Medical cannabis in the United States#Compassionate IND program

The medical use of cannabis dates back thousands of years, to ancient China, India, and Egypt. It was popularized in Western medicine by the Irish physician William Brooke O'Shaughnessy, who was introduced to the drug in the 1830s while living abroad in India.{{cite book|last1=Mack|first1=Alison|last2=Joy|first2=Janet|title=Marijuana As Medicine?: The Science Beyond the Controversy|date=2001|publisher=National Academies Press|location=Washington, D.C.|isbn=978-0-309-06531-3|url=https://www.nap.edu/read/9586/chapter/1}} O'Shaughnessy documented a number of medical applications for cannabis from the experiments he conducted, noting in particular its analgesic and anticonvulsant effects. He returned to England with a supply of cannabis in 1842, after which its use as medicine quickly spread throughout Europe and the United States.{{citation|last1=Grinspoon|first1=Lester|title=History of Cannabis as a Medicine|date=August 16, 2005|url=http://www.maps.org/research-archive/mmj/grinspoon_history_cannabis_medicine.pdf}}

File:Old bottle of Parke Davis cannabis pills 2.jpg

Cannabis was entered into the United States Pharmacopeia in 1850, as a treatment for neuralgia, tetanus, typhus, cholera, rabies, dysentery, alcoholism, opiate addiction, anthrax, leprosy, incontinence, snakebite, gout, convulsive disorders, tonsillitis, insanity, excessive menstrual bleeding, and uterine bleeding. It was widely available in pharmacies and even grocery stores during the latter half of the 19th century, priced affordably relative to other drugs with no requirement for a doctor's prescription.{{cite book|last1=Booth|first1=Martin|title=Cannabis: A History|date=June 2005|publisher=St. Martin's Press|location=New York|isbn=978-0-312-42494-7|url=https://books.google.com/books?id=O7AoY6ljSygC}} Cannabis was commonly sold in tincture form by Parke-Davis, Eli Lilly, E. R. Squibb & Sons, and other drug manufacturers.{{cite news |last1=Borchardt |first1=Debra |title=Pfizer, Eli Lilly Were The Original Medical Marijuana Sellers |url=https://www.forbes.com/sites/debraborchardt/2015/04/08/pfizer-eli-lilly-were-the-original-medical-marijuana-sellers/ |access-date=March 3, 2019 |work=Forbes |date=April 8, 2015}}{{cite news |last1=Wren |first1=Adam |title=Eli Lilly's Hazy Memory |url=https://www.indianapolismonthly.com/features/eli-lillys-hazy-memory/ |access-date=March 3, 2019 |work=Indianapolis Monthly |date=March 2019}}

By the end of the 19th century, the use of cannabis in medicine had declined due to a number of factors, including difficulty in controlling dosages and the rise in popularity of synthetic and opium-derived drugs. The advent of the hypodermic syringe also allowed these drugs to be injected for immediate effect, in contrast to cannabis which is not water-soluble and therefore cannot be injected.{{cite book|last1=Boire|first1=Richard Glen|last2=Feeney|first2=Kevin|title=Medical Marijuana Law|date=January 26, 2007|publisher=Ronin Publishing|url=https://books.google.com/books?id=c1Tw_UFU2XEC|isbn=9781579510343}} Additionally, as fears regarding the recreational use of cannabis began to take hold (prompted by sensationalist media reports and government propaganda campaigns), states began passing legislation to restrict the sale and possession of cannabis, eliminating its availability as an over-the-counter drug. By 1936, every state had passed a law of this manner.

The use of cannabis as medicine further declined with the passage of the Marihuana Tax Act of 1937. The purpose of the act was to prohibit all non-medical use of cannabis in the U.S.; however, it also had the effect of severely curtailing medical use of the drug, due to new fees and regulatory requirements put in place that imposed a significant burden on doctors prescribing cannabis.{{cite journal|last1=Pacula|first1=Rosalie Piccardo|title=State Medical Marijuana Laws: Understanding the Laws and Their Limitations|journal=Journal of Public Health Policy|volume=23|issue=4|pages=413–439|date=February 2002|doi=10.2307/3343240|url=http://impacteen.uic.edu/generalarea_PDFs/medicalmarijuanapaper100301.pdf|jstor=3343240|pmid=12532682|citeseerx=10.1.1.202.2274|s2cid=13389317}} For this reason the American Medical Association opposed the Marihuana Tax Act of 1937, but to no avail. Cannabis was removed from the U.S. Pharmacopeia in 1941, at the urging of famed anti-cannabis crusader Harry Anslinger.{{cite book |last1=Brecher |first1=Edward M. |title=Licit and Illicit Drugs: The Consumers Union Report on Narcotics, Stimulants, Depressants, Inhalants, Hallucinogens, and Marijuana – Including Caffeine, Nicotine, and Alcohol |date=1972 |publisher=Little, Brown and Company |isbn=978-0316107174 |url=http://www.druglibrary.net/schaffer/Library/studies/cu/cu56.html}}

During the 1960s, as large numbers of people began to use cannabis recreationally, the medical utility of cannabis was rediscovered by some as anecdotes began to appear about its effectiveness in treating a variety of medical conditions. It was officially banned for even medical use, however, following the passage of the 1970 Controlled Substances Act. Despite the strict federal prohibition in place, cannabis continued to gain renewed interest as medicine in the 1970s and 1980s, in particular due to the testimonials of cancer and AIDS patients who reported significant relief from the effects of chemotherapy and wasting syndrome.{{citation|last1=Joy|first1=Janet E.|last2=Watson|first2=Stanley J.|last3=Benson|first3=John A.|title=Marijuana and Medicine | Assessing the Science Base|url=https://medicalmarijuana.procon.org/wp-content/uploads/sites/37/iom_report.pdf|publisher=National Academy Press|location=Washington, D.C.|date=1999}} The smoking method of consumption – popularized by recreational users of the drug – offered particular aid to patients who had trouble keeping down oral medication, and also offered advantages in terms of rapid onset of action and the ability to more carefully control dosages.

On October 27, 1970, the Comprehensive Drug Abuse Prevention and Control Act was signed into law by President Richard Nixon. Title II of the act – the Controlled Substances Act – established a system under which all controlled substances are categorized, varying from Schedule I (the strictest classification) to Schedule V (the least strict). Cannabis was placed in the Schedule I category, assumed to have a high potential for abuse and no accepted medical use – thereby prohibiting its use for any purpose.{{citation|last1=Eddy|first1=Mark|title=Medical Marijuana: Review and Analysis of Federal and State Policies|url=https://medicalmarijuana.procon.org/wp-content/uploads/sites/37/medicalmarjiuanastatepolicies040210.pdf|publisher=Congressional Research Service|date=April 2, 2010}} This placement was intended only as a temporary measure, however, pending the results of a commission formed under decree of the CSA to study the dangers of cannabis. Formally known as the National Commission on Marihuana and Drug Abuse, the Shafer Commission – led by former Pennsylvania governor Raymond P. Shafer – submitted the first of its two final reports to the President and Congress in March 1972. Although the report did not address the subject of scheduling,{{cite news|last1=Gardner|first1=Fred|title=How Nixon Destroyed the Evidence on Marijuana|url=https://www.marijuana.com/news/2014/08/richard-nixon-was-the-marijuana-antichrist/|access-date=May 16, 2017|work=marijuana.com|date=August 5, 2014|archive-url=https://web.archive.org/web/20170813224341/https://www.marijuana.com/news/2014/08/richard-nixon-was-the-marijuana-antichrist/|archive-date=August 13, 2017}} it found that the harms caused by cannabis were overstated, and recommended removal of criminal penalties for possession and distribution of small amounts of the drug.{{cite news|last1=Zeese|first1=Kevin|title=Once-Secret "Nixon Tapes" Show Why the U.S. Outlawed Pot|url=http://www.alternet.org/story/12666/once-secret_%22nixon_tapes%22_show_why_the_u.s._outlawed_pot|access-date=May 16, 2017|work=AlterNet|date=March 20, 2002|archive-url=https://web.archive.org/web/20180307234852/http://www.alternet.org/story/12666/once-secret_%22nixon_tapes%22_show_why_the_u.s._outlawed_pot |archive-date=March 7, 2018}} Despite these findings, no action was subsequently taken to move cannabis into a less restrictive category,{{cite book|last1=Anderson|first1=Patrick|title=High In America: The True Story Behind NORML And The Politics Of Marijuana|date=February 27, 1981|publisher=The Viking Press|isbn=978-0670119905|url=http://www.druglibrary.org/special/anderson/highinamerica.htm}} and the Schedule I classification of cannabis remains in place, alongside other drugs such as heroin, LSD, MDMA, DMT, and peyote – none of which can be prescribed. Schedule II drugs – determined to have a high potential for abuse but also some accepted medical use (thus able to be prescribed) – include cocaine, PCP, methamphetamine, oxycodone, and fentanyl.{{cite web|title=DRUG SCHEDULING|url=https://www.dea.gov/drug-information/drug-scheduling|website=dea.gov|access-date=May 23, 2021}}{{cite web|title=Controlled Substances|url=https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf|website=usdoj.gov|access-date=May 4, 2017}}

Since enactment of the Controlled Substances Act, there have been a number of efforts seeking to place cannabis in a less restrictive category, but none have succeeded. The Drug Enforcement Administration is granted authority under the CSA to change the classification of any drug, based upon the recommendation of the Food and Drug Administration which evaluates all drugs for safety and efficacy.{{citation |last1=Lampe |first1=Joanna R. |title=The Controlled Substances Act (CSA): A Legal Overview for the 118th Congress |url=https://crsreports.congress.gov/product/pdf/R/R45948/4 |work=Congressional Research Service |date=January 19, 2023}} A 2016 FDA review concluded that cannabis has "no currently accepted medical use in treatment in the United States", in response to a petition filed with the DEA in 2011 by the governors of Washington and Rhode Island.{{cite news|last1=Johnson|first1=Carrie|title=DEA Rejects Attempt To Loosen Federal Restrictions On Marijuana|url=https://www.npr.org/2016/08/10/489509471/dea-rejects-attempt-to-loosen-federal-restrictions-on-marijuana|access-date=April 15, 2017|work=NPR|date=August 10, 2016}} Previous efforts to petition the DEA for rescheduling have also been unsuccessful, spanning the years 1972–1994, 1995–2001, and 2002–2013. Congressional attempts to reschedule have failed as well, including a 1981 bill introduced by Representatives Stewart McKinney and Newt Gingrich that grew to 84 cosponsors but never received a floor vote.{{citation |title=Newt Gingrich's Letter Supporting Medical Marijuana |url=https://norml.org/pdf_files/NORML_Gingrich_Letter.pdf |website=NORML |date=March 19, 1982 |archive-url=https://web.archive.org/web/20191123045129/https://norml.org/pdf_files/NORML_Gingrich_Letter.pdf |archive-date=November 23, 2019}}{{cite web |title=All Information (Except Text) for H.R.4498 - A bill to provide for the therapeutic use of marijuana in situations involving life-threatening illnesses and to provide adequate supplies of marijuana for such use. |url=https://www.congress.gov/bill/97th-congress/house-bill/4498/all-info |website=congress.gov |date=September 18, 1981 |access-date=September 27, 2019}} However, President Joe Biden announced in October 2022 that he would ask the Secretary of Health and Human Services and Attorney General to initiate a review as to how cannabis should be scheduled under federal law, adding that the Schedule I classification of cannabis "makes no sense".{{cite news |last1=Wilkie |first1=Christina |title=Biden pardons thousands of people convicted of marijuana possession, orders review of federal pot laws |url=https://www.cnbc.com/2022/10/06/biden-to-pardon-all-prior-federal-offenses-of-simple-marijuana-possession-.html |access-date=October 6, 2022 |work=CNBC |date=October 6, 2022}}{{cite press release |date=October 6, 2022 |title=Statement from President Biden on Marijuana Reform |url=https://bidenwhitehouse.archives.gov/briefing-room/statements-releases/2022/10/06/statement-from-president-biden-on-marijuana-reform/ |publisher=The White House}} In August 2023, following a review by the Food and Drug Administration, the Department of Health and Human Services issued a recommendation to the DEA that cannabis be moved to Schedule III.{{cite news |last1=Fertig |first1=Natalie |last2=Demko |first2=Paul |title=Slightly higher times: Biden administration moves to loosen weed restrictions |url=https://www.politico.com/news/2023/08/30/marijuana-review-move-to-schedule-iii-00113493 |access-date=September 2, 2023 |work=Politico |date=August 30, 2023}} In April 2024, the DEA confirmed its intention to reclassify cannabis as a Schedule III drug, pending review by the Office of Management and Budget, a public comment period, and review by an administrative judge.{{cite news |last1=Miller |first1=Zeke |last2=Goodman |first2=Joshua |last3=Mustian |first3=Jim |last4=Whitehurst |first4=Lindsay |title=US poised to ease restrictions on marijuana in historic shift, but it’ll remain controlled substance |url=https://apnews.com/article/marijuana-biden-dea-criminal-justice-pot-f833a8dae6ceb31a8658a5d65832a3b8 |access-date=May 12, 2024 |work=Associated Press |date=April 30, 2024}}

