Using medical marijuana helps people who suffer from lower pain significantly reduce their opioid use as well as experience lower pain intensity and functional disability, according to a new study that involved hundreds of patients.

Researchers with Tel Aviv University, Rabin Medical Center and Clalit Health Services in Israel enrolled 1,000 patients with chronic low back pain (CLBP) who had previously never used cannabis and tracked their pain, disability status and medication usage annually for a period of 10 years at a specialized orthopedic pain clinic.

After a decade, opioid use, measured in morphine milligram equivalents, “decreased substantially” by 90 percent.

“Opioid reduction was rapid in the first year and remained stable through Year 10,” the researchers wrote.

Pain intensity also dropped by 84 percent, and functional disability was reduced by 30 percent.

The study, published in the European Spine Journal, also looked at how many patients achieved significant pre-specified thresholds for the outcome measures.

For reduced opioid use, 91 percent of patients met the target of at least 50 percent reduction in opioid use.

The goal of 30 percent of greater reduction on a pain intensity scale was achieved by 62 percent of participants. Sixty-two percent of patients reached the targeted decrease in functional disability scores of 10 points or more on a standardized scale.

“Medical cannabis therapy was associated with reductions in opioid use, pain intensity, and functional disability over 10 years, accompanied by polypharmacy reduction and acceptable tolerability.”

There was also a “substantial” reduction in use of other non-opioid medications among patients who completed the study.

“Tramadol/tapentadol use decreased from 89.7% to 5.6% (−84.0% points), benzodiazepines from 78.8% to 5.3% (−73.5 pp), SSRIs from 77.7% to 5.8% (−71.9 pp), and gabapentinoids from 31.3% to 0.6% (−30.7 pp),” the study said. “These reductions were clinically driven rather than protocol-mandated, reflecting individual physician-patient decisions based on symptom response. The pattern of polypharmacy reduction paralleled opioid reduction, occurring primarily in the first 2 years.”

The reduction in use of several different kinds of medications suggests that “medical cannabis may address multiple symptom domains simultaneously,” the researchers wrote.

“Chronic pain patients frequently require polypharmacy to manage pain, sleep disturbance, anxiety, and depression, each of which carries risks of adverse effects and drug interactions,” the said.

Participants in the study used marijuana products that included dried flower for vaporization and cannabis oils for oral/sublingual administration. There was some patient drop off as the study went on, and 638 of the 1,000 who enrolled ended up completing the final follow-up observation.

The researchers cautioned that the single-arm observational nature of the study means that causality cannot be inferred. They also noted that the size of the reductions in the outcome measures in the study “substantially exceeded” those from previously published randomized controlled trials, suggesting that “observational biases contribute to these findings.”

Nonetheless, they said their study is the “longest follow-up of medical cannabis therapy specifically in CLBP patients and demonstrates sustained, clinically meaningful improvements exceeding pre-specified [minimal clinically important difference] thresholds for opioid reduction, pain relief, and functional disability.”

“In this 10-year single-arm observational study, medical cannabis therapy was associated with reductions in opioid use (−89.8%), pain intensity (−84.2%), and functional disability (−30.4%), with high proportions of patients achieving pre-specified MCID thresholds,” the study concluded. “Substantial polypharmacy reductions and acceptable tolerability were observed.”

This is far from the only study supporting the efficacy of marijuana in the treatment of pain—nor is it the first to suggest cannabis can serve as a substitute for conventional therapies such as opioids.

A study published earlier this year found that medical cannabis use by people with chronic lower back pain leads to “large, sustained, and statistically robust improvements.”

In April, a study found that using medical marijuana appears to help people reduce the use of other medications, including opioids, sleeping aids and antidepressants. They also experience far fewer negative side effects after switching to cannabis from prescription drugs, the study involving more than 3,500 patients determined. 

About one in three Americans who use CBD say they take it as an alternative or supplement to at least one medication—particularly painkillers—according to a federally funded study published in February.

