As of today, there are 30 states (and one district) that have active medical marijuana programs. These success stories have been earned through a lengthy timeline of wins and losses for the cannabis industry.
The history of medical marijuana in the United States reflects what we know of cannabis culture: Small victories over time have yielded large-scale results.
History of Medical Marijuana
The United States' war on marijuana became official in 1956. Congress put together the Narcotics Control Act with a special inclusion for marijuana. With this clause, those caught possessing cannabis faced strict penalties, including a two to 10-year prison sentence and a fine up to $20,000 – quite a large sum in the 50s. At this point in time, medical marijuana is a distant, lackluster dream.
THC, scientifically known as delta-9-tetrahydrocannabinol, was first discovered in 1964 by Dr. Raphael Mechoulam. In addition to the psychoactive agent in marijuana being identified, THC could also be synthesized.
The federal government was curious about cannabis, to the point that they allowed the University of Mississippi to become an official marijuana grower. This cultivation was for government use and research activities, looking at everything from chemical research to toxicology to human clinical trials. This move allowed for more education, paving the way for medical marijuana discoveries.
In the same year, President Johnson created the Bureau of Narcotics and Dangerous Drugs (BNDD), to address the dramatic increase of marijuana use in the sixties. For the people who were afraid of free love, Johnson gave a reason to remain calm.
The United States government drove its anti-cannabis stance home with the Controlled Substances Act, which classified marijuana as "a drug with no accepted medical use." This is also where the Schedule I classification came from, the most dangerous level of narcotic.
President Nixon declared his infamous "War on Drugs," which was stated in a press conference on June 17, 1971: "America’s public enemy number one in the United States is drug abuse. In order to fight and defeat this enemy, it is necessary to wage a new, all-out offensive." He nixed the hopes and dreams of medical marijuana advocates everywhere.
The BNND and the Office of Drug Abuse Law Enforcement (ODALE) merged to create one single anti-drug entity, the Drug Enforcement Agency (DEA). The DEA still exists today, tackling drug issues in the U.S., internationally, and educating the public.
The National Institute on Drug Abuse (NIDA) was created in 1974 and took on the task of administrating the growth of weed for research purposes. NIDA became the only legal source for such research and continued to contract the University of Mississippi to grow specific amounts of marijuana based on research need; they also contracted the Research Triangle Institute to manufacture joints.
As with any movement, education is key. At this point, the U.S. opened the door to information, though still with reluctant and anti-marijuana stances.
A huge development: In 1978, NIDA supplied seven patients with marijuana in a new, compassionate-use program. This is where medical marijuana truly began. This program, administrated under the Investigational New Drug (IND) title, worked through an application submitted by the patients' physicians.
In the same year, New Mexico passed the first state law to recognize the medical value in marijuana. This was an epic step for the MMJ community, and states' rights as a whole.
Speaking of Marinol, a synthetic weed, it was tested in 1980 as a cannabis replacement. The National Cancer Institute (NCI) administered Marinol to cancer patients in San Francisco. Studies began in several states, all with similar findings: The patients found weed more effective and safer than the synthetic variant. This did not, however, sway the government's enthusiasm with promoting Marinol over marijuana.
The first ever legal medical marijuana patient under the IND program, Bob Randall, along with his wife Alice O'Leary, started an organization with the specific goal to help other patients get access to the medicinal benefits of cannabis.
Their group was called the Alliance for Cannabis Therapeutics (ACT), and their duties involved helping other patients and their doctors file Compassionate Care Protocols, sort through government loops, and urging marijuana education. This was the start of a movement.
When things seemed to be moving forward, the government had another thing to say. In 1986, President Reagan signed the Anti-Drug Abuse Act, which increased the penalties for marijuana dealing and possession. This time around, the law was reworked to be dependent on how much weed was involved. For example, having 100 marijuana plants was equivalent to having 100 grams of heroin.
This same act later introduced the "three strikes and you are out policy," which involved life sentencing for repeat offenders and the threat of the death penalty for drug-world leadership.
Science evolves, and cannabis is not immune to the perks of advancement. In 1990, scientists at the National Institute of Mental Health discovered cannabinoid receptors. With this information, there was finally a concrete way of understanding how and why marijuana has an effect on humans: The THC in weed binds with the brain's cannabinoid receptors. This fact of science fueled progression.
Medical marijuana history was made on November 5, 1991 as the first ever medical marijuana initiative passed in San Francisco. Named Proposition P, this vote passed by 79 percent, allowing cannabis to be considered a viable medicine in the city, while taking away the penalties physicians faced for prescribing it.
