Select a State  
Marijuana Policy Project
Marijuana Policy Project
Donate
Menu
Marijuana Policy Project
Marijuana Policy Project
Donate

Medical Cannabis Program Implementation Timelines

The time states have taken to implement medical cannabis laws has varied widely. On the quickest end of the spectrum, Montana issued patient ID cards 41 days after voters approved a medical cannabis initiative in 2004, and Oklahoma issued business licenses just two months after that initiative’s June 2018 enactment. Oklahoma’s first medical cannabis dispensaries opened three months after the law’s passage. Other states have also been able to swiftly implement medical cannabis laws: In Minnesota, Maine, Mississippi, and New York, the first dispensary sales occurred within 11 to 18 months of the laws’ enactment.

West Virginia was the slowest state to implement. Patients did not receive legal access to cannabis until 4.5 years after the law’s May 2017 enactment, and they had no legal protections until the registry opened in February 2021 — more than 3.5 years after passage. Until West Virginia broke the record, the slowest state to provide patients ID cards was Maryland, where it took three years. In the other slowest three states to implement medical cannabis access — Delaware, Maryland, and Rhode Island — the first medical cannabis sales did not begin until three-and-a-half to four years after passage. (In two of those cases, concerning signals from federal prosecutors were largely to blame.)[1]

Alabama may be poised to become the slowest state. The governor signed medical cannabis legislation in May 2021, and sales have still not begun. Licensing has been repeatedly delayed by litigation, and the state has not issued any patient ID cards.

MPP encourages states to implement medical cannabis laws swiftly and responsibly. States should also grant patients who obtain a doctor’s written certification immediate protections from arrest, rather than requiring them to needlessly suffer while they wait for a governmental agency to issue ID cards. Medical cannabis businesses should be promptly licensed, to provide patients with safe, convenient access to their medicine with undue delay.

Issuing a limited number of licenses based on competitive scoring licensing tends to lead to litigation, allegations of favoritism or bias, and delay. If a state imposes a numerical limit on businesses, a lottery of qualified applicants — with adequate geographic distribution for retailers — allows more rapid implementation and less vulnerability to litigation than a scored system.

 

