Maryland

Overview

Maryland operates parallel medical and adult-use cannabis programs. The medical program was authorized by legislation signed in 2013 and became operational on December 1, 2017 through the Natalie M. LaPrade Maryland Medical Cannabis Commission (now folded into the Maryland Cannabis Administration). Adult-use cannabis was legalized via Question 4 of the November 2022 ballot (passed with 67.2% support) effective July 1, 2023.

The Maryland Cannabis Administration (MCA) regulates both programs. As of September 2023, the MCA had issued cannabis-dispensary licenses to 101 entities.

Adult-use (Question 4, 2022)

• Public possession: 1.5 ounces of cannabis flower (or equivalent in other forms).
• Home cultivation: up to 2 plants per adult, kept out of public view. No specified household cap.
• Tax: 9% state sales tax on adult-use cannabis.

Medical program

Qualifying conditions

The medical program uses a physician-certification standard. Qualifying conditions include cancer, glaucoma, HIV/AIDS, ALS, MS, Crohn's disease, IBD, epilepsy, severe and chronic pain, severe nausea, PTSD, cachexia, and terminal illness. Healthcare providers may also certify for "any chronic or debilitating disease or medical condition" subject to specific listing criteria.

Patient access

• Possession: 30-day supply as certified by the patient's registered practitioner.
• Approved forms: flower, edibles, oils, tinctures, capsules, vapes, topicals.
• Home cultivation: medical patients may exercise the 2-plant adult-use right introduced in 2023. The medical program itself does not grant additional cultivation rights.
• Reciprocity: Maryland does not formally recognize out-of-state medical cards for in-state medical-program preferential pricing; visiting patients aged 21+ may purchase from any adult-use retailer.

Patients and caregivers

• Patient minimum age: 18. Minor patients require a designated caregiver and practitioner certification.
• Caregiver minimum age: 21.
• Caregivers per patient: typically up to 2 (verify against current MCA rule).
• Caregiver registration: via MCA; criminal background check.

Patient registration steps

1. Locate a Maryland-registered certifying provider (MD, DO, NP, PA, or dentist for dental-specific certifications).
2. The provider issues a written certification through the Maryland Cannabis Administration patient portal.
3. The patient completes the online application, submits identity documents (Maryland residency required), and pays the registration fee.
4. Approved patients receive an MCA ID card.
5. With the ID card, the patient may purchase from any licensed Maryland medical dispensary at preferential pricing.

Employment protections

Maryland law does not require employers to accommodate medical-cannabis use. Employers may maintain drug-free workplace policies and may terminate employees for off-duty cannabis use under current statute. The Maryland Cannabis Administration and the Maryland Department of Labor have not issued comprehensive employee-protection rules tied to the 2023 adult-use rollout.

Reciprocity callout

Maryland does not offer formal medical-cannabis reciprocity. Visiting adults 21 and older may purchase from any licensed adult-use retailer with a valid government ID, but they cannot access medical-only inventory, tax exemptions, or higher possession allowances. Out-of-state medical cardholders should plan accordingly when visiting.

Recent developments (2025-2026)

The Maryland Cannabis Administration continued program-stability rulemaking through 2025-2026, including licensee oversight, social-equity license issuance, and intoxicating-hemp regulation. Maryland's social-equity framework under Question 4 includes preferential licensing for applicants from areas disproportionately impacted by prior cannabis enforcement. Question 4 funds and state revenue allocations have continued to support expungement and reinvestment programs.

Hemp-derived intoxicants

Maryland enacted comprehensive restrictions on hemp-derived intoxicating cannabinoids through SB 516 (2023) and follow-on rulemaking, placing delta-8 THC, delta-9 THC from hemp, delta-10 THC, THC-O, HHC, and similar compounds under MCA regulatory authority. Outside the licensed adult-use and medical-cannabis supply chain, these products are not lawful for retail sale to consumers. The 2024 rulemaking adjusted the dosing and packaging framework. Litigation by hemp retailers has produced some enforcement uncertainty.

Employment supplement

Maryland is an at-will employment state. The Cannabis Reform Act and the medical-cannabis statute preserve broad employer discretion:

• Safety-sensitive positions: employers may continue to enforce drug-free workplace policies for safety-sensitive roles as defined by the employer.
• Federal contractor and DOT-regulated positions: federal drug-free workplace and DOT testing rules supersede state-level protection.
• Pre-employment testing: Maryland law does not prohibit pre-employment cannabis testing or adverse hiring action based on positive results.
• Workers' compensation: post-incident testing positive for THC may result in benefit denial.

Public-employee positions, healthcare licensing, and CDL holders face additional licensing-board exposure.

Expungement and social equity

Question 4 included automatic expungement of low-level cannabis convictions. The Maryland Judiciary has carried out implementation since 2023, expunging or sealing tens of thousands of records. The MCA's social-equity license categories prioritize applicants from disproportionately impacted areas (DIAs) defined by historical cannabis conviction rate, median household income, and other criteria. The Maryland Cannabis Capital Access Program provides loans and grants to social-equity licensees.

Legislative history

Maryland cannabis policy has evolved through both legislative and ballot mechanisms:

• 2013: medical-cannabis program authorized.
• 2014: decriminalization of small-amount possession.
• 2017: medical-cannabis program became operational December 1.
• 2022: Question 4 (adult-use legalization) approved with 67.2%.
• 2023: adult-use possession and limited home cultivation effective July 1; licensed adult-use retail sales began.
• 2024: social-equity license rounds; hemp-derived intoxicant restrictions enacted.
• 2025-2026: continued legislative and rulemaking work on on-premises consumption pilots, license-cap adjustments, and dispensary licensing.

The April 2026 federal Schedule III rescheduling order produced no immediate Maryland legislative response.

Federal context

Federal jurisdiction layers additional exposure on federal land, federal courthouses, military installations (Joint Base Andrews, Fort Meade, Naval Air Station Patuxent River, Naval Support Activity Bethesda, Naval Academy, Aberdeen Proving Ground, Walter Reed National Military Medical Center), and interstate highways. Antietam National Battlefield, Assateague Island National Seashore, Catoctin Mountain Park, Chesapeake & Ohio Canal National Historical Park, Fort McHenry National Monument, Greenbelt Park, and the District of Columbia federal jurisdiction fall under federal cannabis prohibition regardless of state authorization. The substantial federal-installation footprint in central Maryland creates significant complexity for patients and operators in Anne Arundel, Prince George's, Montgomery, and Howard Counties. I-70, I-81, I-83, I-95, I-97, I-270, I-495 (Capital Beltway), and I-695 (Baltimore Beltway) corridors see active state-patrol and federal drug-interdiction activity.