The classification of cannabis as a Schedule I drug was first challenged by the National Organization for the Reform of Marijuana Laws (NORML) in a 1972 petition to the Bureau of Narcotics and Dangerous Drugs (which was merged with other agencies to form the DEA in 1973).{{cite journal|last1=Zeese|first1=Kevin|title=History of medical marijuana policy in US|journal=International Journal of Drug Policy|date=September 1, 1999|volume=10|issue=4|pages=319–328|doi=10.1016/S0955-3959(99)00031-6|url=https://vdocuments.site/history-of-medical-marijuana-policy-in-us.html|access-date=May 2, 2017}} After a decade of legal battles in which the DEA refused to consider the petition, public hearings were finally held on the matter beginning in 1986. In September 1988, after two years of extensive public hearings, DEA Chief Administrative Law Judge Francis L. Young ruled in favor of moving cannabis to a Schedule II classification, finding that "Marijuana, in its natural form, is one of the safest therapeutically active substances known to man."{{cite news |title=Judge Urges Allowing Medicinal Use of Marijauna |url=https://www.nytimes.com/1988/09/07/us/judge-urges-allowing-medicinal-use-of-marijauna.html |access-date=August 25, 2019 |work=The New York Times |agency=Associated Press |date=September 7, 1988}}{{cite news |last1=Isikoff |first1=Michael |title=DEA judge's 'fresh' view on legal marijuana use |url=https://www.washingtonpost.com/archive/politics/1988/09/19/dea-judges-fresh-view-on-legal-marijuana-use/2055d246-9003-403d-94a6-69fb9b469a3e/ |access-date=August 25, 2019 |newspaper=The Washington Post |date=September 19, 1988}} Young concluded: "The evidence in this record clearly shows that marijuana has been accepted as capable of relieving the distress of great numbers of very ill people, and doing so with safety under medical supervision. It would be unreasonable, arbitrary and capricious for DEA to continue to stand between those sufferers and the benefits of this substance in light of the evidence in this record."{{citation|last1=Young|first1=Francis L.|title=Opinion and Recommended Ruling, Findings of Fact, Conclusions of Law and Decision of Administrative Law Judge | In the Matter of: Marijuana Rescheduling Petition|url=https://images.procon.org/wp-content/uploads/sites/37/young1988.pdf|publisher=Drug Enforcement Administration|date=September 6, 1988}} As Young's ruling was only a non-binding recommendation, however, it was rejected by DEA Administrator John Lawn in December 1989.{{cite news |title=U.S. resists easing curb on marijuana |url=https://www.nytimes.com/1989/12/31/us/us-resists-easing-curb-on-marijuana.html |access-date=August 25, 2019 |work=The New York Times |agency=Associated Press |date=December 31, 1989}} In February 1994, a final ruling on the original 1972 petition was issued when a U.S. Court of Appeals upheld the decision to keep cannabis a Schedule I drug.

Despite an official policy denying the medical value of cannabis, the federal government began providing the drug to a limited number of patients through the Compassionate Investigational New Drug program in 1978. The program was created following a lawsuit filed by Robert Randall, a Washington, D.C. resident who was arrested for cultivating cannabis in 1975.{{citation|title=Patients in the Crossfire|url=http://american-safe-access.s3.amazonaws.com/documents/crossfire.pdf|publisher=American for Safe Access|date=2004}} Citing the glaucoma that threatened to take his eyesight, Randall employed a medical necessity defense at trial to justify his use of cannabis. The charges against Randall were dismissed, and as a result of an ensuing petition filed with the FDA, Randall became the first person to receive cannabis from the federal government in 1976. After his supply was cut off in 1978, he filed a lawsuit to have it restored, setting in motion the creation of the Compassionate Investigational New Drug program shortly thereafter.{{cite news|last1=de Coning|first1=Lexi|title=Irvin Rosenfeld: Meet the Longest-Surviving U.S. Federal Marijuana Patient|url=https://www.massroots.com/news/irvin-rosenfeld-meet-the-longest-surviving-us-federal-marijuana-patient|access-date=May 17, 2017|work=MassRoots|date=June 23, 2016|archive-url=https://web.archive.org/web/20170905004715/https://www.massroots.com/news/irvin-rosenfeld-meet-the-longest-surviving-us-federal-marijuana-patient|archive-date=September 5, 2017}} The program allowed patients with serious medical conditions to receive a regular supply of cannabis from the federal government; however, only 13 ended up participating due to the complicated and drawn-out application process involved.

The Compassionate IND program was closed to new patients in 1992, due to a flood of new applications from AIDS patients and concerns that the program undercut Bush administration efforts to discourage illegal drug use.{{cite news |last1=Isikoff |first1=Michael |title=HHS to phase out marijuana program |url=https://www.washingtonpost.com/archive/politics/1991/06/22/hhs-to-phase-out-marijuana-program/85908c08-c6d0-4aeb-9f43-3334ece0a35f/ |access-date=August 25, 2019 |newspaper=The Washington Post |date=June 22, 1991}} James O. Mason, the head of U.S. Public Health Service, explained that keeping the program in place created the perception that "this stuff can't be so bad", and noted that AIDS patients provided with cannabis would be more likely to engage in unsafe sex.{{cite book|last1=Lee|first1=Martin A.|title=Smoke Signals: A Social History of Marijuana – Medical, Recreational, and Scientific|date=August 2012|publisher=Scribner|location=New York|isbn=978-1439102602}} Twenty-eight applications that had recently been approved were rescinded, and only the 13 individuals who were already receiving cannabis were allowed to do so moving forward. All but two of the patients have since died; the surviving two patients are the only persons who currently receive cannabis through the program.{{cite news |last1=Devine |first1=Jimi |title=George McMahon, Who Got Medical Pot from the Feds for Decades, Passes Away |url=https://cannabisnow.com/george-mcmahon-passes-away/ |access-date=December 11, 2019 |work=Cannabis Now |date=December 3, 2019}}

Concurrent with the re-election of President Bill Clinton in 1996, California voters approved Proposition 215 to legalize the medical use of cannabis, and a similar (but ultimately ineffective) measure was passed in Arizona. In response, the Clinton administration reiterated its firm opposition to the medical use of cannabis, and threatened to revoke the prescription-writing abilities of doctors who recommend or prescribe the drug.{{cite news|last1=Savage|first1=David G.|last2=Warren|first2=Jenifer|title=U.S. Threatens Penalties if Doctors Prescribe Pot|url=https://www.latimes.com/archives/la-xpm-1996-12-31-mn-14152-story.html|access-date=August 19, 2017|work=Los Angeles Times|date=December 31, 1996}}{{cite news |last1=Gardner |first1=Fred |title=20 Years Ago Today US Threatened Tod Mikuriya |url=https://beyondthc.com/20-years-ago-today-mccaffrey-threatened-tod/ |access-date=November 1, 2021 |work=O'Shaughnessy's Online |date=December 30, 2016 |archive-url=https://web.archive.org/web/20170821024526/https://beyondthc.com/20-years-ago-today-mccaffrey-threatened-tod/ |archive-date=August 21, 2017}} Additionally, threats were made to criminally prosecute physicians, and ban them from participating in Medicare and Medicaid.{{cite news|title=Clinton Plan Attacks Medical Marijuana Initiatives, Targets Doctors|url=http://norml.org/news/1997/01/02/clinton-plan-attacks-medical-marijuana-initiatives-targets-doctors|access-date=May 7, 2017|work=NORML|date=January 2, 1997}} A group of physicians challenged this policy as a violation of First Amendment rights, and in September 2000 prevailed in the case Conant v. McCaffrey, which affirmed the right of physicians to recommend (but not prescribe) cannabis. Prior to the ruling, an April 1997 preliminary injunction prevented the administration from taking these actions.

Apart from the threatened crackdown on physicians, the administration conducted raids on a number of medical cannabis providers, leading to the filing of civil and criminal charges. At trial, prosecutors were set to easily secure convictions, as jurors could not be informed that the cannabis was for medical use authorized under state law. Drug czar Barry McCaffrey also railed strongly against the medical use of cannabis – deriding it as "Cheech & Chong medicine" – and worked behind closed doors to coordinate a media campaign to sway public opinion against approving further initiatives.

Despite previously speaking in support of states' rights on the issue of medical cannabis,{{cite news|last1=Hsu|first1=Spencer S.|title=Bush: Marijuana Laws Up to States|url=https://www.washingtonpost.com/wp-srv/politics/campaigns/wh2000/stories/bush102299.htm|access-date=May 7, 2017|newspaper=The Washington Post|date=October 22, 1999}} President George W. Bush escalated efforts to enforce federal law during his 8 years in office, with more than 260 raids conducted and 84 individuals prosecuted by his administration. Heavy use of paramilitary tactics and gear was common in execution of the raids, along with the frequent use of civil forfeiture, allowing cash and property to be seized without need for criminal conviction. In 2007, the administration began targeting landlords renting to medical cannabis facilities, informing property owners that they faced up to 20 years in prison for violating the "crack house statute" of the CSA, in addition to seizure of their properties. Drug czar John P. Walters was particularly active in opposing the medical use of cannabis, campaigning against initiatives in a number of states in what medical cannabis advocates charged was an inappropriate use of taxpayer dollars and a violation of the Hatch Act.{{cite news|title=MPP Files Complaints Charging Drug Czar Violated Election Laws|url=http://stopthedrugwar.org/chronicle-old/266/violation.shtml|access-date=May 7, 2017|work=stopthedrugwar.org|date=December 6, 2002}} During Bush's second term, in June 2005, the Supreme Court ruled in favor of the federal government's ability to enforce federal law in states that have legalized medical cannabis, in the case Gonzales v. Raich.

The presidency of Barack Obama was noted for a strong federal crackdown on medical cannabis during his first term in office, despite early indications that his administration would take a more hands-off approach. During his 2008 campaign for president, Obama expressed support for allowing states to implement their own medical cannabis policies, stating: "I'm not going to be using Justice Department resources to try to circumvent state laws on this issue."{{cite news|last1=Sullum|first1=Jacob|title=Bummer | Barack Obama turns out to be just another drug warrior|url=http://reason.com/archives/2011/09/12/bummer/singlepage|access-date=May 7, 2017|work=Reason|date=October 2011}} These comments were then echoed by the administration in March 2009 when Attorney General Eric Holder stated that only medical cannabis providers "who violate both federal and state law" would be targeted for prosecution.{{cite magazine|last1=Dickinson|first1=Tim|title=Obama's War on Pot|url=https://www.rollingstone.com/politics/news/obamas-war-on-pot-20120216|access-date=May 7, 2017|magazine=Rolling Stone|date=February 16, 2012|archive-url=https://web.archive.org/web/20170515040424/https://www.rollingstone.com/politics/news/obamas-war-on-pot-20120216|archive-date= May 15, 2017|url-status=dead}} Additionally, an October 2009 memo from Deputy Attorney General David Ogden laid out further guidelines for federal enforcement that largely affirmed this hands-off approach. Despite these pronounced intentions of lessened enforcement from the Obama administration, however, an increasing number of raids were conducted during Obama's first two years in office, surpassing even the Bush administration in frequency.

File:San Francisco, Cannabis is Medicine.jpg

Federal enforcement efforts against medical cannabis were further escalated in early 2011, as a campaign of coercing state and local governments was initiated by the Justice Department. Letters were sent out by U.S. Attorneys to a number of state and city officials, threatening to criminally prosecute these individuals if the implementation of new medical cannabis laws moved forward. Some letters also threatened prosecution of state employees, or even the seizure of state administrative buildings (such as those used for the processing of medical cannabis licenses).{{citation|title=THIRD TIME THE CHARM? | State Laws on Medical Cannabis Distribution and Department of Justice Guidance on Enforcement|url=http://american-safe-access.s3.amazonaws.com/documents/ASA_2013ColeMemo_WhitePaper.pdf|work=Americans for Safe Access|date=November 25, 2013}} In response to outcry and requests for clarification from numerous officials, a new memo was issued by Deputy Attorney General James M. Cole in June 2011. The Cole memo insisted that the 2009 Ogden memo was being adhered to, and that the Ogden memo's protections applied only to individual patients and not commercial operations. As the raids continued following release of the Cole memo, U.S. Attorneys sent out hundreds more letters over the next two years, threatening landlords with criminal prosecution and seizure of property for renting to medical cannabis providers. By June 2013, the total cost of the Obama administration crackdown on medical cannabis had climbed to $289 million, surpassing the previous 8 years of the Bush administration by $100 million. And the number of raids conducted during Obama's first 4 1/2 years had reached 270, in contrast to 260 during Bush's 8 years.

Early in President Obama's second term, in August 2013, the Justice Department issued a new Cole memo setting forth the conditions under which federal law would be enforced. The memo was prompted in particular by the recent legalization of non-medical cannabis in Washington and Colorado, but also addressed enforcement in medical cannabis states. Regarding the medical use of cannabis, the memo was considered to take a significantly more deferential approach towards the states (compared to the 2011 Cole memo), similar in nature to how the 2009 Ogden memo was originally widely interpreted. Federal enforcement efforts were further scaled back with the enactment of the Rohrabacher–Farr amendment in December 2014, although the Justice Department initially continued with a number of prosecutions until a pair of court rulings determined it was interpreting the amendment incorrectly.

