New Hampshire

Overview

New Hampshire legalized therapeutic (medical) cannabis via House Bill 573, signed July 23, 2013 and codified at RSA Chapter 126-X. The program is administered by the New Hampshire Department of Health and Human Services (DHHS). Adult-use cannabis remains illegal, though personal-use quantities are decriminalized.

New Hampshire is the only New England state without legalized adult-use cannabis. Multiple adult-use bills have advanced through one chamber in recent legislative sessions but have not been enacted.

Adult-use status

Adult-use cannabis is illegal but decriminalized for personal-use quantities. Under RSA §318-B:2-c, possession of 0.75 ounce (21 grams) or less of cannabis or 5 grams or less of hashish by an adult is a civil violation with a $100 fine for first and second offenses (third offense $300; fourth offense misdemeanor). Possession above the decriminalized threshold scales to misdemeanor or felony under RSA Chapter 318-B.

Medical program (Chapter 126-X, 2013)

Qualifying conditions

New Hampshire's medical-cannabis program enumerates qualifying conditions including:

• Cancer, glaucoma, HIV/AIDS
• ALS, multiple sclerosis, Parkinson's disease, Alzheimer's disease
• Crohn's disease
• Severe and chronic pain
• Severe nausea, severe and persistent muscle spasms (including MS)
• Cachexia / wasting
• Seizure disorders, epilepsy
• Post-traumatic stress disorder
• Opioid use disorder (as opioid-alternative pilot)
• Terminal illness with under-six-months prognosis
• Any chronic or terminal condition for which the qualifying patient has a chronic or end-stage diagnosis and one or more of a specified set of severe symptoms

Patient access

• Possession: up to 2 ounces of usable cannabis over any 10-day period under medical registration.
• Home cultivation: prohibited.
• Reciprocity: New Hampshire honors out-of-state medical cards at licensed dispensaries (Alternative Treatment Centers) for visiting patients.
• Approved forms: flower (added by amendment), edibles, oils, tinctures, capsules, vapes, topicals.

Patients and caregivers

• Patient minimum age: 18. Minor patients require a parent or legal guardian as designated caregiver plus physician certification.
• Caregiver minimum age: 21.
• Caregivers per patient: up to 1 designated caregiver per patient; caregivers may serve more than one patient under specified rules.
• Caregiver registration: via DHHS; criminal background check.

Patient registration steps

1. Schedule a visit with a New Hampshire-licensed physician, osteopathic physician, APRN, or PA willing to certify a qualifying condition. The provider must establish a bona fide provider-patient relationship and complete the DHHS Provider Certification form.
2. The provider submits the certification to the patient (in some cases through the DHHS portal directly).
3. The patient mails or uploads the certification, identity documents, proof of New Hampshire residency, and the application fee to the DHHS Therapeutic Cannabis Program. The standard application fee is $50; renewals are also $50.
4. Approved patients receive a Registry ID Card valid for one year. The card authorizes purchases at any New Hampshire Alternative Treatment Center (ATC).

Minor patients require a parent or legal guardian as designated caregiver and a second provider's certification for non-terminal conditions. The caregiver completes a separate application and background check.

Reciprocity and visiting patients

New Hampshire is one of the more reciprocity-friendly states. RSA Chapter 126-X authorizes Alternative Treatment Centers to honor valid out-of-state medical-cannabis cards. Practical notes:

• The visiting patient presents the out-of-state card plus a government-issued photo ID at the ATC.
• The visiting-patient pathway is implemented through the ATC point-of-sale system; the patient does not need to apply for a separate New Hampshire registry card.
• Reciprocity covers possession on New Hampshire soil within the program possession cap.
• Reciprocity does not extend to home cultivation (which is prohibited even for in-state registered patients).

Employment and workplace

New Hampshire is an at-will employment state. The Therapeutic Cannabis Program statute does not include broad statutory employment protection for patients:

• 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 any state-level consideration.
• Pre-employment testing: New Hampshire 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.

The opioid-alternative pilot designation has not produced separate workplace-protection language. Public-employee positions, healthcare licensing, and CDL holders face additional licensing-board exposure beyond employer discipline.

Hemp-derived intoxicants

New Hampshire aligns with the federal 2018 Farm Bill on industrial hemp (cannabis with 0.3% THC or less by dry weight). Retail availability of intoxicating hemp-derived cannabinoids has been substantial. The state has not enacted comprehensive restrictions on delta-8 THC, delta-10 THC, THC-O, and HHC products as of mid-2026, though legislative attention has increased.

Recent legislative history

New Hampshire is distinctive in New England for the failure of adult-use legalization to clear both chambers despite multiple attempts:

• 2022: HB 1598 (adult-use legalization with state-store model) passed the House but failed in the Senate.
• 2023-2024: HB 1633 (adult-use with state-control framework) passed the House but failed in the Senate.
• 2025: HB 198 and SB 14 (variations on adult-use frameworks) failed in committee or did not advance.
• 2026: HB 75 (adult-use legalization with private licensing) and HB 186 (decriminalization expansion) failed to advance.

The 2024 House-passed bill notably included a state-store retail model rather than the private-licensee model used in most other adult-use states. Governor Chris Sununu publicly stated he would only sign a state-store framework, narrowing the legislative pathway. Successor Governor Kelly Ayotte's position on adult-use legislation continues to shape the legislative calculus in 2026.

Federal context

Federal jurisdiction layers additional exposure on federal land, federal courthouses, military installations (Portsmouth Naval Shipyard, located on the Maine border), and interstate highways. White Mountain National Forest falls under US Forest Service jurisdiction where federal cannabis prohibition applies. I-89, I-93, I-95, and US-3 corridors see federal drug-interdiction activity, particularly at the Canadian border (where US Customs and Border Protection enforces federal prohibition) and at borders with Massachusetts and Vermont (both adult-use legal).