State Law Enacted Patient ID Card Timing Dispensary Sales Began Comments
Alabama May 2021 As of August 2025, the patient registry is not open. The Commission plans to open the registry after licensing businesses. Dispensary sales have not begun as of August 21, 2025. The Alabama Medical Cannabis Commission began taking requests for applications on Sept. 1, 2022. Applications must be granted or denied (or a deficiency will be noted for curing) within 60 days, but as of August 2025, litigation has stalled the process.
Alaska Nov. 1998   Applications were available in early June 1999, about seven months after passage.       N/A — No medical dispensaries Voters enacted an adult-use cannabis law in Nov. 2014, and regulated sales began less than two years later, in Oct. 2016.
Arizona Nov. 2010 Applications became available about five-and-a-half months after passage, on April 14, 2011. A little over two years after passage, in Dec. 2012. An unsuccessful lawsuit by then-Gov. Jan Brewer delayed the implementation of dispensaries. Regulators published final rules on March 28, 2011, and dispensary certificates were issued on Aug. 7, 2012. Voters enacted an adult-use cannabis law in Nov. 2020, and regulated sales began four months later.
California Nov. 1996; subsequent legislation in 2003 and 2015 Prop. 215 did not provide for ID cards; voluntary cards were available later. Prop. 215 did not provide for regulated sales. Dispensaries existed in a legal gray area until 2018. Collectives received legal protections, but no licensing, in 2003. State regulatory and licensing law passed in 2015, and licenses were first issued in 2018. Voters enacted an adult-use cannabis law in Nov. 2016, and regulated sales began around a year and a month later, on Jan. 1, 2018.
Colorado Nov. 2000; June 2010: dispensary law Patient applications were available in fewer than seven months, on June 1, 2001. Dispensaries existed before there was a state law recognizing, licensing, and regulating them. They smoothly transitioned to a licensed system within a year of the 2010 dispensary law’s passage. The dispensary regulation bill began phasing in within two months of its passage, with the initial state form and fees due. Dispensary regulations were finalized and went into effect within one year of the law’s passage. Also, voters enacted an adult-use cannabis law in Nov. 2012, and regulated sales began around a year and a month later, on Jan. 1, 2014.
Connecticut May 2012 Temporary patient ID cards became available within five months of the law’s passage on Oct. 1, 2012. The first dispensaries opened about two years and five months after the law’s passage in Oct. 2014.   The state began accepting business applications in Sept. 2013, about 16 months after the law’s passage. The governor signed an adult-use cannabis law in June 2021, and adult-use sales began around 2.5 years later, on January 10, 2023.
Delaware Passed May 2011; effective July 1, 2011 Patient applications were available 14 months after the law’s passage on July 2, 2012. Sales began about four years after enactment on June 26, 2015. Then-Gov. Jack Markell significantly delayed implementation in light of a concerning letter he received from Delaware’s U.S. attorney. Final regulations were approved in Jan. 2014. The first “compassion center” was approved on Aug. 11, 2014. The legislature enacted an adult-use cannabis law in April 2023, and regulated sales began about 2.25 years later, on August 1, 2025.
Florida Nov. 2016 A registry became available on June 29, 2016 for patients under earlier, more limited laws. (A 2014 law allowed cancer, seizure, and MS patients to use and obtain low-THC, and a 2016 law allowed terminally ill patients to use THC-rich cannabis.) Dispensary sales began in Sept. 2016, pursuant to earlier, more limited laws. In 2017, the legislature passed a legislative framework for medical cannabis. The health department adopted regulations on July 3, 2017 to implement it and the constitutional amendment. Some of the legislative provisions — such as banning patients from smoking or otherwise using raw cannabis — have been challenged in court.
Hawaii June 2000; dispensary law signed July 14, 2015 Registry became available fewer than seven months after passage, on Dec. 28, 2000. Sales began about two years after the dispensary law passed, in early Aug. 2017. Dispensaries were licensed about nine months after the dispensary law passed.
Illinois Aug. 1, 2013 Illinois first accepted patient applications a little over a year after passage, on Sept. 1, 2014 and Nov. 1, 2014 (depending on last name). The first dispensaries opened on Nov. 9, 2015, about two years and three months after enactment. Patient and caregiver ID card applications were first accepted 13 months after enactment. Medical cannabis business licenses were issued about 18 months after enactment. The governor signed an adult-use law in June 2019, and sales began about six months later.
Kentucky March 31, 2023 Patient registrations were accepted starting January 1, 2025. The first sales are anticipated in fall 2025.. Patient and caregiver ID card applications were first accepted 21 months after enactment. Businesses were licensed 19 months after enactment.
Louisiana May 19, 2016 (an earlier version of the law was not workable) N/A — law does not include patient ID cards   Sales began on Aug. 6, 2019, about three years and two months after the workable law passed. The state licensed nine pharmacies in mid-April  2018, two years after passage.
Maine Nov. 1999 initiative; revised by voters in Nov. 2009 and by the legislature in spring 2010 and spring 2011 ID cards were not available (or needed) under the 1999 law. The first dispensary opened less than 17 months after the dispensary law's passage, in March 2011. Maine's initial law did not have a patient registry or regulated dispensaries. The 2009 law was fully implemented within a year of its passage. Voters enacted an adult-use cannabis law in Nov. 2016. Due to opposition from the then-governor, sales did not begin until Oct. 2020.
Maryland April 14, 2014 (replacing an ineffective 2013) The patient registry opened April 10, 2017, nearly three years after the law passed. The first dispensary sales began on Dec. 1, 2017, three years and seven months after passage. In Nov. 2022, voters approved a legislatively-referred ballot measure to legalize adults’ possession of cannabis. Gov. Wes Moore signed legislation on May 4, 2023, to allow and regulate sales. Adult-use sales began less than two months later.
