How to Get a Medical Marijuana Card in North Carolina in 2023

North Carolina doesn’t have a medical marijuana program like other states. Instead, the state operates a low-THC, CBD-specific cannabis program specifically for patients diagnosed with intractable epilepsy diagnosed by a neurologist. All cannabis extracts must be oil and contain less than 0.9% THC and at least 5% CBD.

However, the North Carolina Compassionate Care Act (SB 711) passed through the Senate and went to the House of Representatives in 2023. It may further expand the state’s medical marijuana program and allow other medical conditions to qualify for cannabis use.

Additionally, the Eastern Band of Cherokee Indians (EBCI) began the first legal sales of marijuana within the Qualla Boundary in 2024. North Carolina residents may apply for a medical marijuana card through the EBCI Cannabis Control Board. However, it is important to note that the Tribe’s medical cannabis laws do not extend beyond Tribal land.

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Benefits of Having a Medical Card in North Carolina

The state has allowed low-THC, high-CBD cannabis for medical use. Patients who have received a recommendation from a neurologist may qualify for CBD oil products that contain at least 0.9% THC and 5% CBD per dry weight. Without a medical card, people are forbidden from possessing or using medical or recreational marijuana.

Those with a doctor’s recommendation and registry ID card from the Department of Health and Human Services may possess up to a 30-day supply of medical products, to be determined by the physician. However, current marijuana laws do not guide establishing dispensaries. As such, North Carolinians must travel to nearby legalized states to purchase and use their medicine.

Patients may also use hemp-extract CBD oil if it fits the cannabinoid guidelines.

Eligibility Requirements

Patients must be at least 18 and North Carolina residents with a current diagnosis of a qualifying condition to apply for medical CBD use in North Carolina. Individuals must also obtain an official written certification from their medical marijuana doctor and appoint a caregiver at their appointment. The caregiver applies on the patient’s behalf to dispense the low-THC product.

Patients applying for an EBCI-CCB medical cannabis card must be at least 21 years old and a current resident of North Carolina.

Can Minors Get a Medical Card in North Carolina?

Patients younger than 18 require parental consent to qualify for a North Carolina medical marijuana card. There’s no official age limit for use, but minors require approval from their parent or legal guardian, who is required to serve as the patient’s caregiver.

Qualifying Conditions

Current laws only allow those diagnosed with intractable epilepsy to qualify for low-THC cannabis use. However, should the North Carolina Compassionate Care Act pass, the program will develop to add additional debilitating medical conditions, such as the following:

AIDS/HIV
Amyotrophic lateral sclerosis, aka Lou Gehrig’s disease
Cachexia or wasting syndrome
Cancer
Crohn’s disease
Epilepsy
Multiple sclerosis (MS)
Parkinson’s disease
Post-traumatic stress disorder (PTSD)
Sickle cell anemia or other sickle cell diseases
Severe or persistent nausea
Any other serious medical condition or its treatment added by the Medical Cannabis Advisory Board

How to Apply

Documents You’ll Need

Because there is no card or application process for the CBD program, patients don’t need to assemble application documents. However, a recommendation from a physician is required to be submitted when appointing a caregiver. Caregivers are the ones who apply with the North Carolina Department of Health and Human Services for a registry ID card.

The EBCI-CCB requires a valid government-issued ID, proof of North Carolina residency, and either a completed Attestation Form or a “Medical Summary” from a healthcare provider.

Steps to Apply

Make an appointment with a North Carolina-registered neurologist to obtain a diagnosis of intractable epilepsy.
Meet with the physician, and obtain a written certification that says, in the doctor’s professional opinion, that they would benefit from medical marijuana treatment. You must appoint a caregiver (parent, legal guardian, or custodian).
Your caregiver must apply with the state by filling out a caregiver registry application form and submitting a valid state ID or driver’s license to prove age and North Carolina residency.
Once approved, the caregiver will receive a caregiver registration card and be able to purchase and administer low-THC marijuana on the patient’s behalf.

