Patients who register with their state’s medical cannabis program typically become, literally, card carrying members. What many do not realize is that some states recognize the registrations of those from outside areas, something that is called reciprocity. While most states do not recognize out-of-state medical cannabis exemptions or qualifications, a few do. Of these, there are important differences of which millions of traveling patients should be aware.
The medical cannabis laws of most states do not allow reciprocity for one simple reason: It invites scrutiny by federal authorities, specifically those in the Drug Enforcement Administration, or DEA. The Justice Department is home to the DEA and exercises oversight for interstate commerce. It therefore has a vested concern to ensure that diversion (legal cannabis being delivered to illegal recipients) and other fraudulent activity is not involved. The issue becomes only more complex based on the fact that medical, and even recreational, cannabis is legal in some states, but all forms of cannabis are illegal at the federal level.
The federal government categorizes cannabis as Schedule I, meaning it is officially as “dangerous and addictive” as heroin and bath salts. In fact, both cocaine and methamphetamines, two truly addictive drugs that nearly any medical professional will testify are more dangerous than cannabis, both reside in less-restrictive Schedule II; they can even be prescribed by a physician.
Possession vs. Purchase
Four states with medical cannabis laws on the books allow visitors to legally possess and consume cannabis (within limits), but do not provide safe access via dispensaries to the medicine or related products (like concentrates, edibles, tinctures, and topicals).
States allowing registered patients from out-of-state to possess cannabis include:
- New Hampshire: Visiting patients are permitted to possess and consume cannabis, but cannot purchase or grow the herb.
- Arizona: Card-carrying patients from other states are permitted to possess and use cannabis, but not purchase it.
- Michigan: Visiting patients may possess and use. If driving with cannabis, the herb must be stored in a case in a locked trunk of the vehicle.
- Rhode Island: Like similar states, visiting qualifying patients may use and possess up to 2.5 ounces of cannabis, but cannot purchase from dispensaries in the state.
There are three states that practice full reciprocity and will legally allow, under certain circumstances, out-of-state patients to make purchases at licensed dispensaries. This is a way for those suffering a debilitating disease or condition, especially those who must medicate daily, to obtain medicine when they are traveling. It is not recommended that patients attempt to carry cannabis through an airport or on a flight. While many are successful, the legal ramifications in some states — or from federal authorities — simply are not worth the risk for the average patient.
It is legal for any patient possessing a valid medical cannabis card, from any state, to purchase, possess, and consume cannabis products at Nevada dispensaries. In fact, because reciprocity is practiced by so few states in the U.S., Nevada may become a destination for patients in other states who wish to vacation or meet business clients, but don’t desire to — or simply can’t — go without their medicine for the duration of their travel.
In Nevada, reciprocity is fairly straightforward. At their first dispensary visit, patients from out-of-state are asked to sign an affidavit testifying that they are currently a valid patient in another state. In addition, traveling patients are restricted to that initial dispensary for one month. Because most travelers, especially those vacationing in Las Vegas, will be staying a considerably shorter period of time than a month (a two to seven day span is more common), they are limited to a single dispensary for that particular trip. Las Vegas is significant, especially considering that 40 million people travel there each year (that’s the entire population of California, the most populous state in the nation).
Thus, patients visiting Las Vegas or Reno should be careful when selecting their initial dispensary. If their next trip to the Silver State is more than 30 days in the future, they will then be able to shop at the dispensary of their choice. Some have pondered if Nevada will pass recreational legalization via a ballot initiative in November 2016. If it does, Las Vegas could become the Amsterdam of the United States, being America’s legal adult playground for more than merely gambling and big-dollar magic acts.
The fact that Nevada is risking federal scrutiny to do what is best for patients is both relatively novel among states that have enacted medical cannabis laws, but also within the theme of Nevada’s tourism. If there are three states that understand the economic and cultural benefits of a robust tourism industry, it is Nevada, Colorado, and California. This spirit is finally being expressed within state laws affecting medical cannabis patients.
In Hawaii, patients from the mainland must simply register with the state. None of the details of this program are available, however, due to the fact that it will not go into effect until January 1, 2018. Patients traveling to this classic vacation destination of perfect temperatures and gorgeous beaches must remain patient for their opportunity to spend a few days in paradise while also remaining medicated to reduce or eliminate pain and nausea or deliver relief from inflammation-based diseases such as fibromyalgia, arthritis, and even cancer.
Maine requires that the recommending physician of visiting patients submit a form that testifies to the patient’s condition and eligibility in their home state. Visiting patients may designate a caregiver or dispensary in Maine, but not both. Surprisingly — in what seems to be an effort to accommodate those who relocate to Maine, not just visitors or vacationers — patients can have their doctor petition for their right to cultivate up to six mature plants.
Thus, patients who qualify for their home state’s medical cannabis program may visit or move to Maine and immediately request, via their recommending doctor, legal permission to consume and even cultivate cannabis.
Federal legality would eliminate the need for states to practice reciprocity in their recognition of registered medical cannabis patients from fellow states. However, this isn’t something that is on the political horizon in Washington, D.C. and a popular topic in Congress. Until true progress is made on Capitol Hill, patients will have to rely upon the handful of states that officially recognize the programs of those outside their own borders.
This post was originally published on January 22, 2016, it was updated on October 5, 2017.