Mass. Nov. 2012 The state began accepting patient applications just under two years after passage, in Oct. 2014. However, patients could initially use their doctors' written recommendations as ID cards. The first dispensary opened in June 2015, about two years and seven months after passage. Six months after Massachusetts’ law was enacted, the state drafted rules, which followed listening sessions throughout the state. Voters enacted an adult-use cannabis law in Nov. 2016, and regulated sales began two years later, in Nov. 2018.
Michigan Nov. 2008; dispensary law Sept. 2016 Patient applications became available on April 4, 2009, about five months after passage. Dispensaries transitioned from lacking a state license and arguably being illegal under state law to having licenses in the last half of 2018, about two years after that law’s passage. The first dispensary licenses were issued in Aug. 2018, a little less than two years after the dispensary law’s passage. Voters enacted an adult-use cannabis law in Nov. 2018, and regulated sales began around a year later, in December 2019.
Minnesota May 29, 2014   Patient applications became available on June 1, 2015, just over a year after passage. The first dispensary opened on July 1, 2015, about 13 months after passage. The health department issued a preliminary draft of rules in Aug. 2014, less than three months after the law's passage.  The department registered two manufacturers by Dec. 1, 2014, about seven months after passage. The governor signed an adult-use law on May 30, 2023. The first adult-use licenses were issued two years later, in June 2025.
Mississippi February 2, 2022 (after the courts threw out a voter- enacted version in 2021) Patient applications became available on June 1, 2022, around four months after passage. Sales began on January 25, 2023, less than a year after enactment. As of August 2023, the program has 184 dispensaries and over 111 cultivators licensed.   Implementation in Mississippi was faster than most states, in part due to the lack of a competitive, scored system, which takes time and often results in litigation. However, the government expected to implement it nearly 1.5 years earlier, after voters enacted a ballot measure that was later thrown out in court, along with the entire state ballot initiative process.
Missouri Nov. 2018 Patients could begin applying for ID cards on July 4, 2019. Medical cannabis cultivation began in summer 2020, and sales began in October 2020, about two years after enactment. Regulators issued dispensary licenses in January 2020, about one year and two months after the law passed. Voters enacted an adult-use cannabis law in Nov. 2022, and regulated sales began three months later, in Feb. 2023
Nebraska Nov. 2024 N/A there is no registry, patients can possess cannabis with a certification Dispensaries are not yet licensed as of August 2025. The commission is accepting applications. Emergency regulations were issued on June 26, 2025, under eight months after passage.
Montana Nov. 2004; dispensary law Nov. 2016 Patient applications became available on Dec. 14, 2004, just 41 days after passage. Dispensaries were not clearly allowed under state law until voters approved an initiative in Nov. 2016, but they existed before then. While initiative language required the licensing process to begin in the summer of 2017, it wasn't until April 2018 that some businesses began receiving licenses. Montana’s medical cannabis law initially allowed caregivers to serve unlimited numbers of patients without dispensary licensing. The legislature dramatically limited the law in 2011 to ban dispensaries and compensated caregivers. . In Nov. 2016, voters approved an initiative allowing caregivers and dispensaries.  In Nov. 2020, voters enacted an adult-use cannabis law. Adult-use sales began a year and two months later, in Jan. 2022.
Nevada June 2001: patient registry legislation; June 2013: dispensary and cultivation law Patient applications became available four months after passage on Oct. 1, 2001. Sales began two months after the dispensary law’s enactment, in Aug. 2015. Dispensary rules were crafted 10 months after that law was enacted. The health department issued preliminary certificates in Nov. 2014, less than a year-and-a-half after the dispensary bill became law. Voters enacted an adult-use cannabis law in Nov. 2016. Adult-use sales began eight months later.
New Hampshire July 23, 2013 Patient applications became available nearly two-and-a-half years after passage, in Dec. 2015. Sales began two years and nine months after passage, on April 30, 2016. Patient and caregiver registry rules were approved on June 25, 2014. However, pursuant to the opinion of the state attorney general, the health department did not begin issuing ID cards until a patient successfully sued in Dec. 2015. Dispensary (ATC) rules were provisionally approved about 15 months after the law's passage. Preliminary dispensary registrations were issued one year and 11 months after the law's passage.
New Jersey Jan. 2010 Patient applications became available more than 2.5 years after passage, on Aug. 9, 2012. Sales began nearly three years after passage, on Dec. 6, 2012. Due to reticence by then-Gov. Chris Christie, along with mixed signals from the federal government at the time, implementation was slow. Six "alternative treatment center" (ATC) licenses were preliminarily issued in March 2011.  In Nov. 2020, voters approved a legislatively-referred constitutional amendment directing the legislature and the Cannabis Regulatory Commission to regulate cannabis for adults’ use. In March 2021, lawmakers approved bills to implement the amendment. Adult-use sales began on April 21, 2022.
New Mexico April 2007 Patient applications became available three months after passage, on July 6, 2007. Initially temporary ID certificates were available. The first sales began in New Mexico in spring 2010, about three years after passage. Although New Mexico was the first state to license larger-scale cultivation and dispensing, its rules were finalized and the first producer was licensed in less than two years. The first producer was registered in March 2009. The governor signed an adult-use law on March 31, 2021. Adult-use sales began a year later, on April 2, 2022.          