Similarly, another recent federally funded study, published by the American Medical Association (AMA), added more evidence that marijuana can serve as an effective substitute for opioids in chronic pain treatment.

Other AMA-published research has found that legalizing marijuana for medical or recreational purposes is “significantly associated with reduced opioid use among patients diagnosed with cancer.”

A separate paper published last year similarly found that medical marijuana legalization is “associated with significant reductions in opioid prescribing.”

In August, meanwhile, Australian researchers published a study showing that marijuana can serve as an effective substitute for opioids in pain management treatment.

Another study published last year in the journal Drug and Alcohol Review found that, among drug users who experience chronic pain, daily cannabis use was linked to a higher likelihood of quitting the use of opioids—especially among men.

Other research also found that legalizing medical cannabis appeared to significantly reduce monetary payments from opioid manufacturers to doctors who specialize in pain, with authors finding “evidence that this decrease is due to medical marijuana becoming available as a substitute” for prescription painkillers.

Further research also showed a decline in fatal opioid overdoses in jurisdictions where marijuana was legalized for adults. That study found a “consistent negative relationship” between legalization and fatal overdoses, with more significant effects in states that legalized cannabis earlier in the opioid crisis. Authors estimated that recreational marijuana legalization “is associated with a decrease of approximately 3.5 deaths per 100,000 individuals.”

“Our findings suggest that broadening recreational marijuana access could help address the opioid epidemic,” that report said. “Previous research largely indicates that marijuana (primarily for medical use) can reduce opioid prescriptions, and we find it may also successfully reduce overdose deaths.”

Another recently published report into prescription opioid use in Utah following the state’s legalization of medical marijuana found that the availability of legal cannabis both reduced opioid use by patients with chronic pain and helped drive down prescription overdose deaths statewide. Overall, results of the study indicated that “cannabis has a substantial role to play in pain management and the reduction of opioid use,” it said.

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“Kuehn did not have either taxpayer standing or standing for a matter of great public concern to challenge the constitutionality of the acts.”

By Zach Wendling, Nebraska Examiner

The Nebraska Supreme Court on Friday decided a longtime medical cannabis opponent will not have another day in court to try to overturn the state’s voter-approved medical cannabis laws, at least for now.

Chief Justice Jeffrey Funke, in a unanimous 29-page ruling, agreed with a lower court judge’s decision that former state Sen. John Kuehn of Heartwell did not have standing to challenge Nebraska’s medical cannabis laws.

Kuehn argues that such state laws, including Nebraska’s voter-enacted legalization of medical cannabis, are “preempted” by federal law under the U.S. Constitution’s supremacy clause defining marijuana as a more dangerous drug that states are precluded from regulating.

“We conclude that Kuehn did not have either taxpayer standing or standing for a matter of great public concern to challenge the constitutionality of the acts,” Funke wrote. “We therefore affirm the district court’s order dismissing Kuehn’s operative complaint without prejudice.”

“Without prejudice” means Kuehn could bring a similar case in the future if circumstances change. For instance, since June 2025, the Nebraska Legislature has appropriated more funds to the Nebraska Medical Cannabis Commission and passed new legislation around cannabis.

What is ‘standing’?

For a case to proceed, a litigant must prove they’ve suffered an “injury in fact” by the time a case is filed or later amended. Kuehn filed his case in December 2024 and last amended it June 2025. Kuehn conceded he had not yet suffered the direct injury but sought to use exceptions.

“Standing refers to whether a party had, at the commencement of the litigation, a personal stake in the outcome of the litigation that would warrant a court’s exercise of its subject matter jurisdiction and remedial powers on that party’s behalf,” Funke explained in the opinion.

Lancaster County District Judge Susan Strong dismissed Kuehn’s case on June 26, 2025. She also presided over and ruled against a preelection challenge from Kuehn, filed in September 2024.

The Supreme Court last week affirmed Strong’s ruling on the validity of Nebraska’s medical cannabis laws, also in a unanimous ruling from Funke.

