Regulators adopt rules to implement voter-approved medical marijuana program; patient applications now available


Last update: July 8, 2019

Last year, Missourians overwhelmingly approved Amendment 2 to establish constitutional protections for medical marijuana patients, legalizing the use of medical marijuana for serious health conditions. The Missouri Department of Health and Senior Services has now posted its final rules to regulate the state’s medical marijuana program, and residents can access the required form to register as a patient. Regulators have begun accepting and processing patient registrations.

More than 500 applications for medical marijuana business licenses were pre-filed earlier this year, generating nearly $4 million in fee revenue for the state. Additional applications for licenses will be accepted later this year, and the department has until December 31 to determine which applicants will be approved. The law requires that licenses be issued to a minimum of 60 cultivators, 86 processing facilities, and 192 dispensaries throughout the state.

Missouri approves Amendment 2 to legalize medical marijuana


On Election Day 2018, Missourians had the opportunity to vote on three different medical marijuana ballot initiatives. The results for each are listed below:

  • Proposition C: Defeated, 56.5% No – 43.5% Yes
  • Amendment 2: Passed, 65.5% Yes – 34.5% No
  • Amendment 3: Defeated, 68.8% No – 31.4% Yes

Many local medical marijuana advocates and national organizations, including MPP, endorsed Amendment 2. With its passage, the right of Missouri patients to safely access medical marijuana will soon be officially enshrined in the state constitution.

Amendment 2 took effect on December 6, 2018. With a physician’s approval, a patient may qualify for medical marijuana if they have been diagnosed with any of the following conditions:

  • Cancer
  • Epilepsy
  • Glaucoma
  • Intractable migraines unresponsive to other treatment
  • Conditions that cause persistent pain or muscle spasms, including MS, Parkinson’s disease, and Tourette’s syndrome
  • Debilitating psychiatric disorders such as PTSD
  • HIV or AIDS
  • A chronic medical condition normally treated with prescription medication that can lead to dependence, when a physician determines that medical marijuana could be an effective and safer treatment
  • Any terminal illness
  • Hepatitis C
  • ALS
  • Inflammatory bowel disease
  • Crohn’s disease
  • Huntington’s disease
  • Autism
  • Neuropathies
  • Sickle cell anemia
  • Alzheimer’s disease
  • Cachexia
  • Wasting syndrome

Home cultivation will be permitted by caregivers and qualified patients who apply for and receive a cultivation card. Each cardholder may grow up to six plants.

Current marijuana laws in Missouri


Medical marijuana is legal for registered patients. Voters approved Amendment 2 in 2018 to establish a medical marijuana program.

Marijuana possession has been decriminalized. Legislation was approved in 2014 to decriminalize the possession of 10 grams or less of cannabis, such that possession is punishable by a fine only. The offense remains a criminal misdemeanor. The possession of greater quantities of cannabis remains punishable by jail time.

Cultivation for non-patients remains illegal. Cultivating 35 grams or less is a Class E felony, which is punishable by up to four years of imprisonment and a maximum fine of $10,000. Cultivating 35 grams or more is a Class C felony, which is punishable by a sentence of three to 10 years imprisonment and a fine of $10,000.

Timeline of marijuana reform in Missouri


2008: In Missouri v. Cox, the state Court of Appeals affirmed a lower court’s rejection of a patient’s medical necessity defense because the legislature had already expressed its intent by placing marijuana in Schedule I, even though statute allowed the dispensing of Schedule I substances by certain professionals.

2014: Governor Jay Nixon signed into law the Missouri Medical Marijuana Bill, allowing the use of CBD oil to treat persistent seizures.

Lawmakers enacted SB 491, which reduced penalties for those possessing up to 10 grams of marijuana and began on January 1, 2017. A first offense is punishable as a class D misdemeanor (an infraction) and carries a fine of $250-$1,000 with no jail time.

2015: Missouri issued licenses to two non-profits to grow cannabis for oil to be sold to patients.

2017: Decriminalization became effective statewide.

Kansas City voted to reduce the penalties for simple possession of marijuana, amending local laws regarding the possession of up to 35 grams of marijuana for adults age 21 and older from a criminal misdemeanor to a civil offense punishable by a $25 fine.

2018: Voters passed Amendment 2, legalizing medical marijuana in Missouri.

Stay connected


Thank you for supporting the Marijuana Policy Project and all of our allies. If you have a personal connection to the issue — including if you are a seriously ill patient, a loved one, a physician, or a clergy member — and would like to get more involved, please contact us by email at Please include your address or nine-digit zip code so we can determine who your state legislators are.

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