On December 16, 2014, a landmark victory was achieved for medical cannabis at the federal level with the signing into law of the Rohrabacher–Farr amendment. Initially introduced by Rep. Maurice Hinchey in 2001, the amendment prohibits the Justice Department from spending funds to interfere with the implementation of state medical cannabis laws.{{cite news|last1=Angell|first1=Tom|title=Federal Medical Marijuana Amendment Author Dies At 79|url=https://www.marijuanamoment.net/federal-medical-marijuana-amendment-author-dies-79/|access-date=November 24, 2017|work=Marijuana Moment|date=November 24, 2017}} It failed 152–273 upon its initial vote in 2003, and was defeated five more times over the next decade until it passed the House by a 219–189 margin on May 30, 2014, as an attachment to the CJS Appropriations bill for fiscal year 2015.{{cite news|last1=Sherer|first1=Steph|title=First major victory in the fight to end federal interference|url=http://www.safeaccessnow.org/first_major_victory_in_the_fight_to_end_federal_interference|access-date=December 27, 2016|work=Americans for Safe Access|date=May 31, 2014}} It did not receive a vote in the Senate, but was inserted into the $1.1 trillion "cromnibus" spending bill during final negotiations, which became law with President Obama's signature on December 16, 2014.{{cite news|last1=Liszewski|first1=Mike|title=Congress Set to Pass Landmark Medical Marijuana Legislation|url=http://www.safeaccessnow.org/congress_set_to_pass_landmark_medical_marijuana_legislation|access-date=December 27, 2016|work=Americans for Safe Access|date=December 10, 2014}} The Rohrabacher–Farr amendment passed the House by an even larger margin (242–186) in June 2015,{{cite press release|date=June 4, 2015|title=Rohrabacher Hails Passage of Medical Marijuana Amendment|url=https://rohrabacher.house.gov/media-center/press-releases/rohrabacher-hails-passage-of-medical-marijuana-amendment|access-date=December 27, 2016|archive-url=https://web.archive.org/web/20180924000103/https://rohrabacher.house.gov/media-center/press-releases/rohrabacher-hails-passage-of-medical-marijuana-amendment|archive-date=September 24, 2018}} then won approval in a 21–9 Senate Appropriations Committee vote,{{cite news|last1=Liszewski|first1=Mike|title=Senate Committee Approves Mikulski Medical Marijuana Amendment with Strong Bipartisan Support|url=http://www.safeaccessnow.org/senate_committee_approves_mikulski_medical_marijuana_amendment_with_strong_bipartisan_support|access-date=December 27, 2016|work=Americans for Safe Access|date=June 11, 2015}} and was signed into law as part of the FY 2016 omnibus appropriations bill on December 18, 2015.{{cite news|last1=Liszewski|first1=Mike|title=Congress Set to Reauthorize the Rohrabacher-Farr Medical Cannabis Amendment|url=http://www.safeaccessnow.org/congress_set_to_reauthorize_the_rohrabacher_farr_medical_cannabis_amendment|access-date=December 27, 2016|work=Americans for Safe Access|date=December 16, 2015}} The amendment was subsequently included in a series of spending bills with the most recent extension effective through September 30, 2024.{{cite news |last1=McDaniel |first1=Eric |title=Biden signs spending package that averts a government shutdown |url=https://www.npr.org/2024/03/08/1237131404/senate-passes-spending-package-hours-ahead-of-shutdown-deadline |access-date=April 23, 2024 |work=NPR |date=March 9, 2024}}{{cite news |last1=Jaeger |first1=Kyle |title=Congress Keeps Ban On D.C. Marijuana Sales While Failing To Act On Cannabis Banking And Expungements |url=https://www.marijuanamoment.net/congress-keeps-ban-on-d-c-marijuana-sales-while-failing-to-act-on-cannabis-banking-and-expungements/ |access-date=January 10, 2023 |work=Marijuana Moment |date=December 20, 2022}}

Although state medical cannabis programs are protected by the amendment, it does not change the legal status of cannabis, and must be renewed each fiscal year in order to remain in effect. The Justice Department has also interpreted the amendment in a manner vastly different from the authors' intent, which it has used to justify a number of raids and prosecutions after the law's enactment.{{cite news|last1=Zilversmit|first1=Marc|title=Obama's Iran-Contra | The president is spending money that Congress has explicitly told him he can't spend|url=http://www.slate.com/articles/news_and_politics/jurisprudence/2016/04/obama_s_medical_marijuana_prosecutions_probably_aren_t_legal.html|access-date=May 9, 2017|work=Slate|date=April 28, 2016}} U.S. District Judge Charles Breyer ruled against the Justice Department in October 2015, however, stating that the DOJ interpretation "defies language and logic" and "tortures the plain meaning of the statute", and was "counterintuitive and opportunistic".{{cite news|last1=Ingraham|first1=Christopher|title=Federal court tells the DEA to stop harassing medical marijuana providers|url=https://www.washingtonpost.com/news/wonk/wp/2015/10/20/federal-court-tells-the-dea-to-stop-harassing-medical-marijuana-providers/|access-date=December 27, 2016|newspaper=The Washington Post|date=October 20, 2015}} The Ninth Circuit Court of Appeals similarly rejected the DOJ's arguments in an August 2016 ruling.{{cite news|last1=Ferner|first1=Matt|title=The Largest Federal Appeals Court Tells DOJ To Back Off State-Legal Medical Marijuana|url=http://www.huffingtonpost.com/entry/medical-marijuana-9th-circuit_us_57b36a31e4b04ff883990337|access-date=December 27, 2016|work=The Huffington Post|date=August 16, 2016}}

Due to increasing public awareness of the medical benefits of cannabis, and in anticipation of forthcoming changes to federal policy, a number of states passed laws in the late 1970s and early 1980s addressing the medical use of cannabis. New Mexico was the first to do so in 1978, and by the end of 1982 over thirty states had followed suit.{{cite web|last1=Markoff|first1=Steven C.|title=State-by-State Medical Marijuana Laws|url=http://www.procon.org/view.background-resource.php?resourceID=001496|website=ProCon.org|access-date=May 31, 2017|archive-url=https://web.archive.org/web/20170515142222/http://www.procon.org/view.background-resource.php?resourceID=001496|archive-date=May 15, 2017}} The majority of these laws sought to provide cannabis through federally-approved research programs administered by the states, using cannabis supplied by the National Institute on Drug Abuse. Only seven states ended up implementing the programs, however, due to the large bureaucratic and regulatory obstacles imposed by the federal government. Other states passed legislation allowing doctors to prescribe cannabis, or reclassifying cannabis in a state's internal drug scheduling system. These laws were largely ineffectual though, due to the continued prohibition of medical cannabis at the federal level. A few states passed laws affirming the right of individuals to present a medical necessity defense at trial. By the mid-80s, however, efforts to pass new medical cannabis laws had ground to a halt, and a number of existing laws were either repealed or allowed to expire.

Medical cannabis advocates began to gain ground in the early 1990s with a series of legislative achievements in the state of California. Proposition P was approved by 79% of San Francisco voters in November 1991, calling on state lawmakers to pass legislation allowing the medical use of cannabis. Additionally, the city board of supervisors passed a resolution in August 1992 urging the police commission and district attorney to "make lowest priority the arrest or prosecution of those involved in the possession or cultivation of [cannabis] for medicinal purposes" and to "allow a letter from a treating physician to be used as prima facia evidence that marijuana can alleviate the pain and suffering of that patient's medical condition".{{cite web|title=Proposition P|url=http://www.marijuanalibrary.org/Proposition_P_Nov_1991.html|website=marijuanalibrary.org|access-date=April 30, 2017}} The resolution enabled the open sale of cannabis to AIDS patients and others within the city, most notably through the San Francisco Cannabis Buyers Club which was operated by medical cannabis activist Dennis Peron (who spearheaded Proposition P and later the statewide Proposition 215).{{cite news|last1=Gardner|first1=Fred|title=The Cannabis Buyers Club: How Medical Marijuana Began in California|url=https://www.marijuana.com/news/2014/08/the-cannabis-buyers-club-how-medical-marijuana-began-in-california/|access-date=May 4, 2017|work=marijuana.com|date=August 26, 2014|archive-url=https://web.archive.org/web/20181120221138/https://www.marijuana.com/news/2014/08/the-cannabis-buyers-club-how-medical-marijuana-began-in-california/|archive-date=November 20, 2018}} Similar clubs appeared outside San Francisco in the ensuing years as other cities passed legislation to support the medical use of cannabis. The Wo/Men's Alliance for Medical Marijuana was founded in 1993 after 75% of Santa Cruz voters approved Measure A in November 1992.{{cite thesis|last1=Heddleston|first1=Thomas R.|title=From the Frontlines to the Bottom Line: Medical Marijuana, the War on Drugs, and the Drug Policy Reform Movement|url=http://escholarship.org/uc/item/1t7220hj|publisher=UC Santa Cruz Electronic Theses and Dissertations|date=June 2012|archive-url=https://web.archive.org/web/20151019053506/http://escholarship.org/uc/item/1t7220hj|archive-date=October 19, 2015|url-status=live}} [https://archive.org/details/MedicalMarijuanaTheWarOnDrugsAndTheDrugPolicyReformMovement Alt URL] And the Oakland Cannabis Buyers' Cooperative was founded in 1995 shortly before the city council passed multiple medical cannabis resolutions.

Following the lead of San Francisco and other cities in California, state lawmakers passed Senate Joint Resolution 8 in 1993, a non-binding measure calling on the federal government to enact legislation allowing physicians to prescribe cannabis.{{citation|last1=Vitiello|first1=Michael|title=Proposition 215: De Facto Legalization of Pot and the Shortcomings of Direct Democracy|url=http://scholarlycommons.pacific.edu/cgi/viewcontent.cgi?article=1093&context=facultyarticles|access-date=April 30, 2017|publisher=McGeorge School of Law|date=1998}} In 1994, Senate Bill 1364 was approved by state legislators, to reclassify cannabis as a Schedule II drug at the state level. And Assembly Bill 1529 was approved in 1995, to create a medical necessity defense for patients using cannabis with a physician's recommendation, for treatment of AIDS, cancer, glaucoma, and multiple sclerosis. Both SB 1364 and AB 1529 were vetoed by Governor Pete Wilson, however, paving the way for the passage of Proposition 215 in 1996.

Frustrated by vetoes of medical cannabis bills in successive years, medical cannabis advocates in California took the issue directly to the voters, collecting 775,000 signatures for qualification of a statewide ballot initiative in 1996.{{cite news|title=Medical Marijuana Initiative Qualifies For November Ballot|url=http://norml.org/news/1996/06/06/medical-marijuana-initiative-qualifies-for-november-ballot|access-date=April 30, 2017|work=NORML|date=June 6, 1996}} Proposition 215 – the Compassionate Use Act of 1996 – was subsequently approved with 56% of the vote, legalizing the use, possession, and cultivation of cannabis by patients with a physician's recommendation, for treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or "any other illness for which marijuana provides relief".{{cite web|title=Proposition 215: Text of Proposed Law|url=http://medicalmarijuana.procon.org/sourcefiles/california-proposition-215.pdf|website=ProCon.org|archive-url=https://web.archive.org/web/20170517131727/http://medicalmarijuana.procon.org/sourcefiles/california-proposition-215.pdf|archive-date=May 17, 2017}} The law also allowed patient caregivers to cultivate cannabis, and urged lawmakers to facilitate the "safe and affordable distribution of marijuana".

Also in 1996, 65% of Arizona voters approved Proposition 200, a drug policy reform initiative containing a provision allowing physicians to prescribe cannabis.{{cite news|title=Drug Reform Measure Signed Into Law In Arizona|url=http://norml.org/news/1996/12/09/drug-reform-measure-signed-into-law-in-arizona|access-date=May 1, 2017|work=NORML|date=December 9, 1996}} The medical use provision was then essentially repealed by state legislators a few months later,{{cite news|title=Arizona Bill Delays Medical Marijuana Use|url=https://www.latimes.com/archives/la-xpm-1997-04-16-mn-49181-story.html|access-date=May 1, 2017|work=Los Angeles Times|agency=Associated Press|date=April 16, 1997}} but the change was rejected by voters in a 1998 veto referendum.{{cite news|last1=Spivack|first1=Sarah|title=Doctors leery to prescribe marijuana as medication|url=http://wc.arizona.edu/papers/92/57/01_4_m.html|access-date=May 1, 2017|work=Arizona Daily Wildcat|date=November 12, 1998|archive-url=https://web.archive.org/web/20170501210231/http://wc.arizona.edu/papers/92/57/01_4_m.html|archive-date=May 1, 2017}} Ultimately the medical use provision was ineffective, however, due to language that created significant conflict with federal law (use of the word "prescribe" instead of "recommend").

In 1998, medical cannabis initiatives were voted on in the states of Washington, Oregon, Alaska, and Nevada – all of which passed. Also, in Washington, D.C., Initiative 59 to legalize the medical use of cannabis passed with 69% of the vote,{{cite news |last1=Miller |first1=Bill |last2=Hsu |first2=Spencer S. |title=Results Are Out: Marijuana Initiative Passes |url=https://www.washingtonpost.com/wp-srv/local/daily/sept99/marijuana21.htm |access-date=August 25, 2019 |newspaper=The Washington Post |date=September 21, 1999}} but a series of amendments introduced by Rep. Bob Barr and approved by Congress prevented its implementation for over a decade.{{cite news|title=Congress Lifts Ban on Medical Marijuana for Nation's Capitol|url=http://www.safeaccessnow.org/congress_lifts_ban_on_medical_marijuana_for_nations_capitol|access-date=April 26, 2017|work=Americans for Safe Access|date=December 13, 2009}} The initial Barr amendment was enacted prior to the November 1998 election but after ballots had been printed, thereby allowing D.C. residents to vote on the initiative but preventing the results from being made public.{{cite news|last1=Slevin|first1=Peter|last2=Murphy|first2=Caryle|title=Marijuana Vote Results Kept Secret|url=https://www.washingtonpost.com/wp-srv/local/longterm/library/dcelections/marijuana4.htm|access-date=April 26, 2017|newspaper=The Washington Post|date=November 4, 1998}} The amendment was challenged by the American Civil Liberties Union on grounds that it violated First Amendment rights, and in September 1999 U.S. District Judge Richard W. Roberts agreed, overturning the Barr amendment.{{cite news|title=Democracy Held Hostage|url=https://www.aclu.org/other/democracy-held-hostage|access-date=April 26, 2017|work=ACLU|date=December 31, 2000|archive-url=https://web.archive.org/web/20060114081620/https://www.aclu.org/drugpolicy/medmarijuana/10718res20001231.html|archive-date=January 14, 2006|url-status=live}} Rep. Barr then introduced a similar amendment which became law in November 1999, setting off a long legal battle{{cite web|title=Timeline of Initiative Events|url=http://www.mpp.org/legislation/dc/bills/timeline-of-initiative-events.html|website=Marijuana Policy Project|archive-url=https://web.archive.org/web/20080918150902/http://www.mpp.org/legislation/dc/bills/timeline-of-initiative-events.html|archive-date=September 18, 2008}} until finally in December 2009 the Barr amendment was removed from the annual D.C. appropriations bill, allowing the original 1998 ballot initiative to move forward.