Shifting federal guidance

During oral arguments in April in Kuehn’s preemption appeal, no attorneys or justices asked about shifting federal guidelines on marijuana. U.S. Attorney General Todd Blanche federally downgraded state-licensed medical cannabis to a Schedule III drug in April, down from a Schedule I drug.

Schedule I drugs, such as heroin, LSD, ecstasy and peyote, are drugs the federal government has classified as having a high likelihood of abuse and no currently accepted medical value. Schedule III drugs are defined as those with moderate to low potential for physical and psychological dependence, such as Tylenol with codeine, ketamine and testosterone.

Nebraska’s Medical Cannabis Commission is working toward implementing a state-licensed program and has licensed four cultivators. Nebraska Gov. Jim Pillen (R) and Attorney General Mike Hilgers (R) signed off on a first set of regulations for the commission this summer.

The commission is rewriting its regulations to add fees before moving to license product manufacturers or dispensaries. The Legislature authorized the commission to do so this year.

Access to legally purchase medicine in Nebraska is still months, if not at least a year, away.

Standing exceptions

Kuehn tried to use two “narrow” exceptions to the standing rule: that he should be able to sue to try to prevent an “illegal expenditure” of public funds (taxpayer standing) or because the laws constitute a “matter of great public concern” (“great public concern standing”).

“It is not enough to wait for the United States government to one day come to Nebraska and challenge these acts,” Kuehn’s attorney Eddie Greim of Missouri had told the justices. “Instead, Nebraska’s courts should be open to Nebraskans who want to hold their Nebraska state government to its constitutional limitations.”

Funke wrote that other jurisdictions might find Kuehn had taxpayer standing, such as in other states, but Funke said doing so for Nebraska would be “inconsistent with our jurisprudence.” Funke also wrote that Kuehn’s claims did not present the “rare” circumstances to justify an exception for great public concern.

Unlike in other taxpayer standing cases that try to block public spending alone, Kuehn sought to go further and declare the Nebraska medical cannabis laws unconstitutional.

Had the case proceeded and later returned to the Supreme Court, it would take five justices to declare the laws unconstitutional. For standing, Kuehn needed a simple majority, or four judges.

AG’s Office: Others could sue

Zachary Pohlman, the state deputy solicitor general defending five state officials from Kuehn’s lawsuit, had argued that at least five parties would be better suited to sue than Kuehn, such as the federal government, Hilgers, a property owner, a prospective medical cannabis user or a criminal defendant charged with illegally possessing cannabis asserting the laws as a defense.

The Supreme Court ruled that its finding whether Kuehn lacked standing was not related to whether others could sue in Kuehn’s place.

Pillen was named in the suit, as were Secretary of State Bob Evnen, Department of Health and Human Services CEO Steve Corsi, former State Treasurer Tom Briese and Tax Commissioner Jim Kamm.

Kuehn had also sued the 2024 ballot sponsors behind the voter-approved laws and current and former members of the Medical Cannabis Commission.

The Nebraska Attorney General’s Office had threatened to sue the state Medical Cannabis Commission if it issued licenses. But no such challenge materialized when the commission licensed the first cultivators in October 2025. No other state lawsuits have been filed at this time.

Hilgers’s office has joined a federal lawsuit seeking to challenge the DOJ’s rescheduling of marijuana, which President Donald Trump is calling for.

In an unsigned statement Friday, Nebraskans for Medical Marijuana said another “desperate lawsuit, designed to erase the will of Nebraska voters and destroy medical cannabis, has failed.”

“For nearly two years, people with powerful political connections and deep pockets have thrown everything they can at us,” the statement said. “Lawsuits, accusations, obstruction and delay, because they refuse to accept what 71 percent of Nebraskans overwhelmingly decided.”

The group, which led the 2024 effort to legalize and regulate medical cannabis, said no matter the money, influence or political power behind the “next attack,” it won’t erase that vote.

