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North Carolina Senate Gives Initial Approval To Bill That Would Legalize Medical Marijuana In Rebuke Of House Opposition

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The North Carolina Senate has given initial approval to a bill that would legalize medical marijuana, with bipartisan members once again pushing strongly to enact the reform despite consistent resistance from the House.

Just one day after senators attached the medical cannabis proposal to a hemp- and kratom-related measure and then advanced it through the Judiciary Committee, the Senate Rules Committee signed off on the legislation and sent it to the floor, where it was approved on second reading in a 33-9 vote, with further amendments.

A final Senate vote is expected on Monday, after which point the measure would go back to the House, where its fate remains uncertain.

The underlying legislation originated in the House, so the Senate’s choice to amend it with the medical marijuana language further underscores the chamber’s seriousness about getting the job done, even if it has to force the House’s hands on an issue the chamber has appeared reluctant to take up.

As revised with this week’s committee amendment from Sen. Michael Lazzara (R), the bill would allow doctors to recommend medical marijuana to patients with certain qualifying conditions. That’s in addition to the original provisions on restricting kratom and intoxicating hemp cannabinoid products such as delta-8 THC.

The cannabis text is similar to that of a standalone bill from Sen. Bill Rabon (R), a cancer survivor who has sponsored multiple medical marijuana proposals. The senator previously described his interest in using the hemp legislation as a potential vehicle after his latest standalone stalled in the House.

“The people that need and can benefit from medical-grade cannabis are dying. They’re dying every day,” Rabon said in the Rules Committee hearing on Thursday. “They’ve died for six years since I started working on this. I want to know where the compassion in this room is. I want to know because I’m not seeing it.”

“People that need help have the right to try to stay alive—to stay with their loved ones another day, to feel good about life—not to be put on morphine so they don’t know what world they’re in, but to have a meal, to be able to clean themselves, to have a conversation with their loved ones before they die,” he said. “They deserve that right.”

The senator emphasized that he was speaking from personal experience. As he’s previously disclosed, Rabon said his doctor advised him to use marijuana before he went through serious chemotherapy, and he visited his local law enforcement to tell them that he intended to break the law to use the plant for therapy. Packages of marijuana then regularly showed up in the mail, and he’d take “three puffs” of cannabis after work to treat his symptoms.

“If you’re scared of the boogeyman, so what? Sleep with the lights on,” he said on Thursday. “I’m telling you, this is something that we should do. I know. I’ve been there. I’ve lived it. You folks who are so dead set against it haven’t walk in my shoes, but I stand before you and tell you I was close to death a long time ago, and I would have died had I not broken the law and I had not taken the advice of my health care provider and gotten a cannabis product.”

“I was ready to give up. I couldn’t eat. There’s not a trash can in this room that would hold how much vomit I’d throw up every day,” Rabon said. “I’m going to push it. I’m going to stay in this legislature until it passes.”

On the floor on Thursday, members also adopted an amendment to expand a proposed cannabis production commission to add another pharmacist, as well as an emergency room physician. Rabon said the change was responsive to requests from House lawmakers, adding that further amendments are expected during Monday’s third reading consideration of the bill.

Senators also rejected a floor amendment to expand the bill to legalize adult-use marijuana.

Here are the main components of the medical cannabis provisions of the bill: 

  • Patients would be allowed to access cannabis if they have a “debilitating medical condition” such as cancer, epilepsy, HIV/AIDS, Parkinson’s disease, multiple sclerosis and post-traumatic stress disorder.
  • Smoking and vaping would also be allowed, but doctors would need to prescribe a specific method of delivery and dosages for patients under the revised legislation. And they would need to reevaluate patients’ eligibility for the program at least once a year.
  • The bill provides for up to 10 medical marijuana suppliers who control the cultivation and sale of cannabis.
  • Under the bill, a Compassionate Use Advisory Board would be established, and it could add new qualifying medical conditions.
  • Separately, a Medical Cannabis Production Commission would be created to ensure that there’s an adequate supply of cannabis for patients, oversee licensing and generate enough revenue to regulate the program.
  • The measure would further create a North Carolina Cannabis Research Program to “undertake objective, scientific research regarding the administration of cannabis or cannabis-infused products as part of medical treatment.”
  • There don’t appear to be specific equity provisions that many advocates push for as part of legalization legislation.

Senate President Pro Tempore Phil Berger (R) said in April that he’s had bicameral discussions about the prospect of moving the medical marijuana proposal from Rabon forward as part of the hemp measure.

Rabon’s standalone legislation moved through the Senate and was taken up by a House committee last year, but it has not advanced further in that chamber.

Certain Democratic senators, such as Sen. Graig Meyer (D), have said that any future proposal would need to include “some type of decriminalization language,” in addition to the limited medical cannabis program. So it’s unclear whether the Democratic caucus would back the amended hemp bill as it’s currently drafted, as it calls for a relatively conservative medical cannabis authorization.

House Majority Leader John Bell (R) said last year that while there were “still discussions going on” about the medical marijuana bill, he was “very sure you won’t see that bill move” due to insufficient support among Republicans. He said that was “unfortunately” the case.

A previous version of the North Carolina Compassionate Care Act from Rabon passed the Senate but did not get a vote in the House of Representatives in 2022.

The Senate president previously acknowledged that opinions are shifting when it comes to marijuana in the state, and he said that Rabon specifically “for a long time has looked at the issue.”

House Speaker Tim Moore (R) is among key lawmakers who have downplayed the idea of enacting medical cannabis legislation, saying at one point that “there are a lot of concerns” with Rabon’s bill that moved through the Senate.

Rabon also took another step, including medical marijuana regulatory appointments for the yet-to-be-enacted program in a separate measure that passed the Senate in March.


Marijuana Moment is tracking more than 1,500 cannabis, psychedelics and drug policy bills in state legislatures and Congress this year. Patreon supporters pledging at least $25/month get access to our interactive maps, charts and hearing calendar so they don’t miss any developments.

Learn more about our marijuana bill tracker and become a supporter on Patreon to get access.

An Indian tribe in North Carolina launched the state’s first medical marijuana dispensary in April—despite the protests of certain Republican congressional lawmakers.

Sens. Thom Tillis (R-NC) and Ted Budd (R-NC) have also asked federal, state and local officials what steps they were taking to enforce marijuana prohibition ahead of the tribe’s April 20 launch.

Meanwhile in North Carolina, a state judge declared in February that anyone who “has the odor of marijuana” will be barred from entering the North Carolina Superior Courts of Robeson County.

The order, from Senior Resident Superior Court Judge James Gregory Bell, said that smelling like cannabis is grounds for removal from the courthouse, and the sheriff will be directed to “ask you to leave and come back without the odor owns [sic] your persons.”

Pennsylvania Could See Up To $2.8 Billion In Marijuana Sales In First Year Of Legalization And Create 45,000 Jobs, Analysis Finds

Photo courtesy of Mike Latimer.

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Kyle Jaeger is Marijuana Moment's Sacramento-based managing editor. His work has also appeared in High Times, VICE and attn.

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