Following the approval of several ballot measures in 1998, Maine voters passed a medical cannabis initiative in 1999 that was expanded by both state legislature and another ballot initiative in subsequent years. In 2000, medical cannabis initiatives were passed in the states of Colorado and Nevada, with Nevada's initiative passing for a second consecutive election as required to amend the state's constitution.{{cite news|title=Medical Marijuana Initiatives Pass In Colorado and Nevada; Californians Pass Initiative To Keep Non-Violent Drug Offenders Out Of Jail|url=http://norml.org/news/2000/11/09/medical-marijuana-initiatives-pass-in-colorado-and-nevada-californians-pass-initiative-to-keep-non-violent-drug-offenders-out-of-jail|access-date=June 1, 2017|work=NORML|date=November 9, 2000}} Also in 2000, Hawaii became the first state to legalize medical cannabis through an act of state legislature.

File:Jim Justice DSC 3785 (34022175232).jpg signs a bill to legalize medical cannabis on April 19, 2017]]

In the following years, medical cannabis was legalized by ballot measure in Montana (2004), Michigan (2008), Arizona (2010), Massachusetts (2012), Arkansas (2016), Florida (2016), North Dakota (2016), Oklahoma (2018), Missouri (2018), Utah (2018), and South Dakota (2020),{{efn|Mississippi voters approved a ballot measure to legalize medical cannabis in 2020, but it was overturned by the Supreme Court of Mississippi due to a flaw in the state's ballot initiative process.{{cite news|url=https://www.nbcnews.com/politics/politics-news/mississippi-supreme-court-overturns-voter-approved-marijuana-initiative-n1267472 |title=Mississippi Supreme Court overturns voter-approved medical marijuana initiative |first=Dareh |last=Gregorian |publisher=NBC News |date=May 14, 2021 |accessdate=May 15, 2021}}{{cite web|url=https://courts.ms.gov/Images/Opinions/CO154253.pdf |title=In Re Initiative Measure No. 65 |publisher=Supreme Court of Mississippi |date=May 14, 2021 |accessdate=May 15, 2021}} Mississippi later legalized through an act of state legislature in 2022.}} and by an act of state legislature in Vermont (2004), Rhode Island (2006), New Mexico (2007), New Jersey (2010), Delaware (2011), Connecticut (2012), New Hampshire (2013), Illinois (2013), Maryland (2014), Minnesota (2014), New York (2014), Pennsylvania (2016), Louisiana (2016), Ohio (2016), West Virginia (2017), Virginia (2020), Alabama (2021), Mississippi (2022), and Kentucky (2023).{{cite web|title=30 Legal Medical Marijuana States and DC|url=http://medicalmarijuana.procon.org/view.resource.php?resourceID=000881|website=ProCon.org|access-date=July 3, 2018}} Eighteen states have legalized by ballot measure and 20 have by state legislature, for a total of 38 states according to the National Conference of State Legislatures. The U.S. territories of Guam (2014 – ballot measure),{{cite news|last1=Schwartz|first1=Carly|title=Guam Legalizes Medical Marijuana|url=http://www.huffingtonpost.com/2014/11/04/guam-medical-marijuana_n_6100972.html|access-date=April 26, 2017|work=HuffPost|date=November 4, 2014}} Puerto Rico (2015 – executive order),{{cite magazine|last1=Kreps|first1=Daniel|title=In Surprise Move, Puerto Rico Legalizes Medical Marijuana|url=https://www.rollingstone.com/culture/news/puerto-rico-legalizes-medical-marijuana-20150504|access-date=April 26, 2017|magazine=Rolling Stone|date=May 4, 2015|archive-url=https://web.archive.org/web/20170429000732/https://www.rollingstone.com/culture/news/puerto-rico-legalizes-medical-marijuana-20150504|archive-date=April 29, 2017|url-status=dead}} the Northern Mariana Islands (2018 – legislature),{{cite news |last1=Angell |first1=Tom |title=Governor Signs Marijuana Legalization Bill, Making History In US Territory |url=https://www.forbes.com/sites/tomangell/2018/09/21/governor-signs-marijuana-legalization-bill-making-history-in-us-territory/ |access-date=October 8, 2018 |work=Forbes |date=September 21, 2018}} and the U.S. Virgin Islands (2019 – legislature){{cite news |last1=Jaeger |first1=Kyle |title=Governor Signs Bill Legalizing Medical Marijuana In The U.S. Virgin Islands |url=https://www.marijuanamoment.net/governor-signs-bill-legalizing-medical-marijuana-in-the-u-s-virgin-islands/ |access-date=January 18, 2019 |work=Marijuana Moment |date=January 18, 2019}} have also legalized the medical use of cannabis.

In addition to states that have passed comprehensive medical cannabis laws, a number of states have passed more restrictive laws that limit the allowable concentration of tetrahydrocannabinol (THC), the main psychoactive component of cannabis. The primary purpose of these laws is to allow for the use of cannabidiol (CBD), a non-psychoactive cannabinoid that has been shown to be effective in the treatment of seizure disorders, particularly in children.{{cite web|title=16 States with Laws Specifically about Legal Cannabidiol (CBD)|url=http://medicalmarijuana.procon.org/view.resource.php?resourceID=006473|website=ProCon.org|access-date=April 27, 2017|archive-url=https://web.archive.org/web/20220805052230/https://medicalmarijuana.procon.org/states-with-legal-cannabidiol-cbd/|archive-date=August 5, 2022|url-status=dead}} The use of CBD to treat seizure disorders gained increased attention with a number of media reports in 2012 and 2013, and by the end of 2015 sixteen states had "low-THC, high-CBD" laws in effect. Currently 10 states are considered to have low-THC, high-CBD laws. These laws vary in THC content allowed all the way up to 5% in Georgia and Kansas.

As a Schedule I drug in the U.S., clinical research on cannabis must be approved by the Food and Drug Administration, and a license (also referred to as a "registration") must be obtained from the Drug Enforcement Administration specific to conducting research on Schedule I drugs. The petition to the FDA is submitted in the form of an Investigational New Drug application,{{citation|last1=Hudak|first1=John|last2=Wallack|first2=Grace|title=Ending the U.S. government's war on medical marijuana research|url=https://www.brookings.edu/wp-content/uploads/2016/06/Ending-the-US-governments-war-on-medical-marijuana-research.pdf|work=Center for Effective Public Management at Brookings|publisher=The Brookings Institution|date=October 2015}} which the FDA has 30 days to respond to.{{citation|title=The Obstruction Of Medical Cannabis Research In The U.S.|url=http://american-safe-access.s3.amazonaws.com/documents/Research_Obstruction_Report.pdf|publisher=Americans for Safe Access|date=April 2009}} DEA research registrations are issued for Schedule I and Schedule II–V drugs, with the Schedule I registration mandating stricter compliance requirements such as the manner in which substances are stored and secured.{{cite news|last1=Zielinski|first1=Alex|title=The DEA Hasn't Made Marijuana Research Any Easier|url=https://archive.thinkprogress.org/the-dea-hasnt-made-marijuana-research-any-easier-cf21c0a9cc83/|access-date=May 15, 2017|work=ThinkProgress|date=August 17, 2016}} The DEA has 60 days to respond to registration applications as required by the 2022 Medical Marijuana and Cannabidiol Research Expansion Act.{{cite news |last1=Wadman |first1=Meredith |title=New U.S. law promises to light up marijuana research |url=https://www.science.org/content/article/new-u-s-law-promises-light-marijuana-research |access-date=December 3, 2022 |work=Science Magazine |date=December 2, 2022}} Prior to the act, researchers reported that the application process sometimes took over a year.{{cite news |last1=Jaeger |first1=Kyle |title=Top Federal Drug Agency Tells Congress About Marijuana Research Barriers Caused By Restrictive Scheduling |url=https://www.marijuanamoment.net/top-federal-drug-agency-tells-congress-about-marijuana-research-barriers-caused-by-restrictive-scheduling/ |access-date=November 4, 2021 |work=Marijuana Moment |date=October 25, 2021}}

In addition to FDA approval and DEA registration, other requirements have been imposed for cannabis research that do not exist for any other drug, which has had a significant effect in limiting the amount of research conducted. One such requirement was established in 1999 when it was mandated that all proposed research be submitted to the U.S. Public Health Service for approval. This was of particular burden to researchers as there was no timeline in which PHS was required to respond, with some reviews taking years to complete. In June 2015 the PHS review was eliminated, however, to better streamline the process for approving medical cannabis research.{{cite news|last1=Nelson|first1=Steven|title=Major Pot Research Barrier Goes Up in Smoke|url=https://www.usnews.com/news/articles/2015/06/22/major-pot-research-barrier-goes-up-in-smoke|access-date=May 15, 2017|work=U.S. News & World Report|date=June 22, 2015}}

Prior to 2021, clinical research on cannabis also required the approval of the National Institute on Drug Abuse.{{cite news|last1=Ferro|first1=Shaunacy|title=Why It's So Hard For Scientists To Study Medical Marijuana|url=http://www.popsci.com/science/article/2013-04/why-its-so-hard-scientists-study-pot|access-date=August 19, 2017|work=Popular Science|date=April 18, 2013|archive-url=https://web.archive.org/web/20130424064724/http://www.popsci.com/science/article/2013-04/why-its-so-hard-scientists-study-pot?single-page-view=true|archive-date=April 24, 2013}} The stated mission of NIDA is to support research on the causes, consequences, prevention, and treatment of drug abuse and drug addiction, and not the medicinal uses of drugs.{{citation|title=Federal Obstruction of Medical Marijuana Research|url=https://www.mpp.org/issues/medical-marijuana/federal-obstruction-of-medical-marijuana-research/|publisher=Marijuana Policy Project|access-date=May 15, 2017}} Consequently, many studies on the therapeutic benefits of cannabis were either denied or altered to comply with the limited scope and mission of NIDA. There is also no timeline in which NIDA is required to respond to proposals (as with the PHS review), which has resulted in delays in getting research approved ranging from months to years.{{citation|title=The DEA: Four Decades of Impeding And Rejecting Science|url=https://www.drugpolicy.org/sites/default/files/DPA-MAPS_DEA_Science_Final.pdf|publisher=Drug Policy Alliance / Multidisciplinary Associations for Psychedelic Studies|date=June 2014|archive-url=https://web.archive.org/web/20170729132013/https://www.drugpolicy.org/sites/default/files/DPA-MAPS_DEA_Science_Final.pdf|archive-date=July 29, 2017|url-status=dead}} Additionally, the cannabis provided by NIDA has been criticized as being inferior to that which is commonly used by medical cannabis patients in states where it is legal.{{cite news|last1=Breen|first1=Bill|title=Pipe Dream? | Rick Doblin has a prescription for fixing NIDA's ailing medical-marijuana program: establish an alternative|url=https://www.fastcompany.com/47962/pipe-dream|access-date=September 9, 2017|work=Fast Company|date=February 1, 2004}}{{cite news|last1=Ingraham|first1=Christopher|last2=Chappell|first2=Tauhid|title=Government marijuana looks nothing like the real stuff. See for yourself.|url=https://www.washingtonpost.com/news/wonk/wp/2017/03/13/government-marijuana-looks-nothing-like-the-real-stuff-see-for-yourself/|access-date=May 22, 2018|newspaper=The Washington Post|date=March 13, 2017}}{{cite news |last1=Jaeger |first1=Kyle |title=Federally Produced Marijuana Is Closer To Hemp Than Commercial Cannabis, Study Shows |url=https://www.marijuanamoment.net/federally-produced-marijuana-is-closer-to-hemp-than-commercial-cannabis-study-shows/ |access-date=August 25, 2019 |work=Marijuana Moment |date=April 2, 2019}} Criticisms of NIDA-supplied cannabis include high amounts of stems and seeds,{{cite news|last1=Hudak|first1=John|title=The DEA's marijuana decision is more important than rescheduling|url=https://www.brookings.edu/blog/fixgov/2016/08/11/the-deas-marijuana-decision-is-more-important-than-rescheduling/|access-date=May 15, 2017|work=The Brookings Institution|date=August 11, 2016}} high mold and yeast levels,{{cite news|last1=Hellerman|first1=Caleb|title=Scientists say the government's only pot farm has moldy samples — and no federal testing standards|url=https://www.pbs.org/newshour/nation/scientists-say-governments-pot-farm-moldy-samples-no-guidelines|access-date=May 15, 2017|work=PBS|date=March 8, 2017}} low THC content, and low diversity of strains available.{{citation |title=The Evolution of Marijuana as a Controlled Substance and the Federal-State Policy Gap |url=https://crsreports.congress.gov/product/pdf/R/R44782 |publisher=Congressional Research Service |date=April 7, 2022}}

From the agency's 1974 inception until 2021, NIDA was the sole provider of cannabis for research purposes in the U.S., contracting with the University of Mississippi for cultivation of the cannabis. The monopoly was maintained by the refusal of the Drug Enforcement Administration to issue additional licenses for the cultivation and distribution of cannabis, which the DEA said was consistent with the terms of the U.N. Single Convention on Narcotic Drugs that was ratified in 1961. Others disputed this interpretation of the treaty, however (including the U.S. State Department),{{cite news |last1=Angell |first1=Tom |title=State Department Says DEA Is Wrong on Marijuana Monopoly |url=https://www.marijuana.com/news/2016/05/state-department-says-dea-is-wrong-on-marijuana-monopoly/ |access-date=October 11, 2018 |work=marijuana.com |date=May 6, 2016 |archive-url=https://web.archive.org/web/20181011133436/https://www.marijuana.com/news/2016/05/state-department-says-dea-is-wrong-on-marijuana-monopoly/ |archive-date=October 11, 2018}} and the DEA's interpretation was not consistent with the fact that multiple licenses have been issued for the production of other Schedule I drugs. The DEA also cited the possibility of diversion from cultivation facilities as justification for not issuing additional licenses.

