What a medical cannabis prescribing doctor does

A medical cannabis prescribing doctor is a licensed clinician who signs a written certification for a patient under state law. The document lets the patient apply for a state registry card and buy from a licensed dispensary. 38 states and the District of Columbia run a medical cannabis program.

The doctor does not write a prescription in the federal sense. Cannabis is a Schedule I controlled substance under the Controlled Substances Act. A prescription sent to a pharmacy is not legal at the federal level. States use the words certification, recommendation, or authorization instead.

Who can sign a certification

State rules list who may certify. Most states allow physicians (MD, DO), nurse practitioners, and physician assistants. Some states limit minor patients to MDs and DOs. The clinician needs an active license and no board sanctions. A few states require a separate cannabis course or a registration with the state health department before the clinician can certify anyone.

What happens at the appointment

  1. Intake. The clinician reviews medical history, current drugs, and prior treatments.
  2. Exam. The clinician assesses the condition and its symptoms.
  3. Records. The patient brings records or signs a release so the office can pull them.
  4. Decision. The clinician signs the certification or declines.
  5. Submission. The certification goes to the state registry. The patient pays a state fee.

Qualifying conditions

Lists differ by state. Common entries include cancer, HIV/AIDS, epilepsy, multiple sclerosis, Crohn's disease, glaucoma, PTSD, chronic pain, and terminal illness. Some states add a clause that lets a doctor certify any condition that cannabis may help. Others keep a fixed list with no additions.

Cost and renewal

An evaluation costs about $75 to $300. State registration fees run about $10 to $100. Some states waive the fee for veterans and low-income patients. Certifications expire. Terms run from 30 days to 3 years, based on the state. Renewal needs another visit in most states.

What the certification does not do

It is not a federal prescription. It does not shield a patient under federal law. It does not authorize driving while impaired. It does not apply outside the state that issued it. Employers, landlords, and federal agencies keep their own rules on drug testing and use.

Federal status

The FDA has approved one purified CBD drug, Epidiolex, and synthetic THC drugs such as dronabinol. The agency has not approved smoked cannabis or most edibles and tinctures. Products sold in state dispensaries are regulated by the state, not the FDA.