Not long after scientists found out about cannabinoid receptors, they were able to discover and identify the endocannabinoids in the brain. The endocannabinoid acts as the brain's natural version of THC. It was called "anandamide," which translates to "supreme joy" or "eternal bliss." The endocannabinoid system became connected to the post-exercise highs (think of the runner's high), memory, movement coordination, and emotion control.
California became the first state to legalize medical marijuana in 1996. What started as a San Francisco initiative grew and flowered into a historic, state-wide movement. Proposition 215 allowed patients and their caregivers to own and grow marijuana with a doctor's recommendation. Medical marijuana could be used to treat certain qualifying conditions, including cancer, muscular spasticity, migraines, and AIDS, among others.
Following the November election, the National Institutes of Health (NIH) stated that they need more research to determine the potential of medical marijuana. The NIH essentially determined that there wasn't enough scientific evidence to truly assess the healing potential of cannabis and advised that more testing should be done.
This pertains to the history of medical marijuana because agencies were asking for more information, education, and access to growth. People were more willing to search for answers, without necessarily advocating for or against the herb – a staunch difference from medical marijuana's humble, underdog roots.
The call for progress was short lived. In 1998, three living, former presidents urged voters to reject the idea of medical marijuana, right before the election. Presidents Bush, Ford, and Carter joined forces and released a statement saying that state initiatives miss out on the standard processes of the Food and Drug Administration (FDA), which test for safety and effectiveness.
Thankfully for activists, medical marijuana initiatives passed in every state that it was marked on a ballot. These states include Alaska, Oregon, and Washington, which in turn became the second, third, and fourth states to legalize medical marijuana.
Alaska won the vote by a 58 percent, 55 percent in Oregon, and 59 percent in Washington. The law took effect in March, December, and in November day, respectively. Each initiative removed the penalties faced by physicians, as well as the criminal implications of the use, possession, and cultivation of medical marijuana.
For medical marijuana patients in Alaska, the state required them to enroll in a registry. Starting in 1999, all patients had to register for the program, which then entitled them to a valid ID card. This is the origin of the MMJ card, a piece of history regarding medical marijuana and where the program is today.
The same year, Maine became the fifth state to legalize medicinal cannabis, passing with a 61 percent vote in November.
Hawaii continued the trend, passing legislation to be the sixth state to legalize medical marijuana in June, which also removed criminal penalties for patients.
Colorado and Nevada followed suit in November 2000, becoming the seventh and eighth states to legalize the use and growth of the healing herb. The amendments passed by 54 percent in the Mile-High State and took effect in June, while the Silver State passed Question 9 by 65 percent.
The medical marijuana industry took a hit in May 2001, when the Supreme Court ruled against its favor.
Initially, the Oakland Cannabis Buyers' Cooperative, which distributed MMJ to qualifying patients, was sued by the United States government. The government wanted the cooperative to stop providing weed. Though the case was initially rejected, citing the medical necessity of the marijuana, the rejection was overturned by the Ninth Circuit.
The Supreme Court decided that there "was no medical necessity exception to the Controlled Substances Act's prohibitions on manufacturing and distributing marijuana." That pesky act, which was initiated in 1970 (as you remember), prevented patients from getting the care they voted to receive.
On a happier note, the IND program released the results of their study in 2002, with a positive tone: Research concluded that medical marijuana improved the quality of life for the patients involved in the study.
The research concluded that smoking marijuana – even low-grade stuff – leads to relief for pain and muscle spasms and can potentially decrease dependence on other prescription medications.
Later in 2002, the Supreme Court ruled that the government cannot revoke a physician's license just for recommending MMJ. Since states started legalizing medical marijuana in 1996, there was always a threat looming over doctors – that they could lose everything for giving their honest opinion regarding weed, punished by the federal government. Thanks to Conant v. Walters, a new standard was set.
However, later that year, voters in Washington, D.C. were disheartened. Their license plates read "taxation without representation" for a reason; although voters approved a medical marijuana initiative by a 69 percent vote, Congress blocked it, without offering rationale.
In 2003, the United States Government received a patent for medical marijuana – specifically "for the therapeutic use of cannabinoids as antioxidants and neuroprotectants."
In the aptly named "Senate Bill 420," California placed limits on the amount of medicinal cannabis a patient could have. Patients and their caregivers could own six mature or 12 immature plants for home growth or have eight ounces of weed in their possession.
Vermont's governor approved an act to allow medicinal cannabis for people with severe illnesses, making the state the ninth to do so.
In November 2004, Montana joined the ranks of MMJ-approved states as number 10. The initiative passed by 62 percent and took effect that day.