The next Medical Cannabis Commission meeting is Monday.

This story was first published by Nebraska Examiner.

Photo courtesy of Mike Latimer.

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For decades, there has been one supplier of medical cannabis in the Netherlands: Bedrocan. That contract, however, has recently come to an end. The government is shifting away from a sole-supplier model and toward a landscape in which multiple companies can obtain licenses to supply medical cannabis. 

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“The state is working really hard to operationalize this program as quickly as possible. People are suffering and they want to address that suffering.”

By Leah Romero, Source NM

New Mexico’s Medical Psilocybin Program recently opened up applications for producers of the psychedelic mushroom, marking a significant step toward the therapeutic program becoming fully operational.

“We’re no longer talking about a piece of legislation and some rulemaking. This is real, this is happening and it’s being operationalized right now,” Santa Fe-based psychedelic attorney Victoria Cvitanovic told Source NM.

The program was created last year with the signing of Senate Bill 219, which created the medical psilocybin program, an advisory board and legalized use of the psychedelic in controlled, therapeutic settings. Qualifying conditions currently include major treatment-resistant depression, post traumatic stress disorder, substance use disorders and end-of-life care.

The New Mexico Department of Health Center for Medical Cannabis and Psilocybin began accepting applications last week from potential producers to grow the mushrooms for future program participants.

Cvitanovic told Source that the application is intended to ensure the psilocybin “produced for this program in New Mexico is both safe and medically beneficial for patients, as well as that this doesn’t cause safety issues for people in New Mexico generally.”

According to the permit requirements, applicants must provide a state business license; proof of registration with the New Mexico Secretary of State and the Taxation and Revenue Department; facility safety documents; proof of ownership of the facility or a signed statement from the landowner; proof of compliance with city and county zoning requirements; and verification that psilocybin products will only be produced and tested in New Mexico.

“I think it’s notable that the application balances both the safety of the patients who will be receiving the end product and the safety of people who may live in areas of the state where someone is granted a license to produce psilocybin,” Cvitanovic said. “These applications are open to anyone, but they are fairly extensive because of the high stakes of producing a controlled substance, specifically for very limited medical use.”

She said she believes that most applicants will have an agricultural and entrepreneurial background, but likely only a small number of “highly qualified” applications will meet the requirements.

A DOH spokesperson told Source NM in an email that there is currently no deadline for applications and that they will be reviewed in order of submission.

Cvitanovic said she recommends those considering applying to be a producer confer with a lawyer and accountant and get documentation together to submit the most complete and compliant application as possible. However, they should also consider whether their plans are operational if a permit is granted.

SB219 set a deadline of December 31, 2027 for the psilocybin program to be implemented; however, the state committed to expediting the timeline by a year, aiming to open the program to its first patients by the end of 2026.

“The state is working really hard to operationalize this program as quickly as possible,” Cvitanovic said. “People are suffering and they want to address that suffering.”

She added that the program’s rulemaking process is not complete and more permit applications will open up down the line for testing and for qualified clinicians. A “buildout and inspection period” will also likely follow before treatment begins with patients. She encouraged people interested in participating in the program to speak with their behavioral health providers about becoming certified to facilitate the treatment.

“Programs like this are only as strong as the clinicians and therapists and other people who choose to participate in them. This is hard work, and it is not risk free, but it has the ability to change the lives of thousands of New Mexicans who are suffering,” Cvitanovic said.

This story was first published by Source NM.

Photo courtesy of Alan Rockefeller.

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Medical marijuana helps 91 percent of older adults improve their pain, insomnia and mood or behavioral symptoms, a new study has found.

The research involved 124 people over the age of 65 who received medical cannabis from a specialized practice in Colombia and whose symptoms were measured at baseline, 44 of whom had a follow-up visit after three months.