Critics of the former NIDA monopoly have pointed to the case of University of Massachusetts Amherst professor Lyle Craker as an example of the DEA's undue resistance to granting additional cultivation licenses. Professor Craker's endeavor to obtain a license began in June 2001, when he submitted an application to the DEA, which, later in 2001, the DEA claimed to have lost. After a photocopy was resubmitted, the DEA rejected the application in February 2002 because it did not have an original signature.{{cite web|title=DEA Lawsuit Timeline|url=http://www.maps.org/research/mmj/dea-lawsuit-timeline|website=Multidisciplinary Association for Psychedelic Studies|access-date=July 14, 2017|archive-url=https://web.archive.org/web/20170701153614/http://www.maps.org/research/mmj/dea-lawsuit-timeline|archive-date=July 1, 2017}} In July 2002, the original application was returned to Professor Craker unprocessed, with a date stamp showing it had been received in June 2001.{{cite web|title=Timeline: In the matter of Lyle Craker|url=https://www.aclu.org/other/time-line-matter-lyle-craker|website=ACLU|access-date=August 15, 2017}} The application was then resubmitted in August 2002, upon which the DEA confirmed receipt.{{cite web|title=MAPS Medical Marijuana Research|url=http://www.maps.org/research-archive/mmj/|website=Multidisciplinary Association for Psychedelic Studies|access-date=August 15, 2017}} On July 24, 2003, a notice regarding Craker's application was filed in the Federal Register, with a public comment period ending on September 23, 2003. In October 2003, U.S. Senators John Kerry and Ted Kennedy wrote a letter to DEA Administrator Karen Tandy expressing support for granting Professor Craker a license.{{citation|title=U.S. Senators from Massachusetts Send Letter to DEA|url=http://www.maps.org/research-archive/mmj/kennedy&kerry_to_dea_signed_retyped_letter.pdf|website=Multidisciplinary Association for Psychedelic Studies|date=October 20, 2003}} On December 10, 2004, however, following a lawsuit filed over unreasonable delay in responding to the application,{{cite news |last1=Pearson |first1=Helen |title=Joint suits aim to weed out agencies' red tape |url=https://www.nature.com/articles/430492a |access-date=November 1, 2021 |work=Nature |date=July 28, 2004}} the DEA rejected Craker's application.{{cite news |last1=McNeil |first1=Donald G. Jr. |title=College Fails in Bid to Grow Marijuana |url=https://www.nytimes.com/2004/12/14/us/college-fails-in-bid-to-grow-marijuana.html |access-date=November 1, 2021 |work=The New York Times |date=December 14, 2004}} Professor Craker then filed another lawsuit in response to the rejection, and also requested a hearing on the matter from a DEA Administrative Law Judge, which was granted. On February 12, 2007, after almost two years of extensive public testimony and evidence gathering, DEA Administrative Law Judge Ellen Bittner issued an 87-page opinion in favor of granting Professor Craker a license.{{cite news|last1=Smith|first1=Phillip|title=Medical Marijuana: DEA Judge Says Let Professor Grow Marijuana for Research Purposes|url=http://stopthedrugwar.org/chronicle/2007/feb/16/medical_marijuana_dea_judge_says|access-date=July 14, 2017|work=stopthedrugwar.org|date=February 16, 2007}} Additionally, 45 members of Congress wrote to DEA Administrator Karen Tandy in September 2007 urging that the decision be upheld.{{citation|title=Congress urges DEA to OK medical cannabis research|url=http://american-safe-access.s3.amazonaws.com/documents/Amherst.House%20Signon.Final.pdf|website=Americans for Safe Access|date=September 17, 2007}} In January 2009, however, acting DEA Administrator Michele Leonhart rejected the recommended ruling of Judge Bittner and declined to issue a license.{{cite news|title=Bush Administration Deals Eleventh Hour Blow To Scientific Freedom|url=https://www.aclu.org/news/bush-administration-deals-eleventh-hour-blow-scientific-freedom|access-date=July 14, 2017|work=ACLU|date=January 12, 2009}} In response, 16 members of Congress wrote to Attorney General Eric Holder in February 2009, asking that the Leonhart ruling be withdrawn.{{citation|title=February 5th letter to Holder from Olver|url=http://american-safe-access.s3.amazonaws.com/documents/Olver_to_Holder_Letter.pdf|website=Americans for Safe Access|date=February 5, 2009}} An additional letter was sent by Senators John Kerry and Ted Kennedy in April 2009.{{citation|title=Kerry/Kennedy letter to Deputy Attorney General Ogden|url=http://www.maps.org/research-archive/mmj/kennedy_Kerry_to_Ogden_april_29_2009.pdf|website=Multidisciplinary Association for Psychedelic Studies|date=April 29, 2009}} The ruling was upheld by Leonhart in an August 2011 decision, however,{{cite press release|title=DEA Upholds Federal Marijuana Monopoly, Obstructing Privately-Funded FDA Research|url=http://www.prnewswire.com/news-releases/dea-upholds-federal-marijuana-monopoly-obstructing-privately-funded-fda-research-128335763.html|access-date=July 14, 2017|agency=PR Newswire|publisher=Multidisciplinary Association for Psychedelic Studies|date=August 24, 2011}} and again by the First Circuit Court of Appeals in April 2013.

On August 11, 2016, the DEA announced intention to issue additional licenses for the cultivation of research-grade cannabis, in order to end the decades-long monopoly held by NIDA and the University of Mississippi.{{cite press release|title=DEA Eliminates 48-Year-Old Monopoly on Research-Grade Marijuana, Clearing Pathway for FDA Approval and Rescheduling|url=http://www.maps.org/news/media/6290-dea-eliminates-monopoly|access-date=May 15, 2017|publisher=Multidisciplinary Associations for Psychedelic Studies|date=August 11, 2016}}{{cite news|last1=Nelson|first1=Steven|title=DEA Ends Half-Century Pot Monopoly, But Withholds Big Prize for Reformers|url=https://www.usnews.com/news/articles/2016-08-11/dea-ends-half-century-pot-monopoly-but-withholds-big-prize-for-reformers|access-date=May 15, 2017|work=U.S. News & World Report|date=August 11, 2016}} In August 2019, following inquiries from Congress about the status of the licenses,{{cite news |last1=Jaeger |first1=Kyle |title=Senators Push Sessions To Stop Blocking Marijuana Cultivation Applications |url=https://www.marijuanamoment.net/senators-push-sessions-to-stop-blocking-marijuana-cultivation-applications/ |access-date=May 19, 2021 |work=Marijuana Moment |date=July 25, 2018}}{{cite news |last1=Jaeger |first1=Kyle |title=Bipartisan Lawmakers Urge DEA To Approve More Marijuana Growers |url=https://www.marijuanamoment.net/bipartisan-lawmakers-urge-dea-to-approve-more-marijuana-growers/ |access-date=May 19, 2021 |work=Marijuana Moment |date=May 7, 2019}} the DEA clarified that new regulations needed to be developed before the approval of applications could proceed.{{cite news |last1=Wallace |first1=Alicia |title=Bad weed is hurting cannabis research, scientists say. The DEA may finally fix that |url=https://www.cnn.com/2019/08/27/business/cannabis-dea-research |access-date=May 19, 2021 |work=CNN |date=August 27, 2019}}{{cite news |last1=Jaeger |first1=Kyle |title=DEA Announces It Will Finally Take Action On Marijuana Grower Applications |url=https://www.marijuanamoment.net/dea-announces-it-will-finally-take-action-on-marijuana-grower-applications/ |access-date=August 26, 2019 |work=Marijuana Moment |date=August 26, 2019}} In May 2021, the DEA announced that it had notified an unspecified number of cultivators that they had been granted preliminary approval for a license.{{cite press release |date=May 14, 2021 |title=DEA Continues to Prioritize Efforts to Expand Access to Marijuana for Research in the United States |url=https://www.dea.gov/stories/2021/2021-05/2021-05-14/dea-continues-prioritize-efforts-expand-access-marijuana-research |publisher=Drug Enforcement Administration }}{{cite news |last1=Gurman |first1=Sadie |title=Marijuana Medical Research Growers Receive U.S. Approval |url=https://www.wsj.com/articles/marijuana-research-growers-receive-u-s-approval-11621024843 |access-date=May 19, 2021 |work=The Wall Street Journal |date=May 14, 2021 |archive-url=https://archive.today/20210515223318/https://www.wsj.com/articles/marijuana-research-growers-receive-u-s-approval-11621024843 |archive-date=May 15, 2021}} As of August 2022 the DEA lists seven organizations that have active licenses to cultivate cannabis.{{cite web |title=Marihuana Growers Information |url=https://www.deadiversion.usdoj.gov/drugreg/marihuana.htm |website=usdoj.gov |access-date=August 24, 2022}}

Americans for Safe Access is the leading advocacy group in the U.S. dedicated to medical cannabis policy reform. Founded in 2002 by medical cannabis patient Steph Sherer, it has grown to over 100,000 members in 50 states.{{cite web|title=About|url=http://www.safeaccessnow.org/about_asa|website=Americans for Safe Access|access-date=February 9, 2017}} Other groups include the National Organization for the Reform of Marijuana Laws, Marijuana Policy Project, and Drug Policy Alliance, although these focus more broadly on policy reform regarding both medical and non-medical use.

Medical organizations that have issued statements in support of allowing patient access to medical cannabis include the American Nurses Association,{{citation|title=Therapeutic Use of Marijuana and Related Cannabinoids|url=https://www.nursingworld.org/~4ad4a8/globalassets/docs/ana/therapeutic-use-of-marijuana-and-related-cannabinoids.pdf|publisher=American Nurses Association|date=2016}} American Public Health Association,{{cite web|title=Resolution on Medical Marijuana|url=http://druglibrary.org/schaffer/hemp/medical/apha.htm|website=druglibrary.org|access-date=July 10, 2017}} American Medical Student Association,{{cite web|title=American Medical Student Association (AMSA) - Medical Marijuana|url=https://medicalmarijuana.procon.org/source-biographies/american-medical-student-association-amsa/|website=ProCon.org|access-date=July 10, 2017|archive-url=https://web.archive.org/web/20220520043000/https://medicalmarijuana.procon.org/source-biographies/american-medical-student-association-amsa/|archive-date=May 20, 2022|url-status=dead}} National Multiple Sclerosis Society,{{cite web|title=Medical Marijuana (Cannabis) FAQs|url=http://www.nationalmssociety.org/Treating-MS/Complementary-Alternative-Medicines/Marijuana/Marijuana-FAQs|website=National Multiple Sclerosis Society|access-date=July 10, 2017}} Epilepsy Foundation,{{cite press release|last1=Gattone|first1=Philip M.|last2=Lammert|first2=Warreb|title=Epilepsy Foundation Calls for Increased Medical Marijuana Access and Research|url=http://www.epilepsy.com/article/2014/2/epilepsy-foundation-calls-increased-medical-marijuana-access-and-research|access-date=July 31, 2017|location=Washington, D.C.|publisher=Epilepsy Foundation|date=February 20, 2014}} Leukemia & Lymphoma Society,{{cite web|title=Medical Marijuana Use and Research|url=https://www.maps.org/research-archive/mmj/lnls-res.pdf|website=maps.org|publisher=Leukemia & Lymphoma Society|access-date=July 12, 2017}} National Women's Health Network,{{cite web|title=New York Times full-page ad - March 6, 2002|url=http://www.compassionateaccess.org:80/pdf/nytimesad.pdf|website=Coalition for Compassionate Access|archive-url=https://web.archive.org/web/20030401110805/http://www.compassionateaccess.org/pdf/nytimesad.pdf|archive-date=April 1, 2003}} Gay and Lesbian Medical Association, and several AIDS advocacy organizations.{{cite web |title=Health Organizations Endorsements |url=https://norml.org/marijuana/library/health-organizations-endorsements/ |website=NORML |access-date=July 24, 2020}}{{cite web|title=Medical Marijuana Endorsements and Statements of Support|url=https://www.mpp.org/issues/medical-marijuana/medical-marijuana-endorsements-and-statements-of-support/|website=Marijuana Policy Project|access-date=February 10, 2017}}{{cite web|title="Should Marijuana Be a Medical Option?" - Summary of Positions|url=http://medicalmarijuana.procon.org/source-biographies.php|website=ProCon.org|access-date=February 12, 2017|archive-date=January 30, 2017|archive-url=https://web.archive.org/web/20170130112425/http://medicalmarijuana.procon.org/source-biographies.php|url-status=dead}}

Religious denominations in the U.S. that have voiced support for allowing the medical use of cannabis include the Episcopal Church, Presbyterian Church (USA), United Church of Christ, United Methodist Church, Union for Reform Judaism, the Unitarian Universalist Association,{{cite web|title=Religious Organizations Supportive of Medical Marijuana|url=https://www.mpp.org/issues/medical-marijuana/religious-organizations-supportive-medical-marijuana/|website=Marijuana Policy Project|access-date=February 10, 2017}} and the Catholic Church. {{cite web |url=https://www.vatican.va/archive/ENG0015/_P80.HTM |title=Catechism of the Catholic Church |publisher=Libreria Editrice Vaticana |access-date=18 May 2018 |archive-date=27 May 2018 |archive-url=https://web.archive.org/web/20180527004104/http://www.vatican.va/archive/ENG0015/_P80.HTM |url-status=live }} https://www.pgdiocese.bc.ca/wp-content/uploads/2018/12/BC-and-Yukon-Bishops-Statement-on-the-Legalization-of-Marijuana-in-Canada-3.pdf