Though California was the first state to pass legalized MMJ, it was far from perfect in the history of medical marijuana timeline. In 2005, California suspended its ID card program following the Angel v. Raich case. The Supreme Court ruled that the possession and cultivation of weed – regardless of state legislation – is still a federal offense. In response, California temporarily pulled the plug on their program.
It was reinstated 10 days later. The state attorney general found that state employees could not be prosecuted for issuing the federally illicit ID cards. Thankfully, Californian patients were able to still sign up and receive legitimate ID cards.
Rhode Island became the 11th state to legalize medical marijuana. In this scenario, the governor vetoed the measure; the legislature overrode the veto, leading an effective law in 2006.
Scandal further erupted later that year when the DEA made a drug bust in California: According to the LA Times, 12 people were arrested for manufacturing weed-laced candy. This messy arrest seized four indoor growing operations, thousands of cannabis plants, many weapons, lots of money, and candy infused with marijuana.
Conservative-controlled New Mexico became the 12th state to join the history of medical marijuana for compassionate use via a senate bill. The care was designated to be provided by the New Mexico Department of Health.
In February 2008, the American College of Physicians (ACP) released a paper announcing their support for the use of non-smoked forms of THC. They credited research on the medicinal benefits of cannabis, called for criminal prosecution reform, and urged for a review of the federal Schedule I classification.
Sixty-three percent of voters later approved the legalization of medical marijuana in Michigan that year. They were the 13th state to do so.
New Jersey added their name into the MMJ-approved list, as the 14th in the nation.
In July 2010, the U.S. Department of Veterans Affairs took a step in the right direction by relaxing marijuana rules for vets. Their official release stated, "veterans who participate in legal state medical marijuana programs will no longer be disqualified from substance abuse programs, pain control programs, or other clinical programs."
In the same month, medical marijuana was legalized in Washington, D.C. The democratic-controlled Congress allowed the voters to enjoy the legislation they passed. Eight dispensaries were allowed to be built.
In November, Arizona followed suit, earning its title as the 15th state to legalize MMJ. Its success was passed by a small margin.
Delaware's governor signed a law legalizing medical marijuana in May 2011. The state became the 16th state to allow a medicinal cannabis program.
The next state legalization took place in 2012 with Connecticut. HB 5389 was signed into law, which gave Connecticut its title as the 17th legalized state.
Massachusetts followed state as number 18, with a significant 63 percent vote.
New Hampshire became the 19th state to legalize MMJ, thanks to House Bill 573, followed by Illinois at number 20.
A huge part of the history of medical marijuana is the financial history. Struggling with the federal government's disdain for cannabis, medical marijuana community members had difficulty with finance. Banks were off limits. They were, at least, until February 2014, when the Obama Administration gave banks the opportunity to legally conduct transactions with legitimate medical marijuana sellers. This way, businesses could save, conduct payroll, and pay taxes.
Maryland, Minnesota, and New York followed up by legalizing medical marijuana – the 21st, 22nd, and 23rd states to do so. Minnesota had an interesting clause, however: The bill allowed for oil, pill, and vaporized marijuana, but not smokable weed.
In an overdue move of retribution, the U.S. Justice Department announced that it would not enforce federal cannabis laws on Native American reservations, which are considered sovereign lands, even in states without legalization.
The federal government has made it difficult to make headway with cannabis. In 2015, it made small amends by removing a bureaucratic obstacle in the way of marijuana research. Privately-funded companies were finally able to easily conduct their own research without any red tape.
Dubbed the 24th state to legalize MMJ, Pennsylvania joined the ranks of de-criminalized programs. its Senate Bill 3, however, does not allow for smokable pot – it has to be used or ingested in other ways.
Ohio followed suit shortly after, becoming the 25th state. It also does not allow smokable marijuana. Election day recruited several more states into the legalized club, including Arkansas (26), Florida (27), and North Dakota (28), passing by 53.2 percent, 71.3 percent, and 63.7 percent.
West Virginia became the 29th U.S. state to legalize medical marijuana. Smoking the herb is prohibited.
As presidential administrations shifted completely, U.S. Attorney General Jeff Sessions overturned Obama-era marijuana guidelines. Sessions rescinded the policy that barred federal law enforcement officials from interfering marijuana sales in legalized states.
Oklahoma recently became the 30th state to legalize medical marijuana. Voters passed a law allowing 3 ounces of usable weed, 6 mature plants, and 6 immature plants. More, specific legislation is expected.
Though the future of MMJ programs in legalized states is unclear, the history of medical marijuana lends a truth of its own: Change is possible, though it won't happen overnight.