Most of the participants had not previously used marijuana, and the most frequent diagnoses they presented with were pain-related and musculoskeletal disorders, cancer and neurodegenerative and non-degenerative neurological disorders—with their top therapeutic objectives being relief of pain, mood/behavioral issues, insomnia and motor symptoms.

Patients’ symptoms were recorded by treating physicians and then coded by researchers on a four-point scale (0 = absent, 1 = mild, 2 = moderate, and 3 = severe), “classified according to its documented impact on patients’ autonomy, basic and instrumental activities of daily living, and participation in meaningful daily activities,” the paper said.

“Symptom severity decreased significantly across the three main symptom domains, with improvement in approximately 90% of patients.”

Symptom improvement was defined as a reduction of at least one point in severity relative to baseline, and 91 percent of participants met that threshold, the study, which has not yet been published in a journal and has been made available as a preprint, found.

“The first documented improvement occurred at visit 2 in 67.7% of patients with pain, 65.4% of those with insomnia, and 73.9% of those with mood or behavioral symptoms, with median times to first improvement of three, two, and one month, respectively,” the researchers wrote.

“Symptom evolution between baseline and the last available follow-up visit demonstrated a consistent reduction in symptom severity across the three most prevalent clinical domains. Median severity scores for pain, insomnia, and mood or behavioral symptoms decreased significantly from baseline to the last available assessment, and no patient showed worsening of symptom severity.”

Analyses also showed that there were “strong effect sizes” for descriptive improvements in digestive and motor symptoms, appetite, well-being and physical strength—though those were not statistically significant.

There was a “significant progressive decline in symptom severity over successive follow-up visits for pain, insomnia, and mood or behavioral symptoms.”

While total resolution of symptoms was uncommon, a small numbers of patients with pain, insomnia and mood/behavioral issues did report complete relief.

Notably, the researchers said that the clinically effective doses of cannabis, which was most commonly administered in oral oil-based formulations, was “low”—typically using just a few milligrams per day of THC, CBD and/or CBG.

The study, which received funding from the European Union, also measured patients’ ongoing use of other medications after starting cannabis, finding that while the “overall medication burden remained stable,” there were dose reductions or discontinuations of concomitant medications in a quarter of the patients.

Overall, there was a “favorable longitudinal evolution of the three most prevalent symptom domains—pain, insomnia, and mood or behavioral symptoms—during routine treatment with supervised medical cannabis,” the paper said.

“Symptom intensity decreased from predominantly moderate to mild levels, and most patients experienced at least a one-point reduction in the severity of their principal symptom during follow-up. Longitudinal analyses further showed progressive improvement across successive follow-up visits, suggesting that these changes reflected a sustained clinical trajectory rather than an isolated difference between baseline and the final assessment.”

“In this retrospective real-world study, older adults receiving supervised medical cannabis experienced favorable symptom evolution during follow-up, while treatment showed a clinically acceptable safety profile and was characterized by consistently low documented clinically effective doses,” the researchers concluded.

The findings, they said, “add to the growing evidence that cannabis may represent a therapeutic option for selected older adults under specialist supervision.”

The researchers cautioned that the observational nature of the study means that causality cannot be inferred, though they do plan to follow up with larger cohorts of patients in Colombia, Argentina and Chile, which they said will “improve statistical power, increase the diversity of clinical practice settings, and allow more robust evaluation of treatment patterns, effectiveness, and safety across different healthcare contexts.”

A separate recent federally funded study published by the American Medical Association (AMA) found that “older adults are increasingly turning to cannabis for symptom management”—with many motivated to try marijuana “as an alternative to traditional pharmaceuticals due to concerns about adverse effects.”

“As cannabis legalization becomes more widespread, older adults are increasingly turning to it not just for recreational use, but to manage symptoms associated with aging, including pain, sleep disturbances, and mental health concerns,” that research found.

AMA separately adopted a resolution this year that recognizes both the risks and potential therapeutic benefits of marijuana use among older adults.

Photo courtesy of Max Pixel.

