photo showing marijuana leaves
A photograph of hemp (Cannabis sativa L.) in Sherburne National Wildlife Refuge. A photograph of a cannabis plant. The photo at that site is marked as being copyright-free, and is credited to the United States Fish and Wildlife Service.

By Elizabeth Thompson

As Americans across the country observe 4/20, a day that recognizes cannabis, North Carolina remains one of just 13 states that have not legalized medical marijuana.

That may not be the case for long. 

A bill in the North Carolina Senate, the NC Compassionate Care Act, would make medical marijuana legal for a narrowly crafted group of people diagnosed with certain medical conditions.

That bill stalled in the Senate in summer 2021, and it has not yet come up for a vote again. It is backed by two powerful state Republicans, Sens. Bill Rabon (R-Southport) and Michael Lee (R-Wilmington), the primary sponsors of the bill.

The Senate is expected to take up the bill in 2022, during a short session set to begin May 18, after the statewide primary on May 17.

One of the bill’s sponsors, Sen. Wiley Nickel (D-Cary), said not to expect much news until the session starts, but he is optimistic that the bill will be passed, he told NC Health News.

“This is a bill that is moving in the right direction, with lots of good, important support in a bipartisan manner,” Nickel said. “And I’m very hopeful that we will pass that bill when we return.”

Liz Sharpe, a spokesperson for one of the bill’s primary sponsors, Sen. Paul Lowe (D-Winston Salem), said in an email that no action has been taken on the bill since August due to redistricting and the state budget, but “we are hoping to get the bill moving!”

The bill has support from the majority of North Carolinians, according to one poll by WRAL News. The SurveyUSA poll found that 72 percent of North Carolinians supported medical marijuana legalization.

Support for medical marijuana is high across the political spectrum. The poll found that 64 percent of registered Republicans, 75 percent of registered Democrats and 78 percent of unaffiliated voters supported legalization.

What’s in the bill?

The Compassionate Care Act would make North Carolina “the most conservative state” of states with laws legalizing medical marijauana” with “a very, very narrowly tailored focus just on folks with chronic conditions, end of life care,” Nickel said at a judiciary committee hearing on the bill last summer.

Rabon called the bill “the most tightly regulated and controlled bill of its type,” at a committee hearing. 

Only people diagnosed by a doctor with a “debilitating medical condition” including cancer, epilepsy, positive HIV or AIDS status, or post traumatic stress disorder would qualify for a medical marijuana card, according to the bill.

If passed, the bill would also set up an advisory committee that would report on the effectiveness of the program annually and keep track of medical marijuana cards and physicians who issue the cards.

It would also establish a program in the University of North Carolina system to research cannabis as a medical product.

Marijuana as medicine

There are benefits and risks to medical marijuana as there are for most drugs, said Keith Humphreys, professor of psychiatry and behavioral sciences at Stanford University, in a March webinar hosted by Attorney General Josh Stein’s office.

The U.S. Food and Drug Administration (FDA) has not yet approved cannabis for specific medical conditions, as it is still completing medical research studying the impact of cannabis for medical use.

However, one cannabis-derived product, Epidiolex, has been approved by the FDA, for some seizure disorders. Three synthetic cannabis-related products — Marinol, Syndros and Cesamet — have also been approved.

Humphreys predicted more medications made using cannabis will be made.

“There’s no reason to be afraid of cannabis-based medications,” Humphreys said.

Does this mean recreational marijuana is going to be legalized?

Some people may be opposed to medical marijuana legalization because they don’t want it to lead to recreational marijuana legalization.

Legalizing recreational use of marijuana received less support than medical marijuana from North Carolinians in the WRAL/Survey USA poll. Nonetheless, over half of North Carolinians surveyed — 57 percent — agreed that recreational marijuana should be made legal.

Key legislators behind the bill have been clear they are not in favor of recreational marijuana legalization.

“Recreational marijuana is not what we want in our state,” Lee said at the judicial committee hearing.

As of November 2021, 18 states have taken measures to legalize recreational marijuana, less than half of the 37 states that have legalized medical marijuana.

Accessing THC in NC

At the same time as state legislators craft a narrowly tailored medical marijuana bill, North Carolinians can go to a store right now and buy products containing THC, the substance mostly responsible for marijuana’s impact on a person’s mental state.

Delta-8 THC, a hemp-derived product with a similar chemical structure to Delta-9 THC, the compound found in marijuana, is widely available across North Carolina, NC Health News previously reported.

Image of various Prime Sunshine CBD and Delta-8 products on display as well as a picture of the hemp plant to the left. Photo Credit: Mona Dougani

The 2018 Farm Bill, passed by the U.S. Congress makes this possible by creating a loophole companies use to sell CBD-derived products containing less than 0.3 percent THC.

Delta-8 THC has psychoactive effects similar to Delta-9 THC, and it can have intoxicating effects, or make users “high.”

