by a 35-3 count. The new law will make Rhode Island the third state, following New Mexico and California, to allow the sale of medical cannabis. Under the new law, one marijuana dispensaries will be authorized to open in 2010, to be followed by two more in 2011.
In 2011, Governor Chafee announced that he was putting a hold on the licenses that were to be issued to the 3 Compassion Centers. As of 2016, there were 3 marijuana dispensaries in Rhode Island.
On May 4, 2015, Governor Bill Haslam, acting on the advice of his Health Commissioner, John Dreyzehner, signed legislation that would allow the use of CBD, but not the plant itself, to treat cases of seizures and epilepsy, and have the recommendation of their doctor.
Texas legalized CBD for the treatment of epilepsy on June 1, 2015, with the passage of the Texas Compassionate Use Act. The act permits certain physicians (usually neurologists) to prescribe CBD for the treatment of epilepsy in patients who have not responded to other treatments. Before a physician is able to prescribe CBD under this act, he/she must complete specialized training on the proper use and administration of the oil. 
Other than this, cannabis is still currently illegal under Texas law, including for medical purposes
In Vermont, Senate Bill 76 went into effect July 1, 2004, legalizing medical cannabis, provided certain conditions are met. Patients or their primary doctor are allowed to possess a maximum of 2 ounces of usable cannabis and a maximum of 3 cannabis plants, a maximum of which one can be mature.
Vermont Senate Bill 7 went into effect July 1, 2007, further defining which patients qualify for medical cannabis and how much they may possess without penalty of law at the state level. The amendment allows physicians licensed outside of Vermont to recommend medical cannabis for Vermont patients.
The State of Washington adopted a law in November 1998 (Initiative 692), legalizing the use, possession, and cultivation of cannabis for patients with a medical certificate. The vote was 59% yes to 41% no. The legislature amended the statute in 2007 and 2010. After June 10, 2010, the medical documentation may be issued by a physician, physician assistant, naturopath, or advanced registered nurse practitioner; it must be on tamper-resistant paper and accompanied by photo ID. The following conditions are eligible: cachexia, cancer, HIV or AIDS, epilepsy or other seizure disorders, glaucoma unrelieved by standard drugs or treatments, chronic pain otherwise intractable, Crohn's disease with intractable symptoms, Hepatitis C with intractable nausea or pain, and multiple sclerosis. According to the law in Washington, a qualified patient and the patient's designated provider may together possess not more than a 60-day supply; it is presumed in regulation that this will be not more than 24 ounces of usable marijuana and not more than 15 marijuana plants.
In November 2012, Washington voters passed Initiative 502 which legalized cannabis for recreational use. The initiative passed 55 to 45 percent and allows citizens over the age of 21 to possess up to an ounce of marijuana. It provides a new "drugged driving" law with guidelines for THC levels that are illegal, akin to blood alcohol levels.
A bill by the Washington, D.C. council was not overruled by Congress. Medical cannabis became legal on Jan. 1, 2011. Dispensaries have begun opening  and cultivation centers are in process to be permitted. The DC council has also reduced penalties for possession of 1 oz. of marijuana to a $25 civil fine without jail. This bill was signed by the Mayor and took effect in July 2014.
Opposition and support
The American Medical Association (AMA) and the United States Food and Drug Administration (FDA) remain categorically opposed to use of marijuana for medicinal purposes without customary FDA safety and efficacy testing.
In its consideration of the topic in November 2013, the AMA rejected their California delegation's proposal that the AMA drop its opposition and become neutral on states' adoption of medical marijuana measures. Also, the AMA reaffirmed past positions to "Discourage cannabis use, especially by persons vulnerable to the drug's effects and in high-risk situation", "Support the determination of the consequences of long-term cannabis use through concentrated research, especially among youth and adolescents", and "Support the modification of state and federal laws to emphasize public health-based strategies to address and reduce cannabis use."
According to the FDA: "The FDA has not approved marijuana as a safe and effective drug for any indication." The FDA continues to warn manufacturers of possible violations of the Federal Food, Drug, and Cosmetic Act of 1938.
Notable pro-medical cannabis advocates
In 2011, the Marijuana Policy Project called on the government to allow the FDA-approved study of veterans. The California Medical Association called for legalization of marijuana on October 15, 2011, stating to the Los Angeles Times that the question of whether marijuana is a medicine "can only be answered once it is legalized and more research is done".
Some university-sponsored studies have concluded that patients using medical marijuana end up decreasing use of prescription narcotics, and in some cases was perceived marijuana as more effective at relieving pain.
Notable anti-medical cannabis advocates
Politicians who oppose the medicinal use of cannabis include: former Attorney General Bonnie Dumanis, former Arkansas governor Mike Huckabee Barry McCaffrey, Arizona's Republican Senior Senator John McCain, former Massachusetts governor Mitt Romney, and Maryland Democrat Theodore J. Sophocleus.
A 2016 study finds that medical marijuana laws are associated with significant drops in violent crime.
A 2016 study finds that the legalization of marijuana for recreational purposes reduces rapes and thefts.
A 2013 study found that medical marijuana legalization is associated with an 8-11% reduction in traffic fatalities.
Multiple studies have shown that states that legalize medical marijuana have higher rates of marijuana use, but this does not appear to reflect a cause and effect relationship between these two factors.
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