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The governor of Kentucky says that the state’s efforts to get medical cannabis dispensaries open is now past the “halfway mark” to becoming “fully operational.”

Gov. Andy Beshear (D) noted at a press briefing on Thursday that he recently attended the ribbon cutting ceremony for a medical marijuana cultivation business, saying it is “just the latest example of how we’ve kept our promise to Kentuckians” to provide legal access to patients in need.

The governor, who signed medical cannabis legalization legislation in 2023 that took effect at the beginning of last year, said he is “proud” that the state is “moving forward in every step of the process.”

“So far, more than 25,209 Kentuckians have been approved for medical cannabis cards,” he said. “We now have over 490 practitioners registered to issue certifications. And we have 41 businesses up and running. That includes 11 cultivators, two safety compliance facilities, five processors and 23 dispensaries. Those numbers will continue to grow.”

The increasing access to medical marijuana means that “more Kentuckians won’t have to turn to addictive opioids” and will be able to “deal with chronic conditions, will get the relief they deserve, will be able to to address the PTSD that they may have gotten while serving our country.”

With the Blue Sage Dispensary planning to open in Lebanon on Friday, Beshear said, the state will be “over the halfway mark of Kentucky becoming fully operational when it comes to dispensaries.”

“Medical cannabis is helping our people in need live fuller lives with less pain,” the governor said. “It is a win-win.”

Beshear signed an executive order in June to broaden the list of health conditions that make patients eligible to legally obtain medical cannabis.

But days later, House Majority Whip Jason Nemes (R) asked Attorney General Russell Coleman (R) to ensure that state agencies “not cooperate” with the governor’s marijuana directive, which he called “unlawful.”

“Any organization, any licensee, that participates in this unlawful expansion should be prosecuted,” Nemes said during a legislative committee hearing. “This is not the way forward.”

The governor pushed back, however, saying that the GOP lawmaker exhibited a “complete lack of humanity.”

“It’s helping a lot of people, and I was really surprised to see an attack from one lawmaker who called on the attorney general to prosecute people dying of a terminal illness for securing medical cannabis,” Beshear said. “I mean, that’s a complete lack of humanity. It is really low. I mean, an individual with ALS, you want to prosecute? That is certainly not leadership, and even for that individual, is a new record low.”

After the legislature declined to take him up on a suggestion to expand the qualifying condition list this session, the governor used his authority to make it so patients with 15 additional health disorders—including Parkinson’s disease, HIV/AIDS, sickle cell anemia, fibromyalgia, arthritis and glaucoma—can also be certified for medical marijuana access.

Beshear also rescinded an earlier executive order he issued in 2022 through which he offered to provide pardons for any patients who got into trouble for possessing medical cannabis that they purchased at a legal dispensary in a neighboring state.

The more recent executive order on qualifying conditions is a follow up to a medical marijuana legalization law Beshear signed in 2023. The state’s first medical cannabis dispensary opened in December of last year.

The governor in February announced that cannabis gummies are available for purchase in the state’s licensed dispensaries.

Beshear in January said he’s “not satisfied” with the time it’s taken to launch the state’s medical marijuana program—but that he anticipates the pace of patient access would “pick up significantly” in 2026.

In recognition of the delayed implementation, he signed an executive order to waive renewal fees for patients who get their cards so that they don’t get charged again before retailers open.

Beshear separately announced last year that the state had launched a new online directory that lets people see where medical cannabis dispensaries will be opening near them.

He emphasized that the state has been working to deliver access to patients “at the earliest possible date,” and that involved expediting the licensing process. Last year, the governor also ceremonially awarded the commonwealth’s first medical marijuana cards.

During the November 2024 election, Kentucky also saw more than 100 cities and counties approve local ordinances to allow medical cannabis businesses in their jurisdictions. The governor said the election results demonstrate that “the jury is no longer out” on the issue that is clearly supported by voters across partisan and geographical lines.