The FDA has not approved or evaluated Delta-8 THC products and cautions against using those products for medical use, especially because their production is unregulated and they could be manufactured in “uncontrolled or unsanitary settings,” according to the FDA.

Medical marijuana is also already legal on some tribal land in North Carolina.

The Eastern Band of Cherokee Indians, located in the westernmost part of North Carolina, legalized medical marijuana in August, 2021, as well as possession of up to an ounce of marijuana on tribal lands.

Republish our articles for free, online or in print, under a Creative Commons license.

Elizabeth Thompson

Elizabeth Thompson is our Report for America corps member who covers gender health and prison health topics. Thompson is a UNC Chapel Hill graduate...

24 replies on “What is the state of medical marijuana legalization in North Carolina?”

  1. I think Dare county should legalize it and the rest of NC can go to jail for no reason

  2. Quit playing games and Legalize It you would save lives after all marijuana is good ground and chemicals and alcohol are man-made I’m all for legalizing marijuana

  3. Newly to the area from a legal state. Had medical card not only to have in a legal state but due to the amazing effects that help me due to having epilepsy myself. They were under control and doing well with less meds and help of marijuana. Now living in NC I have had 48 I believe seizures and quite sick at times in my opinion not having God’s natural medicine coming from being a pastor grandkid and a pharmacy technician 11. So please help me and many others. Thank you and God Bless ❤️

  4. Legalize all you know we have rights I’m tried of people telling me what’s good for me.Read the Bible it says the Healing of the nations the leaves on the trees Jesus had it along with herbs and it’s only in man made laws for their profit look at Congress it made them money no health benefits and a patten to controll it That’s what is wrong in the world now,I’m so glad this is not my world I’m just passing through it What Happen to the land of the Free it’s gone to Shit.Amen,Amen

  5. Theres so many people in chronic pain that have severe anxiety and have other mental ordeals that would be so much better off if is was legalized, so plz do the right thing and help save so many lives in so many ways. Elizabeth Cox

  6. Majority rules that why we vote ,get off your high horse and have your Martini. Soo fed up with politics.

  7. I have epilepsy other underlying medical conditions, including impaired vision. If marijuana is in fact a better medicinal treatment instead of pills, etc, etc..for all underlying medical conditions I’m for it 💯%. Besides marijuana is a natural plant within the soil of the EARTH. BRING IT ON!!!

  8. Release medicinal marijuana in all of NC for end of life patients and long term permanent conditions and illnesses that effect the daily life and health (ie… ptsd, insomnia, chronic pain, hiv/aids, seizures,) and even relationships. It was legal before in USA before 1973; it shroud be released and legal again. With all the research done on marijuana, legal prescription drugs, illegal drugs, cigarettes, (snuff, cigars) and other tobacco products; it is not worse than alcohol, opioids, any street drug and other prescribed medications and their side effects. Every drug prescribed to me has hindered my friends and family, as well as mine and my veteran comrades whole health (ie., biological, psychological, skin, physical, sleep, appetite, behavioral, glaucoma, asthma, nerves, hair) in many ways and organs with no improvements.
    In the past and present this natural herb has helped many people and patients around the world. I don’t know why they can’t find a way to tax, sale, prescribe, regulate and move to lifting the regulations from the medical field, county (city and state) government entities. What’s is the catch. Plus NC is always crying about money, when the solution is right here and other states and proven successful. Even your mentor and big brother VA has passed a bill and helped economy, medical conditions of the community and government too. Too much BS with bureaucrats, out of touch lobbyist, and ridiculous favors while people are suffering with no real results.

  9. I am originally from Michigan and I move here 12 years ago. My home state is now fully legal and we are now aging with medical disorders. Why in the world is this state NOT with the times on a commodity that could be taxed make marijuana completely legal for medical & recreational use is beyond me! Michigan, I may be back!

  10. Just Do It already. It’s called a no brainer decision for peoples health and the economy .

  11. I use cannabis for pain relief for to MS, there is absolutely no reason for this to illegal to use possess or for folks not to be able to grow their own medicine. Thanks for listenin!

  12. Give me a break. It should be legal period.if you can buy BOOZE. You should be able to buy marijuana. I’dont know anyone who has beat up there wife or anyone after they smoke a joint but plenty do after thier drunk. Why don’t you outlaw alcohol.