What to Expect During Your Leafwell Appointment

Leafwell does not offer our telemedicine services in North Carolina at this time.

Costs

As the North Carolina Department of Health and Human Services (NCDHHS) does not issue cards to medical marijuana patients, there are no associated costs. Caregivers are not required to pay to obtain letters of approval from the NCDHHS.

The EBCI-CCB charges a $50 initial fee for enrolled EBCI members and a $100 initial fee for North Carolina residents. Renewal fees are $25 for enrolled EBCI members and $100 for North Carolina residents.

Medical Marijuana Reciprocity

The state of North Carolina does not recognize out-of-state medical marijuana patients.

However, several other states practice medical marijuana reciprocity and would recognize a North Carolina medical marijuana card. But because the state does not have a medical marijuana identification card system, it is difficult to see how reciprocity will be possible except in states like Hawaii and Illinois, where qualified patients from other states can apply and provide an identification number.

The following states accept or recognize out-of-state medical marijuana cards:

Arizona
Arkansas *
California ^
Colorado ^
Connecticut ^
Hawaii *
Illinois ^
Maine
Maryland ^ (as of July 2023)
Massachusetts
Michigan (qualifying state must also have reciprocity with Michigan)
Missouri ^
Nevada
New Hampshire
New Jersey *
New Mexico * (recreational cannabis is legal in NM)
New York ^
Oklahoma *
Oregon ^
Pennsylvania (minors only)
Puerto Rico
Rhode Island
U.S. Virgin Islands *
Utah (max. 45 days, after which the patient must apply for a Utah MMJ card)
Vermont ^
Virginia ^
Washington ^
Washington, D.C.

States marked with * require visitors to complete a visiting patient application for their stay.

States marked with ^ have adult use programs but do not accept out-of-state cards.

Applying as a Caregiver

Medical marijuana caregivers can assist qualified medical marijuana patients in administering medical cannabis for their patients’ use.

Per the Epilepsy Alternative Treatment Act, MMJ patients must appoint a caregiver. The caregiver must be older than 18 and the patient’s legal parent, guardian, or custodian.

Caregivers in North Carolina must register with the North Carolina Department of Health and Human Services (NCDHHS) and obtain written approval before they can assume their duties. Caregivers must also carry this written letter on their person when possessing low-CBD cannabis.

Patients may have more than one caregiver if they meet the above requirements.

Where to Buy Medical Marijuana

North Carolina currently does not have any medical marijuana dispensaries. This means that North Carolina medical marijuana patients need to purchase their medicine in another state that allows out-of-state medical marijuana cards, the closest one being Pennsylvania.

The Cherokee tribe in North Carolina has opened a medical cannabis dispensary as of April 2024. Patients older than 21 can apply to the program, including non-members of the tribe, as long as they meet specific criteria.

Should SB 711 become law, North Carolina medical marijuana patients may acquire cannabis from any licensed dispensaries statewide, though exact rules are to be determined.

When seeking medical marijuana treatment options, it’s a good idea to talk to dispensary staff and ask plenty of questions. These trained professionals can assist you in identifying the best medical-use cannabis products for specific health conditions and address any questions or concerns.

Cultivation

It is illegal to grow or cultivate cannabis in North Carolina.

North Carolina Medical Marijuana Laws to Know

Cannabis is illegal in North Carolina for any usage, medical or otherwise. Possession of 0.5 ounces or less is decriminalized. There was a failed attempt at the legalization of medical marijuana in 2014. In 2015, Governor Pat McCrory signed the Epilepsy Alternative Treatment Act (HB 766), allowing those with intractable epilepsy to use CBD oil. In 2017, North Carolina legalized industrial hemp.

As the medical cannabis program only accepts low-THC, CBD-only medications as legal, a positive drug test for cannabis should hopefully be unlikely (but potentially still possible). Sadly, there are no current protections for employees who use medical cannabis in North Carolina.

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