Meanwhile, legislature’s Interim Joint Committee on Health Services held a hearing last month on a proposal to allow terminally ill patients to use medical marijuana in hospitals.

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Medical cannabis imports in Germany increased from 8,143 kilograms (17,952 pounds) in the first quarter of 2024 to 50,539 kg (111,419 pounds) during the first quarter of this year, making the nation Europe’s largest regulated cannabis market, the Financial Times reports. The sixfold increase comes after the 2024 reforms, which allowed adults to possess and privately cultivate cannabis, and expanded the medical cannabis regime. 

According to research outlined by FT, more than half of cannabis consumers in Germany obtain their cannabis from outside the medical cannabis system, with 35.2% of cannabis obtained from the “social supply,” with at-home cultivation representing the second largest source of cannabis at 21%. A recent study from the University of Hamburg found that more than 200 tons of cannabis were available in Germany last year, including 2.6 tons produced domestically. 

Cannabis intelligence firm Prohibition Partners estimates Germany’s cannabis market totals $997 million.  

Jakob Manthey, the scientist behind the two-year evaluation, told FT that “the illegal market is shrinking although overall consumption has barely changed,” but producers “exploit regulatory gaps and market products that are not evidence-based at all.” 

The health ministry under the current government led by Chancellor Friedrich Martz has submitted a bill to tighten controls on medical cannabis. Debate on that bill is expected in the fall.   

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Illinois officials have added two new qualifying conditions for the state’s medical marijuana program.

The Illinois Department of Public Health (IDPH) announced on Tuesday that patients with sickle cell disease and polyendocrine metabolic ovarian syndrome (PMOS) with chronic pain can now qualify for legal access to medical cannabis, with a doctor’s recommendation.

IDPH Director Dr. Sameer Vohra approved the conditions following a review by the Medical Cannabis Advisory Board.

“Medical cannabis can provide relief for people living with certain debilitating conditions,” he said. “IDPH reviews petitions carefully using expert opinion and the most up to date evidence to make decisions that best serve Illinois residents. We look forward to working with our medical providers to ensure safe, appropriate access for individuals struggling with these newly approved conditions.”

With the two new additions, Illinois now has 58 medical cannabis qualifying conditions.

The move comes about two weeks after the Illinois Department of Financial and Professional Regulation (IDFPR) posted a new form that recreational marijuana dispensaries can file in order to get permission to begin selling medical cannabis, which is taxed at a much lower rate than adult-use products.

The expanded opportunity for marijuana businesses comes as part of omnibus cannabis legislation that was passed by lawmakers and signed into law by Gov. JB Pritzker (D) this session.

The law also doubles the amount of marijuana that adults can legally possess, allows drive-thrus and curbside pickups at dispensaries and lets them stay open for longer hours of operation, among other changes.

“Any adult use dispensary holding an active license in good standing may opt-in for a medical dispensary license,” IDFPR said in previously issued guidance about changes made by the new cannabis omnibus legislation. “This medical dispensary license will allow the dispensary to sell cannabis to medical cannabis patients at the medical tax rate up to the medical patient’s allotment.”

The medical cannabis sales option for adult-use businesses is part of SB 3222, which was approved by the legislature and signed by Pritzker in June.

As enacted into law, the measure also allows residents of the state who are over 21 years of age to possess up to 60 grams of marijuana flower—double the amount in prior law. They are also able to have up to 10 grams of cannabis concentrates and infused products with up to 1,000 mg of THC—also double the earlier limit. Possession amounts for adult non-residents are also doubled under the bill and are generally set at half of what residents can carry.

Additionally, people with past convictions for possession of up to 60 grams of marijuana are now able to have those records expunged—double the previous cutoff allowing only those with convictions for up to 30 grams to be eligible.

The legislation also recriminalizes hemp THC products with more than 0.4 milligrams of THC per container, in line with a federal ban that is set to take effect in November.

The state’s list of medical marijuana qualifying conditions is also being expanded to add female orgasmic disorder, endometriosis, ovarian cysts and uterine fibroids.