American Legion, the nation's largest military veterans organization, passed a resolution at their September 2016 annual convention calling on Congress to remove cannabis from the list of Schedule I drugs.{{cite news|last1=Angell|first1=Tom|title=American Legion Calls for Marijuana Rescheduling|url=http://www.marijuana.com/blog/news/2016/09/american-legion-calls-for-marijuana-rescheduling/|access-date=February 12, 2017|work=marijuana.com|date=September 6, 2016|archive-url=https://web.archive.org/web/20170214025454/http://www.marijuana.com/blog/news/2016/09/american-legion-calls-for-marijuana-rescheduling/|archive-date=February 14, 2017}} In December 2016, the organization lobbied the incoming Trump administration to reclassify cannabis as a Schedule III drug.{{cite news|last1=Angell|first1=Tom|title=Powerful Veterans Group Pushes Trump On Marijuana Rescheduling|url=http://www.marijuana.com/blog/news/2016/12/powerful-veterans-group-pushes-trump-on-marijuana-rescheduling/|access-date=February 12, 2017|work=marijuana.com|date=December 9, 2016|archive-url=https://web.archive.org/web/20170213173511/http://www.marijuana.com/blog/news/2016/12/powerful-veterans-group-pushes-trump-on-marijuana-rescheduling/|archive-date=February 13, 2017}}

The National Conference of State Legislatures,{{cite news |last1=Angell |first1=Tom |title=State Legislators Push Feds To Deschedule Marijuana |url=https://www.massroots.com/news/state-legislators-push-feds-to-deschedule-marijuana/ |access-date=November 20, 2018 |work=MassRoots |date=August 7, 2017 |archive-url=https://web.archive.org/web/20181120221219/https://www.massroots.com/news/state-legislators-push-feds-to-deschedule-marijuana/ |archive-date=November 20, 2018}} National League of Cities,{{cite news |last1=Jaeger |first1=Kyle |title=Local Officials From Across US Call For Federal Marijuana Rescheduling |url=https://www.marijuanamoment.net/local-officials-from-across-us-call-for-federal-marijuana-rescheduling/ |access-date=November 20, 2018 |work=Marijuana Moment |date=November 13, 2018}} and U.S. Conference of Mayors{{cite news |last1=Angell |first1=Tom |title=Mayors From Across U.S. Call On Feds To Deschedule Marijuana |url=https://www.marijuanamoment.net/mayors-from-across-u-s-call-on-feds-to-deschedule-marijuana/ |access-date=November 20, 2018 |work=Marijuana Moment |date=June 11, 2018}} have all called for cannabis to be removed from the list of Schedule I drugs. The National Association of Counties has called on Congress to "enact legislation that promotes the principles of federalism and local control of cannabis businesses ... under state law".{{cite news |last1=Angell |first1=Tom |title=County Officials From Across The U.S. Push Feds To Reform Marijuana Laws |url=https://www.marijuanamoment.net/county-officials-from-across-the-u-s-push-feds-to-reform-marijuana-laws/ |access-date=July 23, 2018 |work=Marijuana Moment |date=July 16, 2018}}

Delegates at the 2016 Democratic National Convention voted to approve a party platform calling for cannabis to be removed from the list of Schedule I drugs.{{cite news|last1=Hotakainen|first1=Rob|title=Democrats become first major party to back pathway to legalizing pot|url=http://www.mcclatchydc.com/news/politics-government/election/article91968027.html|access-date=February 14, 2017|work=McClatchy|date=July 26, 2016|archive-url=https://archive.today/20170213074057/http://www.mcclatchydc.com/news/politics-government/election/article91968027.html|archive-date=February 13, 2017}} Other organizations that have called for rescheduling include the American Bar Association{{cite news |last1=Jaeger |first1=Kyle |title=American Bar Association Urges Congress To Let States Set Their Own Marijuana Policies |url=https://www.marijuanamoment.net/american-bar-association-urges-congress-to-let-states-set-their-own-marijuana-policies/ |access-date=August 26, 2019 |work=Marijuana Moment |date=August 13, 2019}} and the National Sheriffs' Association.{{cite news |last1=Jaeger |first1=Kyle |title=National Sheriffs' Association Calls For Marijuana Rescheduling |url=https://www.marijuanamoment.net/national-sheriffs-association-calls-for-marijuana-rescheduling/ |access-date=August 26, 2019 |work=Marijuana Moment |date=June 25, 2019}}

File:Medical cannabis demo 2.JPG

Individuals who have been particularly active in efforts to support the medical use of cannabis include Robert Randall, Dennis Peron, Ed Rosenthal, Steve Kubby, Steve DeAngelo, Richard Lee, Jon Gettman, Brownie Mary, and Tod H. Mikuriya. Former talk show host Montel Williams is an advocate who uses cannabis to treat his multiple sclerosis, a topic he has testified about in a number of states considering medical cannabis legislation.{{cite news |last1=Sudborough |first1=Susannah |title=Montel Williams partners with Taunton pot company to create new cannabis brand |url=https://www.boston.com/news/lifestyle/2022/04/18/inspire-by-montel-williams-taunton-cannabis-brand-freshly-baked-company/ |access-date=April 4, 2024 |work=boston.com |date=April 18, 2022}} Former U.S. Surgeon General Joycelyn Elders has also testified in support of medical cannabis legislation in several states.{{cite news|last1=Morgan|first1=Fiona|title=Dr. Joycelyn Elders, former U.S. Surgeon General|url=http://www.indyweek.com/indyweek/dr-joycelyn-elders-former-us-surgeon-general/Content?oid=1209168|access-date=February 12, 2017|work=Indy Week|date=June 24, 2008|archive-url=https://web.archive.org/web/20170214002229/http://www.indyweek.com/indyweek/dr-joycelyn-elders-former-us-surgeon-general/Content?oid=1209168|archive-date=February 14, 2017|url-status=dead}}

Members of Congress who have introduced legislation to allow the medical use of cannabis include Ron Paul,{{cite news|last1=Kampia|first1=Rob|title=Barney Frank and Ron Paul Introduce Bill to End Federal Marijuana Prohibition|url=http://www.huffingtonpost.com/rob-kampia/ron-paul-barney-frank-marijuana-_b_882380.html|access-date=February 19, 2017|work=The Huffington Post|date=June 22, 2011}} Barney Frank, Maurice Hinchey,{{cite news|last1=Everett|first1=Burgess|title=Lawmakers warn DOJ to back off medical marijuana prosecutions|url=https://www.politico.com/story/2015/04/lawmakers-warn-doj-to-back-off-medical-marijuana-prosecutions-116781|access-date=February 19, 2017|work=Politico|date=April 8, 2015}} Sam Farr, Dana Rohrabacher, Steve Cohen,{{cite news|last1=Ferner|first1=Matt|title=Historic Medical Marijuana Bill Gains Momentum|url=http://www.huffingtonpost.com/2015/03/24/medical-marijuana-legalization_n_6933228.html|access-date=February 19, 2017|work=The Huffington Post|date=March 24, 2015}} Don Young, Jared Polis,{{cite news|last1=Ferner|first1=Matt|title=Two House Bills Would End Federal Prohibition Of Marijuana|url=http://www.huffingtonpost.com/2015/02/20/marijuana-legalization-congress_n_6722686.html|access-date=February 19, 2017|work=The Huffington Post|date=February 20, 2015}} Earl Blumenauer, Tom Garrett,{{cite news|last1=Ingraham |first1=Christopher |title=Virginia Republican introduces bill to end federal marijuana prohibition |url=https://www.washingtonpost.com/news/wonk/wp/2017/03/02/an-unlikely-champion-introduces-bill-to-end-the-federal-war-on-marijuana/ |access-date=March 14, 2017 |newspaper=The Washington Post |date=March 2, 2017}} Rand Paul,{{cite news|last1=Ferner|first1=Matt|title=Senate Bill Would Effectively End The Federal War On Medical Marijuana|url=http://www.huffingtonpost.com/2015/03/10/end-federal-war-on-medical-marijuana_n_6836482.html|access-date=February 19, 2017|work=The Huffington Post|date=March 10, 2015}} and Bernie Sanders.{{cite news|last1=Reilly|first1=Molly|title=Bernie Sanders Introduces Bill Ending The Federal Ban On Marijuana|url=http://www.huffingtonpost.com/entry/bernie-sanders-marijuana-ban_us_563a3e21e4b0b24aee4858ae|access-date=February 19, 2017|work=The Huffington Post|date=November 4, 2015}} Rep. Rohrabacher (R–CA) has been particularly active in congressional reform efforts, introducing multiple medical cannabis bills including the Rohrabacher–Farr amendment for a number of years until it became law in 2014.{{cite press release|date=April 12, 2013 |title=Rep. Rohrabacher Introduces Bipartisan "Respect State Marijuana Laws Act of 2013" |url=https://rohrabacher.house.gov/press-release/rep-rohrabacher-introduces-bipartisan-respect-state-marijuana-laws-act-2013 |access-date=February 24, 2017 |archive-url=https://web.archive.org/web/20161109101652/https://rohrabacher.house.gov/press-release/rep-rohrabacher-introduces-bipartisan-respect-state-marijuana-laws-act-2013 |archive-date=November 9, 2016}}{{cite press release|date=November 21, 2014 |title=Rohrabacher: Allow VA Doctors to Prescribe Medical Marijuana |url=https://rohrabacher.house.gov/media-center/press-releases/rohrabacher-allow-va-doctors-to-prescribe-medical-marijuana |access-date=February 24, 2017 |archive-url=https://web.archive.org/web/20161109032258/https://rohrabacher.house.gov/media-center/press-releases/rohrabacher-allow-va-doctors-to-prescribe-medical-marijuana |archive-date=November 9, 2016}}{{cite press release|date=December 16, 2014 |title=Rohrabacher, Farr Hail Medical Marijuana Amendment in Funding Bill |url=https://rohrabacher.house.gov/media-center/press-releases/rohrabacher-farr-hail-medical-marijuana-amendment-in-funding-bill |access-date=February 24, 2017 |archive-url=https://web.archive.org/web/20161209021923/https://rohrabacher.house.gov/media-center/press-releases/rohrabacher-farr-hail-medical-marijuana-amendment-in-funding-bill |archive-date=December 9, 2016}} He also uses a cannabis-based drug to relieve the symptoms of his arthritis.{{cite news|last1=Ferner|first1=Matt|title=GOP Congressman Says He Uses Medical Marijuana To Ease Arthritis Pain|url=http://www.huffingtonpost.com/entry/gop-congressman-says-he-uses-medical-marijuana_us_5744bff2e4b055bb117084d8|access-date=February 9, 2017|work=The Huffington Post|date=May 24, 2016}}

Eugene Monroe, Derrick Morgan, Kyle Turley, and Jim McMahon are among a group of NFL players that have advocated for allowing the use of cannabis in the league, as a treatment option for concussions and a pain reliever that can reduce reliance on addictive opioid drugs.{{cite news|last1=O'Keeffe|first1=Michael|last2=Foote|first2=Dustin|last3=Vinton|first3=Nathaniel|title=Jim McMahon, other NFL veterans push for marijuana as painkiller|url=http://www.nydailynews.com/sports/football/jim-mcmahon-nfl-veterans-push-marijuana-painkiller-article-1.2679087|access-date=February 24, 2017|work=New York Daily News|date=June 18, 2016}}{{cite magazine|last1=Benes|first1=Ross|title=Inside NFL's Backwards Marijuana Policy|url=https://www.rollingstone.com/sports/nfls-backwards-marijuana-policy-w438912|access-date=February 24, 2017|magazine=Rolling Stone|date=September 21, 2016|archive-url=https://web.archive.org/web/20170224211412/https://www.rollingstone.com/sports/nfls-backwards-marijuana-policy-w438912|archive-date=February 24, 2017|url-status=dead}}{{cite news|last1=Saracevic|first1=Al|title=Can cannabis cure the NFL's ills?|url=http://www.sfchronicle.com/sports/article/Can-cannabis-cure-the-NFL-s-ills-10625657.php|access-date=February 24, 2017|work=San Francisco Chronicle|date=November 19, 2016}} NBA head coach Steve Kerr has also voiced support for the medical use of cannabis in professional sports.{{cite news|last1=Hanyes|first1=Chris|title=Steve Kerr says he used marijuana for back pain, hopes leagues soften stance|url=http://www.espn.com/nba/story/_/id/18190785/steve-kerr-says-used-marijuana-back-pain-hopes-leagues-soften-stance|access-date=February 9, 2017|work=ESPN|date=December 4, 2016}}

Dr. Sanjay Gupta, neurosurgeon and chief medical correspondent for CNN, has produced a five-part documentary series for the network – titled Weed – arguing in favor of the medical benefits of cannabis.{{cite news|last1=Gupta|first1=Sanjay|title=It's time for a medical marijuana revolution|url=http://www.cnn.com/2015/04/16/opinions/medical-marijuana-revolution-sanjay-gupta/|access-date=February 9, 2017|work=CNN|date=April 16, 2015}} Gupta was initially dismissive toward the medical use of cannabis, but upon researching further he changed his mind and wrote a column apologizing for his past views.{{cite news|last1=Gupta|first1=Sanjay|title=Why I changed my mind on weed|url=http://www.cnn.com/2013/08/08/health/gupta-changed-mind-marijuana/|access-date=February 9, 2017|work=CNN|date=August 8, 2013}} Filmmaker Jed Riffe has also explored the subject in his 2006 documentary Waiting to Inhale.{{cite web|title=Waiting to Inhale|url=http://jedriffefilms.com/films/waiting-to-inhale/|website=Jed Riffe Films + Electronic Media|access-date=February 9, 2017}}

The American Academy of Pediatrics{{citation|title=American Academy of Pediatrics Reaffirms Opposition to Legalizing Marijuana for Recreational or Medical Use|url=https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/American-Academy-of-Pediatrics-Reaffirms-Opposition-to-Legalizing-Marijuana-for-Recreational-or-Medical-Use.aspx|access-date=July 11, 2017|publisher=American Academy of Pediatrics|date=January 26, 2015|archive-url=https://web.archive.org/web/20170711074228/https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/American-Academy-of-Pediatrics-Reaffirms-Opposition-to-Legalizing-Marijuana-for-Recreational-or-Medical-Use.aspx|archive-date=July 11, 2017}} and American Psychiatric Association{{cite web|title=Position Statement on Marijuana as Medicine|url=https://www.psychiatry.org/file%20library/about-apa/organization-documents-policies/policies/position-2013-marijuana-as-medicine.pdf|website=American Psychiatric Association|access-date=July 12, 2017|archive-url=https://web.archive.org/web/20170731152505/https://www.psychiatry.org/file%20library/about-apa/organization-documents-policies/policies/position-2013-marijuana-as-medicine.pdf|archive-date=July 31, 2017}} oppose the legalization of medical cannabis outside the FDA approval process. However, the AAP also supports rescheduling for the purpose of facilitating research.