  13. I’m disabled due to a drunken driver crashing into my car while stopped at a red light. The drunk driver was driving a 3 ton truck with a large heavy camper on it, and was pulling a large boat. He hit me at 60 MPH . My Nissan Sentra became the trucks hood ornament. It took two tow trucks to pull the vehicles apart. Even our seats broke free from the floorboard an the bolts were sheared . Amazing how the seat belts held. Severe whiplash’s, damage to the thoracic spine also the lumbar. It was terrifying. The screaming, the screech of brakes, the ambulance siren’s, the police, the pain as my neck was nearly torn up muscles, resulting in 16 major surgeries. Fusions, failed laminectimies, titanium rods, Harm’s Cages, bones to fuse, fusion’s that broke loose anyway, thoracic outlet surgery, torn miniscus, bone removal, rib removal, etc, etc. Now my condition still worsen’s, now I have Spinal Stinosis , no more corrective surgeries, now my spine shrinking from 15mm to
    9mm , herniated discs above and below each fusion, and lesions. Every blood vessel, every nerve being pinched by my shrinking spine. It hurt’s. It’s extremely painful. When I lived in Washington State where it was legal to use, no problem, a very necessary natural seed bearing plant it states in Genesis is given by God for our benefit ! It help’s with medical issues, and does no harm. It helps with chronic pain, just make a tea. Please give it a try and thank the Lord for creating this plant ! It also helps with appetite, frequently from the pain I find it difficult to have a appetite.
    Sincerely,

  14. Wash. State is gaining million’s from the legalization of Cannabis . It’s been legal there since the 1990’s I believe. The store dispensaries are clean, and the employees were very helpful with instruction’s. I had to learn as
    I am 64 years of age. So I had to become educated on the medical benefits, and how to use it.

  15. If only future cannabis growers would offer huge kick backs to our states government. Maybe then we would see a change.

    1. I just learned that senators are buying up permits to grow and dispense MMJ. They are such hypocrites

  16. I’m a North Carolina Native who has transplanted to Montana where they have an amazing medical cannabis program . After suffering 8 concussions and having to deal with constant daily migraines , medical cannabis is the only answer. It’s hilarious to think that you can go to the store and buy a half gallon of vodka but cannabis is seen as dangerous . Alcohol is by far a worse drug for our society than cannabis ever was yet you can buy alcohol on just about every street corner . Taxes on a legal cannabis market could also pay for our failing schools which are always struggling to find funding. It’s laughable to say that our state would not benefit from cannabis , yet our school systems flounder to find enough funds to feed and teach kids with adequate resources.

  17. Do you people understand ? It’s another way of life for some . So now look at the people who are selling the CBD now. Its on every store just like the lottery money going to education. STOP THE TRASHING OF OUR PEOPLE .AT FIRST WAS 3 PERCENT BEER . JUST LIKE THE WEED is now the people who are running the show are easing in to get a profit. That would look down on us DOPERS THEY CALL US. NOW THEY ARE FALLING OVER EACH OTHER ON THIS & THAT . THEY OWE ME 47 YEARS OF BACK PAY. NOW THEY WILL COLLECT MORE THE RULES NEED TO GO OUR WAY FOR ONCE IN society Stop robbing us POINT BLANK NOW THEY ARE BUSTED BY THE PEOPLE WHO ARE TIRED OF THERE GOVERMENT BULL GET REAL

  18. Many disabled veterans like myself need this for numerous reason which not only relate to PTSD. I am 100% disabled with diabetes which has caused complete retina detachment in one eye, severe diabetic neuropathy in legs, feet, arms and hands, I have severe back pain from arthritis throughout my back and have a back pain stimulator inserted. I was prescribed so many opioids by VA back in 1984 to 2018 that I now have severe opioid induced constipation. Medical and recreational marijuana should be legalized across the United States and the President of the United States needs to step in!

  19. The whole matter is certain government figures don’t want it legalized because they can’t all come together on how to profit from it . It’s all about MONEY ! What is the freaking problem people? This plant that can grow on It’s own with no help from anybody other than to plant a seed, let it grow, harvest it and smoke it ! You politicians can play this crap all you want too but a lot of us are laughing at your ass cause in atleast the past fifteen years I have never had any problem finding good quality grass to smoke in Eastern NC and you will never stop it. Your law inforcement and your helicopters can’t find it all and their not smart enough ! Stop wasting TAXPAYERS MONEY YOU DAMN FOOLS ! It’s my freaking body not yours and it will not harm you especially like tobacco! Unlike tobacco , you DO NOT sit there and smoke a whole marijuana cigarette at one time by yourself like you would a tobacco cigarette so therefore the carsenigens are not anywhere near as great . YOU AIN’T GOT ME FOOLED. By the way, I’m fifty seven years old and have been smoking it for over thirty years and I have a successful career and own my own home . I don’t engage in any illegal activities other than smoking a good fat joint when I get good and damn ready ! Thanks for listening.

  20. Wow, they are still playing the, “more research is needed” propaganda card? Cannabis has been used for it’s medicinal purposes longer than America has been a country. Ancient Egyptians used it as a medicine. Heck, holy anointing oil pots found that were used during the time of Jesus also contain cannabis oils. What exact research is still lacking? I am so sick and tired of these corrupt NC Republican politicians thinking everyone else is stupid but them. Their complete and total corruption is why most North Carolinians find themselves complaining about the shape of the state now… inflated rent, inflated housing, inflated monopolistic medical, poor public education, and many more issues can ALL be traced back to Republicans like Tillis.

    (Editor’s note: this comment was edited to remove ad hominem comments, as per our comments policy)

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