The governor held a signing ceremony for the legislation at a marijuana dispensary, saying he is “proud that Illinois continues to lead the nation in showing what thoughtful, balanced cannabis policy can achieve.”

In 2019, Pritzker signed the state’s initial marijuana legalization policy into law.

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“Because marijuana use remains illegal under federal law, standard supervision conditions may prohibit consumption.”

By Sephria Reynolds-Tanner, Reason Foundation

Medical marijuana is legal in 47 states, the District of Columbia and three U.S. territories. Yet for millions of Americans on probation or parole suffering from qualifying conditions like chronic pain, post-traumatic stress disorder and anxiety, that legalization is worth very little in practice. In many states, people on probation and parole are forbidden to use medical marijuana, even when legally recommended by a physician.

It’s an oversight that state lawmakers need to address.

Nearly four million adults in the United States are on probation or parole, almost double the number of people held in jails and prisons combined. Because marijuana use remains illegal under federal law, standard supervision conditions may prohibit consumption. A positive drug test can trigger a violation of probation or parole and result in jail or prison time.

In 2023, states collectively spent an estimated $3 billion re-incarcerating people for “technical violations,” such as missing a check-in appointment or failing a drug test. The exact share attributable to marijuana-related test failures is unknown because agencies do not collect substance-specific violation data. But, because marijuana is the most commonly used controlled substance and remains detectable in urine for up to 30 days, that share is likely substantial.

This problem for patients is rooted in marijuana’s Schedule I designation under the federal Controlled Substances Act, which deems it to have “no currently accepted medical use.”

But even the federal government is changing its position. Last year, President Donald Trump ordered the attorney general to expedite rescheduling marijuana to Schedule III. In April, then-Acting Attorney General Todd Blanche issued a final order moving Food and Drug Administration-approved and state-licensed medical marijuana to Schedule III, while setting an expedited hearing on broader rescheduling that ran through July 15, with a formal recommendation still pending.

Federal rescheduling at least removes the primary legal justification agencies and courts have used to strip those under community supervision of legal access to medical marijuana. Yet, federal rescheduling will not fix the problem for people under state supervision who need medical marijuana. Most states independently schedule marijuana in their own drug laws, and supervision conditions that prohibit marijuana specifically need to be revised.

Courts in Arizona, Pennsylvania and Michigan have already struck down state bans on people under supervision using medical cannabis, with judges ruling that the immunity granted by state medical marijuana legalization does not simply disappear because someone is placed on probation.

Legislatures in Connecticut, New York, Minnesota, Missouri and Colorado have also taken steps to harmonize their supervision systems with medical marijuana legalization, enacting laws to allow those under supervision to participate in medical marijuana programs.

Corrections agencies in Washington, Florida and Minnesota have implemented administrative policies to do the same, creating a system to verify registration with medical marijuana programs and maintain oversight without categorical prohibition.

But for those under supervised release in many other states, re-incarceration is still a risk if they use doctor-recommended cannabis.

Probation and parole officers do not prohibit people under supervision from taking prescribed controlled substances like Adderall, Xanax or OxyContin. Standard probation conditions include carve-outs that permit the use of prescribed drugs, managing risks through documentation, monitoring and clinical intervention when problems arise.

States should extend the same framework to medical marijuana: Verify the recommendation, document it in the case files and treat it like any other prescribed medication rather than an automatic violation that can lead to reincarceration.

The states that have legalized medical marijuana have already made the policy decision that patients with qualifying conditions deserve access to physician-recommended treatment without criminal penalty. Supervision systems in those same states should reflect the intent of medical marijuana laws and protect patients.

Sephria Reynolds-Tanner is a criminal justice and drug policy analyst at Reason Foundation and a former probation and community corrections officer in Washington state. She is the author of Medical Cannabis Access Under Probation and Parole: Removing Barriers to Doctor-Recommended Treatment.

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