Individuals who have been particularly active in opposing the medical use of cannabis include Barry McCaffrey,{{cite news|last1=Forbes|first1=Daniel|title=Fighting "Cheech & Chong" medicine|url=http://www.salon.com/2000/07/27/ondcp_2/|access-date=February 19, 2017|work=Salon|date=July 27, 2000}} John Walters,{{cite news|title=Illinois Medical Marijuana Bill Stymied by Drug Czar Appearance -- for Now|url=http://stopthedrugwar.org/chronicle-old/375/fornow.shtml|access-date=February 19, 2017|work=stopthedrugwar.org|date=February 18, 2005}} Andrea Barthwell,{{cite news|last1=Lombardi|first1=Kristen|title=Snake-oil salesmen|url=http://www.bostonphoenix.com/boston/news_features/other_stories/documents/03237095.asp|access-date=February 19, 2017|work=The Boston Phoenix|date=October 17, 2003|archive-url=https://web.archive.org/web/20170220094003/http://www.bostonphoenix.com/boston/news_features/other_stories/documents/03237095.asp|archive-date=February 20, 2017}} Bill Montgomery,{{cite news|last1=Stern|first1=Ray|title=County Attorney Bill Montgomery Continues His Failing Crusade Against Arizona's Medical Marijuana Law|url=http://www.phoenixnewtimes.com/news/county-attorney-bill-montgomery-continues-his-failing-crusade-against-arizonas-medical-marijuana-law-8925079|access-date=February 19, 2017|work=Phoenix New Times|date=December 22, 2016}}{{cite news|last1=Pishko|first1=Jessica|title=This Arizona Prosecutor Is Waging a Strange War on Weed—and That's Just the Beginning|url=https://www.thenation.com/article/this-arizona-prosecutor-is-waging-a-strange-war-on-weed-and-thats-just-the-beginning/|access-date=February 19, 2017|work=The Nation|date=November 7, 2016|archive-url=https://web.archive.org/web/20170220020800/https://www.thenation.com/article/this-arizona-prosecutor-is-waging-a-strange-war-on-weed-and-thats-just-the-beginning/|archive-date=February 20, 2017|url-status=dead}} Mark Souder,{{cite news|title=Rep. Mark Souder, Longtime Anti-Marijuana Zealot, Resigns Amid Scandal|url=https://blog.mpp.org/medical-marijuana/rep-mark-souder-longtime-anti-marijuana-zealot-resigns-amid-scandal/|access-date=February 19, 2017|work=Marijuana Policy Project|date=May 18, 2010}} Sheldon Adelson,{{cite news|last1=Adams|first1=Ben|title=Why Does Casino Billionaire Sheldon Adelson Hate Weed So Much?|url=https://www.merryjane.com/news/why-does-casino-billionaire-sheldon-adelson-hate-weed-so-much|access-date=February 19, 2017|work=Leafly|date=July 1, 2016}} Mel Sembler,{{cite news|last1=Auslen|first1=Michael|title=Marijuana amendment faces biggest foe in GOP heavyweight, anti-drug crusader|url=https://www.tampabay.com/news/politics/stateroundup/marijuana-amendment-faces-biggest-foe-in-gop-heavyweight-anti-drug-crusader/2299615/|access-date=February 19, 2017|work=Tampa Bay Times|date=October 21, 2016}} and Kevin Sabet.{{cite news|last1=Thomas|first1=Dillon|title=Former White House Advisor Speaks Out Against Legalization Of Marijuana In Arkansas|url=http://5newsonline.com/2016/09/20/former-white-house-advisor-speaks-out-against-legalization-of-marijuana-in-arkansas/|access-date=February 19, 2017|work=5 News|date=September 20, 2016}}

Former U.S. Rep. Bob Barr was a particularly ardent opponent of medical cannabis in Congress, introducing the "Barr amendment" which blocked implementation of a Washington, D.C. ballot initiative legalizing the medical use of cannabis.{{cite news|title=Medical Marijuana Patients Celebrate: Georgia Rep. Bob Barr Defeated in GOP Primary|url=http://www.mpp.org/legislation/dc/bills/d-c-initiative-news-4.html|access-date=February 19, 2017|work=Marijuana Policy Project|date=August 20, 2002|archive-url=https://web.archive.org/web/20081012145629/http://www.mpp.org/legislation/dc/bills/d-c-initiative-news-4.html|archive-date=October 12, 2008}} After leaving Congress, however, Barr renounced his earlier views{{cite news|last1=Barr|first1=Bob|title=Federal Drug War Rethought|url=http://www.huffingtonpost.com/bob-barr/federal-drug-war-rethough_b_125458.html|access-date=February 19, 2017|work=The Huffington Post|date=October 11, 2008}} and joined Marijuana Policy Project to lobby for repeal of the legislation he originally authored.{{cite news|last1=Frates|first1=Chris|title=Bob Barr Flip-Flops on Pot|url=https://www.politico.com/story/2007/03/bob-barr-flip-flops-on-pot-003329|access-date=February 19, 2017|work=Politico|date=March 27, 2007}}

The American Medical Association{{citation|title=Use of Cannabis for Medicinal Purposes|url=https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/about-ama/councils/Council%20Reports/council-on-science-public-health/i09-csaph-medical-marijuana.pdf|publisher=American Medical Association|date=2009}} and American College of Physicians{{citation|title=Supporting Research into the Therapeutic Role of Marijuana|url=https://www.acponline.org/acp_policy/policies/supporting_research_therapeutic_role_of_marijuana_2016.pdf|publisher=American College of Physicians|date=February 2016}} do not take a position on the legalization of medical cannabis, but have called for the Schedule I classification to be reviewed. The American Academy of Family Physicians{{cite news |title=AAFP Releases Marijuana, Cannabinoids Position Paper |url=https://www.aafp.org/news/health-of-the-public/20190920cannabispaper.html |access-date=September 27, 2019 |work=American Academy of Family Physicians |date=September 20, 2019}} and American Society of Addiction Medicine{{cite press release |date=October 13, 2020 |title=ASAM Issues New Public Policy Statement on Cannabis |url=https://www.asam.org/Quality-Science/publications/magazine/read/asam-advocacy-blog/2020/10/13/asam-issues-new-public-policy-statement-on-cannabis |location=Rockville, MD |publisher=American Society of Addiction Medicine |archive-url=https://web.archive.org/web/20201030023252/https://www.asam.org/Quality-Science/publications/magazine/read/asam-advocacy-blog/2020/10/13/asam-issues-new-public-policy-statement-on-cannabis |archive-date=October 30, 2020 |url-status=dead}} also do not take a position, but do support rescheduling to better facilitate research. The American Heart Association supports rescheduling to allow for "a more nuanced approach to marijuana legislation and regulation".{{cite journal |author=American Heart Association |title=Medical Marijuana, Recreational Cannabis, and Cardiovascular Health |journal=Circulation |date=August 5, 2020 |volume=142 |issue=10 |pages=e131–e152 |doi=10.1161/CIR.0000000000000883 |pmid=32752884 |doi-access=free }} The American Cancer Society{{cite web|title=Marijuana and Cancer|url=https://www.cancer.org/treatment/treatments-and-side-effects/complementary-and-alternative-medicine/marijuana-and-cancer.html|website=American Cancer Society|access-date=July 12, 2017}} and American Psychological Association{{cite news|title=Marijuana research: Overcoming the barriers|url=http://advocacy.apascience.org/blog/2017/9/13/marijuana-research-overcoming-the-barriers|access-date=October 3, 2017|work=American Psychological Association|date=September 14, 2017|archive-url=https://web.archive.org/web/20171003235307/http://advocacy.apascience.org/blog/2017/9/13/marijuana-research-overcoming-the-barriers|archive-date=October 3, 2017|url-status=dead}} have noted the obstacles that exist for conducting research on cannabis, and have called on the federal government to better enable scientific study of the drug.

There are currently four cannabinoid drugs (Marinol, Syndros, Cesamet, and Epidiolex) available for prescription use in the United States. For non-prescription use, CBD derived from hemp is legal at the federal level but legality (and enforcement) varies by state.

Dronabinol is synthetically manufactured THC.{{cite web|title=MARINOL (dronabinol) capsules, for oral use|url=https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018651s029lbl.pdf|archive-url=https://web.archive.org/web/20171217031410/https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018651s029lbl.pdf|url-status=dead|archive-date=December 17, 2017|website=fda.gov|access-date=December 16, 2017}} It has been approved by the FDA in pill form as Marinol and in oral solution form as Syndros.

Marinol is a sesame oil suspension of dronabinol encapsulated in a gelatin shell. It received FDA approval in 1985 for treatment of nausea and vomiting associated with chemotherapy, and additionally in 1992 as an appetite stimulant for treatment of AIDS-related weight loss. It was initially classified as a Schedule II drug until it was moved to Schedule III in 1999. Marinol was developed by Unimed Pharmaceuticals, although initial research on the drug was mostly funded by the U.S. government. Unimed Pharmaceuticals was acquired by Solvay Pharmaceuticals in 1999.{{cite news|title=Unimed Approves Acquisition By Solvay|url=https://www.chicagotribune.com/1999/06/12/unimed-approves-acquisition-by-solvay/|access-date=June 25, 2017|work=Chicago Tribune|agency=From Tribune News Services|date=June 12, 1999|url-status=live|archive-url=https://web.archive.org/web/20150107111347/http://articles.chicagotribune.com/1999-06-12/business/9906120035_1_solvay-pharmaceuticals-unimed-pharmaceuticals-solvay-group|archive-date=January 7, 2015}}

Syndros is a liquid oral formulation of dronabinol approved for treatment of nausea and vomiting related to chemotherapy and weight loss associated with AIDS. Syndros received FDA approval in July 2016{{cite press release |date=July 5, 2016 |title=Insys Therapeutics Announces FDA Approval of Syndros |url=https://www.globenewswire.com/news-release/2016/07/05/853588/0/en/Insys-Therapeutics-Announces-FDA-Approval-of-Syndros.html |location=Phoenix |agency=GlobeNewswire |access-date=July 24, 2020}} and was assigned a Schedule II classification by the DEA in March 2017.{{cite news|last1=Ingraham|first1=Christopher|title=A pharma company that spent $500,000 trying to keep pot illegal just got DEA approval for synthetic marijuana|url=https://www.washingtonpost.com/news/wonk/wp/2017/03/24/a-pharma-company-that-spent-500000-trying-to-keep-pot-illegal-just-got-dea-approval-for-synthetic-marijuana/|access-date=June 27, 2017|newspaper=The Washington Post|date=March 24, 2017}} Syndros is manufactured by Insys Therapeutics, which received attention in 2016 for contributing heavily to the defeat of a cannabis legalization measure in Arizona, in an apparent attempt to protect market share for the newly developed drug.{{cite news|last1=Fang|first1=Lee|title=Pharma Company Funding Anti-Pot Fight Worried About Losing Business, Filings Show|url=https://theintercept.com/2016/09/12/pharma-opioid-marijuana/|access-date=June 27, 2017|work=The Intercept|date=September 12, 2016}}{{cite news|last1=Levin|first1=Sam|title=Big Pharma's anti-marijuana stance aims to squash the competition, activists say|url=https://www.theguardian.com/us-news/2017/apr/03/big-pharma-marijuana-competition-insys-arizona|access-date=June 27, 2017|work=The Guardian|date=April 3, 2017}} Syndros became available for prescription use in July 2017.{{cite press release|date=July 31, 2017|title=Insys Announces Availability of SYNDROS, the First and Only FDA-Approved Liquid Dronabinol, by Prescription|url=https://globenewswire.com/news-release/2017/07/31/1064808/0/en/Insys-Announces-Availability-of-SYNDROS-the-First-and-Only-FDA-Approved-Liquid-Dronabinol-by-Prescription.html|location=Phoenix|agency=GlobeNewswire|access-date=August 19, 2017}}

Nabilone is a synthetic cannabinoid similar to THC in molecular structure.{{cite web|title=CESAMET (nabilone) Capsules|url=https://www.accessdata.fda.gov/drugsatfda_docs/label/2006/018677s011lbl.pdf|website=fda.gov|access-date=June 26, 2017}} It is sold in pill form only as the drug Cesamet.

Cesamet received FDA approval in 1985 for treatment of chemotherapy-induced nausea and vomiting.{{cite news|last1=Rubin|first1=Rita|title=2nd synthetic marijuana drug OK'd for chemo effects|url=http://usatoday30.usatoday.com/news/health/2006-05-16-marijuana-drug_x.htm|access-date=June 26, 2017|work=USA Today|date=May 16, 2006}} It was discontinued by its manufacturer Eli Lilly in 1989 for commercial reasons, and in 2004 U.S. rights to the drug were sold to Valeant Pharmaceuticals. In 2006 Valeant received FDA approval to resume sales. Cesamet has remained a Schedule II drug since its first introduction.

