eing a medical cannabis patient in the U.S. can be a little bit frustrating. Why? Because your state may allow one thing while a neighboring state does not. There are states with both recreational and medical cannabis, those with medical cannabis only, and still others where marijuana is completely prohibited. Again, why is that?
Why is medical cannabis so different here as opposed to other countries? It is due to our constitutional system. Despite the frustrations medical cannabis users experience, our constitutional system is still the best way to prevent Washington from consolidating too much power to itself.
Medical Cannabis in the U.S.
By federal law, medical cannabis is marijuana. And marijuana is a Schedule I controlled substance under the Controlled Substances Act. That makes it illicit. However, federal prosecutors cannot investigate or prosecute marijuana crimes related to medical cannabis due to Congress exercising the power of the purse. Congress prohibits the DOJ from spending money on medical cannabis investigations and prosecutions.
That being the case, states have been fairly confident in writing their own medical cannabis laws. They have not made medical cannabis legal – they cannot do so, despite so many people referring to state-legal cannabis – they have simply decriminalized it.
Essentially, Washington has turned medical cannabis into a state issue. Our constitution gives more power to the states than Washington. Any matter not explicitly mentioned in the constitution becomes a state matter according to the 10th amendment. So as long as Congress does not change its position on DOJ enforcement, medical cannabis will remain regulated at the state level.
As with anything else in the states, regulations vary. In Utah, Beehive Farmacy operates two of medical cannabis pharmacies in the state. There are only 15 because Utah law prohibits regulators from issuing more licenses. On the other hand, there are thousands of pharmacies and dispensaries in Oklahoma. The Sooner State has not placed any limits on licenses.
Medical Cannabis Elsewhere
Both medical cannabis and recreational marijuana are legal in Canada. Canada does allow some level of autonomy at the provincial level – just not where medical cannabis is concerned. Bear in mind that Canada’s healthcare system is single payer, meaning the federal government operates it. So medical cannabis is a federal issue in Canada.
A similar situation exists in Germany, Italy, Australia, Israel, and even the UK. In all these countries, laws give national regulators authority to control cannabis. They do not have a strong state or provincial format like we do here in this country.
States Must Protect Themselves
In addition to medical cannabis being regulated at the state level, each of the states needs to protect itself. Let us go back to the fact that marijuana is still a federally illegal substance. States are counting on continued congressional action preventing the DOJ from investigating and prosecuting medical cannabis crimes. But the language of the bill responsible for the prohibition is very narrow.
The prohibition only applies to certain medical cannabis crimes in states with legalized medical cannabis. It does not apply to recreational marijuana in any way, shape, or form. The prohibition also does not cover interstate commerce. Therefore, states need to protect themselves by tightly restricting marijuana within their borders and not letting it get outside.
On the one hand, different state medical cannabis regulations can be frustrating and confusing. On the other hand, the constitutional system that creates this frustration is also what allows states to decriminalize marijuana. Without our constitutional system, Washington would have the final say. That would mean medical cannabis still being illegal nationwide in 2025.