New York July 5, 2014 Patient applications became available about a year and five months after passage, in Dec. 2015. The first eight dispensaries opened about 1.5 years after passage, on Jan. 7, 2016. The Department of Health issued regulations within nine months of the law's enactment, in April 2015. Applications for registered organizations were due in June 2015, 11 months after the law's enactment. The governor signed an adult-use law on March 31, 2021. Adult-use sales began at one location on Dec. 29, 2022.
North Dakota Nov. 2016 The state began accepting patient applications in late Oct. 2018, about two years after passage. North Dakota’s first dispensary opened on March 1, 2019, about two years and four months after voters passed the medical cannabis initiative. The legislature rewrote the law in 2017. The health department granted preliminary approval to manufacturers in May 2018. It granted the first dispensary permits in Sept. 2018.
Ohio June 2016 Patient applications became available about one-and-a-half years after passage, in Dec. 2018. The first sales began on Jan. 1, 2019, about two-and-a-half years after passage. Voters enacted an adult-use cannabis law in Nov. 2023 and regulated sales began about nine months later, in Aug. 2024.
Oklahoma June 26, 2018 Patient applications became available about two months after passage, on Aug. 25, 2018. Dispensary sales began within about three months of passage, by late Sept. 2018. Emergency rules, which were revised from an earlier draft, were approved by the governor on Aug. 6, 2018, 41 days after passage. The health department began accepting applications from patients, caregivers, and prospective medical cannabis businesses a few weeks later, on Aug. 25, 2018.
Oregon Nov. 1998; Aug. 2013: dispensary law Patient applications became available about six months after passage, on May 1, 1999. Dispensaries already existed upon the passage of the state law in 2013, but they were not clearly authorized by law or regulated. The first dispensary licenses were issued in March  2014, about seven months after the dispensary law passed. Implementation of patient and caregiver ID cards took just under six months. The first dispensaries were licensed about seven months after the dispensary law passed. Voters enacted an adult-use cannabis law in Nov. 2014 and regulated sales began about two years later, in Oct. 2015.
Penn. April 17, 2016 Patient applications became available about one-and-a- half years after passage, on Nov. 1, 2017. Also, minor patients could receive limited protections via a safe haven letter beginning in June 2017. Medical cannabis sales began about one year and 10 months after passage, on Feb. 15, 2018. The Pennsylvania Department of Health accepted applications for dispensaries and grower/processors beginning on Jan. 20, 2017.
Rhode Island Jan. 2006; dispensaries authorized in June 2009 Patient applications became available about three months after passage, on March 31, 2006. The first medical cannabis sales were nearly four years after the dispensary law’s passage, on April 19, 2013. The health department was expected to issue compassion center registrations in Sept. 2010. However, it maintained that none of the applicants qualified, so it restarted the process. After approving three compassion centers on March 15, 2011, then-Gov. Lincoln Chafee reversed course after receiving a letter from the U.S. attorney. The law was revised, causing further delay. In 2019, the state approved six compassion centers. The governor signed an adult-use law on May 25, 2022. Adult-use sales began about seven months later, on December 1, 2022.
South Dakota Nov. 2020 Physicians could begin certifying patients in Nov. 2021, a year after the law’s enactment. The first sales began on July 27, 2022 — one year and nearly nine months after the law’s enactment.  
Texas Nov. 2025 N/A Texas does not issue patient ID cards February 2018, about 2.5 years after the low-THC medical cannabis law passed. Three dispensaries were licensed in late 2017. On June 1, 2015, Texas’s governor signed a restrictive, low-THC medical cannabis bill into law. It was expanded over the years. With its changes in 2025, it now meets MPP’s definition of an effective medical cannabis law.
Utah Nov. 2018 ID cards became available on March 1, 2020, a year and five months after the law passed. Sales began on March 2, 2020, a year and five months after the law passed. Cultivators were selected on July 19, 2019, nine months after the law’s enactment. "Pharmacies" (which do not have DEA registrations that are required to sell most prescriptions) were licensed on Jan. 3, 2020, one year and two months after enactment.  
Vermont May 2004; dispensaries authorized on June 2, 2011 Patient applications were available around five months after passage, on Oct. 26, 2004. The first dispensary opened in June 2013, about two years after the dispensary law’s passage. The Department of Public Safety began accepting dispensary applications 13 months after the dispensary law passed, on June 4, 2012. The legislature enacted a law allowing adult-use sales in Oct. 2020. Adult-use sales began about two years later.
Washington Nov. 1998; further legislation clarifying rules related to medical use was passed in April 2015 ID cards are not required in the state of Washington, but a voluntary registry became available in July 2016. Registered patients get special privileges, including increased possession limits.   The law does not include state dispensary regulations, but adult-use stores have been able to have a medical cannabis endorsement since July 2016. Washington implemented an adult-use cannabis law, which includes growers, processors, and retailers. The law passed in Nov. 2012, and the first stores opened in July 2014. Beginning in 2016, businesses could get a medical cannabis endorsement, and patients were able to get ID cards.
West Virginia April 2017 The state began issuing patient ID cards in February 2021, three years and 10 months after the law passed. The first medical cannabis sales were on Nov. 12, 2021, more than 4.5 years after lawmakers passed and the governor signed the medical cannabis law. West Virginia was the slowest state to implement a medical cannabis program. It took nearly four years for the state to begin issuing medical cannabis laws, and access to medical cannabis took another 10 months.

[1] In Delaware and Rhode Island, the delays were due in large part to concerning statements from those states’ U.S. attorneys. Those programs were then reworked before they were implemented. Since late 2014, Congress has included a provision preventing the DOJ from interfering with state medical cannabis laws in every appropriations bill.