Cannabidiol (CBD) is a non-psychoactive cannabinoid extracted from the cannabis plant. It has received FDA approval as the drug Epidiolex.

Epidiolex is a liquid oral formulation of cannabidiol.{{cite news |title=U.S. approves first marijuana-based drug for seizures |url=https://www.cbsnews.com/news/fda-approves-epidiolex-first-marijuana-based-drug-for-seizures/ |access-date=June 27, 2018 |work=CBS News |date=June 25, 2018}} It received FDA approval for treatment of seizures associated with Dravet syndrome and Lennox–Gastaut syndrome in June 2018,{{cite press release|date=June 25, 2018|title=Biosciences Announce FDA Approval of EPIDIOLEX® (cannabidiol) oral solution – the First Plant-derived Cannabinoid Prescription Medicine|url=http://ir.gwpharm.com/news-releases/news-release-details/gw-pharmaceuticals-plc-and-its-us-subsidiary-greenwich|publisher=GW Pharmaceuticals|access-date=June 26, 2018|archive-url=https://web.archive.org/web/20180628114142/http://ir.gwpharm.com/news-releases/news-release-details/gw-pharmaceuticals-plc-and-its-us-subsidiary-greenwich|archive-date=June 28, 2018|url-status=dead}} and was assigned a Schedule V classification by the DEA in September 2018.{{cite news |last1=Jaeger |first1=Kyle |title=The DEA Just Placed a Marijuana-Derived Drug In Schedule V |url=https://www.marijuanamoment.net/the-dea-just-placed-a-marijuana-derived-drug-in-schedule-v/ |access-date=September 28, 2018 |work=Marijuana Moment |date=September 27, 2018}} Epidiolex is manufactured by Greenwich Biosciences, a U.S. subsidiary of the British firm GW Pharmaceuticals. Epidiolex became available for prescription use in November 2018.{{cite press release |date=November 1, 2018 |title=EPIDIOLEX (cannabidiol) Oral Solution – the First FDA-approved Plant-derived Cannabinoid Medicine – Now Available by Prescription in the U.S. |url=http://ir.gwpharm.com/news-releases/news-release-details/epidiolexr-cannabidiol-oral-solution-first-fda-approved-plant |publisher=GW Pharmaceuticals |access-date=November 4, 2018 |archive-url=https://web.archive.org/web/20181105160615/http://ir.gwpharm.com/news-releases/news-release-details/epidiolexr-cannabidiol-oral-solution-first-fda-approved-plant |archive-date=November 5, 2018 |url-status=dead}}

In April 2020, the DEA removed Epidiolex from the list of federally controlled substances.{{cite news |last1=Jaeger |first1=Kyle |title=CBD Prescription Drug Is No Longer A Federally Controlled Substance, DEA Says |url=https://www.marijuanamoment.net/cbd-prescription-drug-is-no-longer-a-federally-controlled-substance-dea-says/ |access-date=April 8, 2020 |work=Marijuana Moment |date=April 6, 2020}} In August 2020, Epidiolex was approved for treatment of seizures associated with tuberous sclerosis complex.{{cite press release |date=August 3, 2020 |title=FDA Approves EPIDIOLEX® (cannabidiol) Oral Solution to Treat Seizures Associated with Tuberous Sclerosis Complex |url=https://www.globenewswire.com/news-release/2020/08/03/2071601/0/en/FDA-Approves-EPIDIOLEX-cannabidiol-Oral-Solution-to-Treat-Seizures-Associated-with-Tuberous-Sclerosis-Complex.html |location=Carlsbad, CA |agency=GlobeNewswire}}

In addition to its use for treatment of seizure disorders, cannabidiol is used by some individuals under the belief that it possesses a number of other medical properties – but these claims have yet to be thoroughly studied and proven. The FDA has thus not approved CBD for any other medical use; however, the 2018 farm bill legalized CBD extracted from hemp (less than 0.3% THC) at the federal level.{{cite news |last1=Hudak |first1=John |title=The Farm Bill, hemp legalization and the status of CBD: An explainer |url=https://www.brookings.edu/blog/fixgov/2018/12/14/the-farm-bill-hemp-and-cbd-explainer/ |access-date=June 2, 2019 |work=The Brookings Institution |date=December 14, 2018}} The legality of CBD products also varies by state, and in some jurisdictions prohibition is not strictly enforced.{{cite news |last1=Clark |first1=Meredith |title=Is CBD Even Legal Where You Live? |url=https://www.marieclaire.com/politics/a27033880/where-is-cbd-legal-in-the-united-states/ |access-date=June 2, 2019 |work=Marie Claire |date=April 12, 2019}}{{cite news |last1=Williams |first1=Timothy |title=CBD Is Wildly Popular. Disputes Over Its Legality Are a Growing Source of Tension. |url=https://www.nytimes.com/2019/05/06/us/cbd-cannabis-marijuana-hemp.html |access-date=June 4, 2019 |work=The New York Times |date=May 6, 2019}}

A 2016 study found significant drops in violent crime in states that have legalized medical cannabis.{{cite journal |last1=Shepard |first1=Edward M. |last2=Blackley |first2=Paul R. |title=Medical Marijuana and Crime Further Evidence From the Western States |journal=Journal of Drug Issues |date=January 13, 2016 |volume=46 |issue=2 |pages=122–134 |doi=10.1177/0022042615623983 |s2cid=75327199 |issn = 0022-0426}} A 2017 study similarly found that introduction of medical cannabis laws caused a reduction in violent crime in American states that border Mexico.{{Cite journal|last1=Gavrilova|first1=Evelina|last2=Kamada|first2=Takuma|last3=Zoutman|first3=Floris|title=Is Legal Pot Crippling Mexican Drug Trafficking Organizations? The Effect of Medical Marijuana Laws on US Crime|journal=The Economic Journal|volume=129|issue=617|pages=375–407|language=en|doi=10.1111/ecoj.12521|issn=1468-0297|year=2019|doi-access=free}}

A 2018 study found that legalizing medical cannabis in some states made residents of neighboring states increasingly tolerant toward cannabis regulation.{{cite journal |last1=Felson |first1=Jacob |last2=Adamczyk |first2=Amy |last3=Thomas |first3=Christopher |title=How and why have attitudes about cannabis legalization changed so much? |journal=Social Science Research |date=2018 |volume=78 |pages=12–27 |doi=10.1016/j.ssresearch.2018.12.011 |pmid=30670211 |s2cid=58949541 |url=https://storage.googleapis.com/wzukusers/user-26857839/documents/5c19077499cfdngrg4ST/Full%20document.pdf |access-date=January 1, 2019}}

A 2013 study found that medical cannabis legalization is associated with an 8-11% reduction in traffic fatalities.{{cite journal|last1=Mark Anderson|first1=D.|last2=Hansen|first2=Benjamin|last3=Rees|first3=Daniel I.|title=Medical Marijuana Laws, Traffic Fatalities, and Alcohol Consumption|journal=The Journal of Law and Economics|date=May 2013|volume=56|issue=2|pages=333–369|doi=10.1086/668812|citeseerx=10.1.1.724.5170|s2cid=154800922}}

Several studies have found decreased rates of opioid use and abuse in states that have legalized medical cannabis.{{cite news|title=Legalized Marijuana Could Help Curb the Opioid Epidemic, Study Finds|url=https://www.nbcnews.com/health/health-news/legalized-marijuana-could-help-curb-opioid-epidemic-study-finds-n739301|access-date=April 3, 2017|work=NBC News|agency=Reuters|date=March 27, 2017}}{{cite news|last1=Ingraham |first1=Christopher |title=New study finds that medical marijuana may be helping to curb the opioid epidemic |url=https://www.washingtonpost.com/news/wonk/wp/2016/09/15/new-study-finds-that-medical-marijuana-may-be-helping-to-curb-the-opioid-epidemic/ |access-date=March 18, 2017 |newspaper=The Washington Post |date=September 15, 2016}}{{cite news|last1=Ingraham |first1=Christopher |title=One striking chart shows why pharma companies are fighting legal marijuana |url=https://www.washingtonpost.com/news/wonk/wp/2016/07/13/one-striking-chart-shows-why-pharma-companies-are-fighting-legal-marijuana/ |access-date=March 18, 2017 |newspaper=The Washington Post |date=July 13, 2016}}{{cite news|last1=Ingraham |first1=Christopher |title=How medical marijuana could literally save lives |url=https://www.washingtonpost.com/news/wonk/wp/2015/07/14/how-medical-marijuana-could-literally-save-lives/ |access-date=March 18, 2017 |newspaper=The Washington Post |date=July 14, 2015}}{{cite news|last1=Doyle|first1=Kathryn|title=Prescription painkiller deaths fall in medical marijuana states|url=https://www.reuters.com/article/us-medical-marijuana-deaths-idUSKBN0GP1UJ20140825|access-date=March 18, 2017|work=Reuters|date=August 25, 2014}}

Several studies have found no increase in teen use in states that have legalized cannabis for medical purposes.{{cite news|last1=Ingraham |first1=Christopher |title=A huge new study finds that medical marijuana doesn't "send the wrong message" to kids |url=https://www.washingtonpost.com/news/wonk/wp/2015/06/16/a-huge-new-study-finds-that-medical-marijuana-doesnt-send-the-wrong-message-to-kids/ |access-date=March 18, 2017 |newspaper=The Washington Post |date=June 16, 2015}}{{cite news|last1=Ingraham |first1=Christopher |title=Medical marijuana opponents' most powerful argument is at odds with a mountain of research |url=https://www.washingtonpost.com/news/wonk/wp/2014/07/29/medical-marijuana-opponents-most-powerful-argument-is-at-odds-with-a-mountain-of-research/ |access-date=March 18, 2017 |newspaper=The Washington Post |date=July 29, 2014}}{{cite news|last1=Ferner|first1=Matt|title=Legalizing Medical Marijuana Doesn't Lead To More Teens Smoking Pot: Study|url=http://www.huffingtonpost.com/2014/04/25/medical-marijuana-teens_n_5214875.html|access-date=March 18, 2017|work=The Huffington Post|date=April 25, 2014}}{{cite news|last1=Downs|first1=David|title=Medical marijuana laws' impact on teen use|url=http://blog.sfgate.com/smellthetruth/2013/06/19/medical-marijuana-laws-impact-on-teen-use/|access-date=March 18, 2017|work=SFGate|date=June 19, 2013|archive-url=https://web.archive.org/web/20170319110756/http://blog.sfgate.com/smellthetruth/2013/06/19/medical-marijuana-laws-impact-on-teen-use/|archive-date=March 19, 2017|url-status=dead}}{{cite news|last1=Bindley|first1=Katherine|title=Medical Marijuana Does Not Increase Teen Drug Use, Study Shows|url=http://www.huffingtonpost.com/2012/06/18/medical-marijuana-teen-drug-use_n_1606918.html|access-date=March 18, 2017|work=The Huffington Post|date=June 19, 2012}}{{cite magazine|last1=Szalavitz|first1=Maia|title=Study: Legal Medical Marijuana Doesn't Encourage Kids to Smoke More Pot|url=https://healthland.time.com/2011/11/03/study-legal-medical-marijuana-doesnt-encourage-kids-to-smoke-more-pot/|access-date=March 18, 2017|magazine=Time|date=November 3, 2011}}{{cite news|last1=Bailey|first1=Eric|title=Pot Use Down Where Medical Use OK|url=https://www.latimes.com/archives/la-xpm-2005-sep-07-me-pot7-story.html|access-date=March 18, 2017|work=Los Angeles Times|date=September 7, 2005}} A 2018 meta-analysis in the journal Addiction similarly found no increase.{{Cite journal|last1=Sarvet|first1=Aaron L.|last2=Wall|first2=Melanie M.|author2-link=Melanie Wall|last3=Fink|first3=David S.|last4=Greene|first4=Emily|last5=Le|first5=Aline|last6=Boustead|first6=Anne E.|last7=Pacula|first7=Rosalie Liccardo|last8=Keyes|first8=Katherine M.|last9=Cerdá|first9=Magdalena|title=Medical marijuana laws and adolescent marijuana use in the United States: A systematic review and meta-analysis|journal=Addiction|volume=113|issue=6|language=en|pages=1003–1016|doi=10.1111/add.14136|pmid=29468763|issn=1360-0443|year=2018|pmc=5942879}}

Below is a comparison of medical conditions for which doctors can recommend cannabis in each state or territory. The table does not include all approved conditions and could contain outdated information. Low-THC, high-CBD states are not listed.

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Data additionally obtained from Leafly{{cite web|title=State-By-State MMJ Qualifying Conditions|url=https://www.leafly.com/news/health/qualifying-conditions-for-medical-marijuana-by-state|website=Leafly|access-date=July 7, 2017|date=February 2014}} and ProCon.org.

Many states have reciprocity laws that recognize out-of-state registrations for medical cannabis patients.

Below is a list of reciprocity policies as of October 8, 2021.

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• Legal history of cannabis in the United States
• Timeline of cannabis laws in the United States
• Legality of cannabis by U.S. jurisdiction
• Legalization of non-medical cannabis in the United States
• Removal of cannabis from Schedule I of the Controlled Substances Act
• History of medical cannabis

{{Notelist}}

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• [http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx State Medical Marijuana Laws] (National Conference of State Legislators)

{{Cannabis|state=collapsed}}

{{Cannabis in the United States|state=expanded}}

{{DEFAULTSORT:Medical cannabis in the United States}}

Category:Cannabis in the United States

Category:Cannabis law in the United States

Category:Cannabis law reform in the United States

Category:Drug control law in the United States

Category:Drug policy of the United States

Category:Medicinal use of cannabis

Category:Federalism in the United States