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Epilepsy and cannabis in North Carolina

The state explicitly lists this condition under its medical cannabis program. A certifying physician can pursue state registration for a patient with this diagnosis under the program rules.

Listed qualifying condition
✓ Yes
LEGAL
CBD oil with ≤0.9% THC,…
POSSESSION
$0/yr
STATE FEE
14–60 d
TIMELINE
Listed qualifying condition. The state explicitly lists this condition under its medical cannabis program. A certifying physician can pursue state registration for a patient with this diagnosis under the program rules.

North Carolina statute and program

The North Carolina Epilepsy Alternative Treatment Act (CBD oil only) is the operating authority for North Carolina patient certification. The authoritative legal text is: N.C. Gen. Stat. § 90-94.1: Epilepsy Alternative Treatment Act.

What the evidence says about cannabis and Epilepsy

Epilepsy is a chronic neurological disorder defined by recurrent unprovoked seizures. The condition affects an estimated 3.4 million Americans. Most patients respond to anti-seizure medications, but approximately one-third develop treatment-resistant epilepsy that fails two or more first-line drugs.

For the full evidence base, including the NASEM tier, randomized trial summaries, and symptom-domain breakdown, read the mmjnow Epilepsy page.

How to qualify in North Carolina

The North Carolina Epilepsy Alternative Treatment Act (CBD oil only) requires the following registration steps for a Epilepsy patient (or any qualifying diagnosis):

  1. Get a neurologist’s written statement under the Epilepsy Alternative Treatment Act. A North Carolina-licensed neurologist must provide a written statement under N.C.G.S. §90-94.1 confirming that the patient has intractable epilepsy and may benefit from "hemp extract" (cannabis oil containing not more than 0.9% THC and at least 5% CBD by weight). The statute applies only to intractable epilepsy — North Carolina does not operate a general medical cannabis program.
  2. Register with the North Carolina Department of Health and Human Services. The patient or the patient’s legal guardian registers with the North Carolina Department of Health and Human Services using the neurologist’s written statement, a North Carolina driver license or state ID, and proof of residency. There is no separate online portal; registration is handled by mail or in person at NC DHHS.
  3. No state registration fee. North Carolina does not charge a patient registration fee under §90-94.1. There is also no dispensary infrastructure: the statute authorizes "registered caregivers" — typically a parent of a child with intractable epilepsy — to possess and administer hemp extract obtained out of state. The Cherokee Indian Hospital (on Eastern Band of Cherokee Indians sovereign land in Cherokee, NC) operates the only in-state medical cannabis dispensary, available to registered tribal members only.
  4. Obtain hemp extract from out of state or the EBCI dispensary. Registered patients may possess hemp extract obtained from out-of-state cannabis programs (most commonly Colorado, Virginia, or Washington). The Eastern Band of Cherokee Indians’ Qualla Enterprises tribal dispensary in Cherokee, NC operates a tribal medical cannabis program for enrolled members. North Carolina does not honor out-of-state medical cards for general use, but registered hemp-extract patients have an affirmative defense under §90-94.1 against possession charges.
State registration fee
$0
Physician visit (typical)
$200–$400
Certification to card
14–60 days
Out-of-state patients
Not eligible
Minors
Eligible with caregiver

For full North Carolina registration steps, fees, and reciprocity rules, see the North Carolina cannabis-laws page.

ICD-10 code

A certifying physician documenting Epilepsy for the North Carolina medical cannabis program will typically record ICD-10 G40.909 or SNOMED-CT 84757009 in the patient's record. The state registry does not itself collect ICD-10 codes in most programs, but the physician's chart is the audit trail if the certification is later reviewed.

Frequently asked questions

Does North Carolina list Epilepsy as a qualifying condition for medical cannabis?

Yes. North Carolina explicitly lists Epilepsy as a qualifying condition under North Carolina Epilepsy Alternative Treatment Act (CBD oil only). A patient with a documented Epilepsy diagnosis can pursue state-program certification with a physician registered in the state. The qualifying-condition list is set by state statute or regulation and may change. Inclusion on the list does not guarantee certification — a physician still has to evaluate the patient and decide that medical cannabis is appropriate for that specific case under North Carolina rules.

How do I get a North Carolina medical marijuana card for Epilepsy?

Step one is finding a physician licensed in North Carolina who is registered with North Carolina Epilepsy Alternative Treatment Act (CBD oil only) and willing to evaluate Epilepsy cases. Step two is collecting your records (diagnosis documentation, treatment history, and the ICD-10 code your physician will use) and bringing them to the certification visit. Step three is the physician's certification through the state registry, followed by the patient registration application, state fee, and waiting period before the card is issued. North Carolina does not honor out-of-state cards, so the certification process has to originate inside the state. Verify the patient minimum age with the state program before applying. Confirm the current process with the state regulator before applying, because the rules change.

What does the evidence say about cannabis for Epilepsy?

For Epilepsy, evidence is described as strong (e.g. multiple randomized controlled trials or systematic reviews supporting effect). The mmjnow condition page for Epilepsy lays out the current evidence base, including the citations underlying that evidence tier — typically the National Academies of Sciences, Engineering, and Medicine consensus reports, federal agency guidance, and peer-reviewed reviews. Evidence quality is independent of state law: a state can list a condition for which evidence is limited, and a state can decline to list a condition for which evidence is strong. Patients deciding whether to pursue medical cannabis for Epilepsy should review the underlying evidence (linked on the condition page) and discuss expected benefit, dosing, and risk with a clinician familiar with both Epilepsy and cannabinoid pharmacology. Cannabis is not a substitute for evidence-based first-line treatments for Epilepsy; the evidence position above describes whether trial data supports its use, not whether it should replace standard care.

Sources

  1. N.C. Gen. Stat. § 90-94.1: Epilepsy Alternative Treatment Actaccessed May 15, 2026
  2. NORML: North Carolina Lawsaccessed May 15, 2026
  3. Wikipedia: Cannabis in North Carolinaaccessed May 15, 2026
  4. N.C. Gen. Stat. §90-95: Violations; penalties (controlled substances)accessed May 17, 2026
  5. Eastern Band of Cherokee Indians (EBCI) — Great Smoky Cannabis Co. (Qualla Boundary tribal dispensary)accessed May 17, 2026
  6. North Carolina Department of Agriculture: Industrial Hemp Programaccessed May 17, 2026
  7. North Carolina General Assembly bill trackeraccessed May 17, 2026
  8. NASEM: The Health Effects of Cannabis and Cannabinoids (2017)accessed May 15, 2026

    “Conclusive or substantial evidence that oral cannabidiol is effective for the treatment of certain epilepsy syndromes.”

  9. FDA: Epidiolex (cannabidiol) prescribing informationaccessed May 15, 2026
  10. NIH NCCIH: Cannabis (Marijuana) and Cannabinoidsaccessed May 15, 2026