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Voters in Slovenia approved a pair of cannabis-related ballot measures over the weekend, one on whether medical marijuana patients should be able to cultivate the plant for personal use and the other on whether all adults should be able to legally grow and possess marijuana.

The sale and use of medical cannabis is already legal in the country, but cultivation remains prohibited.

The two marijuana questions appeared on the ballot in Sunday’s election alongside other referendum questions on medically assisted dying and a proposed change to the country’s general elections process.

The first question—”Should the Republic of Slovenia allow the cultivation and processing of cannabis for medical purposes on its territory?”—passed 67 percent to 33 percent.

The second—”Should the Republic of Slovenia allow the cultivation and possession of cannabis for limited personal use on its territory?”—was approved by a margin of 52 percent to 48 percent.

The outcomes are advisory and not binding on lawmakers. Nevertheless, they could influence future legislation and contribute to the growing push for reform in the country.

Slovenia’s National Assembly voted to put the questions on the ballot in April. The country’s National Institute of Public Health had taken a position against the cannabis proposals.

The votes are among the latest examples of a push for marijuana reform making its way through Europe. About two months ago, another country in the region, Germany, began implementing a cannabis legalization law.

In Slovenia’s neighboring Italy, meanwhile, voters were deprived of the opportunity to decide on marijuana and psychedelics policy reform in 2022 following a ruling from the country’s top court. But support has been building for a narrower, cannabis-only measure that would allow the home cultivation of four plants, the eventual creation of social clubs and the elimination of penalties for consumers.

Malta became the first European country to enact marijuana legalization, with the president signing a reform bill in 2021.

A novel international survey released in 2022 found majority support for legalization in several key European countries. Slovenia was not included in that poll, however.

The United Nations’s (UN) drug control body recently reiterated that it considers legalizing marijuana for non-medical or scientific purposes a violation of international treaties, though it also said it appreciates that Germany’s government scaled back its cannabis plan ahead of the recent vote.

German Lawmakers Approve Changes To Marijuana Legalization Law Addressing Social Clubs And Impaired Driving

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President Joe Biden’s health secretary is suggesting that federal drug enforcement officials are not necessarily on board with the administration’s plan to reschedule marijuana.

Asked about the status of the proposed move of cannabis to Schedule III of the Controlled Substances Act at a recent event in Sacramento, U.S. Health and Human Services (HHS) Secretary Xavier Becerra said his agency “took action” based on available science and evidence, saying that the ball is now in the Department of Justice’s court.

He dodged a follow-up question, however, about rumored pushback against the reform by Drug Enforcement Administration (DEA) officials.

“We did our job,” Becerra said of the recommendation in an interview with KQED’s Scott Schafer at the CalMatters Ideas Festival on Thursday, adding that DEA “now has the final call to make that happen.”

“Is there resistance in DEA?” Schafer inquired.

“Talk to DEA,” answered Becerra, repeating: “We did our job.”

“I’m gonna take that as a yes,” Schafer replied.

“Our scientists reviewed the evidence,” Becerra responded. “FDA bases its action on the science and the evidence before us. We took action.”

During the interview, Schafer also asked Becerra whether he has “any concerns, as the father of three daughters—three children—you know, about the use of marijuana?”

“I have concerns when they get out and drive a car, or they go out at night and they’re over 21. I have lots of concerns,” Becerra said. “Thank God they’ve got great heads on their shoulders. And on something like cannabis, I think they would continue to have great heads on their shoulders.”

“Look, if my daughters could go out and buy a pint of whiskey or a menthol cigarette—we know what we’re up against,” he continued. “And let’s be real: You can’t incarcerate your way to a solution here. You can regulate it. And if you regulate it the right way, which we’re supposed to do for alcohol and cigarettes and all the rest, then we can manage it. But we have to make a decision.”

“More than half of the states have made a decision that they’d rather regulate this than criminalize it,” Becerra added of medical marijuana. “The U.S. FDA, the scientists, have spoken and said we should deschedule from Schedule I to Schedule III on cannabis.”

I sat down with @Scottshafer at @CalMatters Ideas Festival to share HHS priorities and successes on lowering drug costs, expanding access to care, and increasing health equity.

We're reaffirming our commitment to ensuring everyone has access to quality, affordable care. pic.twitter.com/X4zeXbmAL7

— Secretary Xavier Becerra (@SecBecerra) June 7, 2024

Becerra’s handling of the question about “resistance” at DEA comes amid ongoing speculation over the internal politics within the administration on marijuana rescheduling.

Indications that DEA might not be on board came alongside the rescheduling move itself, with the proposed rule in the Federal Register noting several times that the agency believes “additional information” needs to be collected via public comment or a possible administrative hearing could influence the final scheduling decision.

“DEA has not yet made a determination as to its views of the appropriate schedule for marijuana,” the document said.

Adding to questions about a possible disconnect between DOJ and DEA over the proposal is the fact that the attorney general, rather than the DEA administrator, signed the draft rule.

Even before the formal announcement, it had been reported that certain DEA officials had been “at odds” with the Biden administration over the rescheduling push.

A DEA official was also absent last week from a scheduled appearance to discuss marijuana policy and regulatory oversight issues for cannabinoid research.

The moderator of that panel said the DEA representative cancelled at the last moment. DEA did, however, issue a message to attendees that the agency’s “goal is to support researchers as they navigate this registration process” to study Schedule I drugs like cannabis, “and outreach is a key component of their model to provide that support,” according to the moderator.

The proposed rule to federally reschedule marijuana was officially posted last month, kicking off a public comment period that’s expected to elicit a major response from supporters and opponents of cannabis reform.

Marijuana reform advocates and stakeholders have made clear that they intend to leverage the opportunity, with some planning to support the reclassification and others intending to call for descheduling cannabis altogether. Prohibitionists are expected to oppose the incremental policy change and seek to keep marijuana in Schedule I, and there’s also a looming threat of litigation.

While DOJ will take all public comments submitted by July 22 into consideration as it weighs the reform, it said in the notice that one of the topics its especially interested in hearing about is the “unique economic impacts” of the rescheduling proposal given that state-level legalization has created a “multibillion dollar industry” that stands to benefit from possible federal tax relief under the reform.

On Capitol Hill, Senate Majority Leader Chuck Schumer (D-NY) and colleagues have reintroduced legislation to federally legalize cannabis and impose certain regulations. The bill’s prospects are dubious in the current divided Congress, however.

Meanwhile, the top Democrat in the U.S. House said that the Biden administration’s move to reschedule marijuana is a “step in the right direction,” but it should be followed up with congressional action such as passing the legalization bill Schumer filed.

In a recent interview with Fox News, former DEA Administrator Asa Hutchinson said it “absolutely looks like” the agency will follow through with moving marijuana from Schedule I to Schedule III under the CSA.

Biden has separately issued two rounds of mass pardons for people who’ve committed federal marijuana possession offenses. Again, a Schedule III reclassification would not legalize cannabis or free people still incarcerated over cannabis.

During his run for the presidency, Biden pledged to move cannabis to Schedule II—a stricter category compared to what’s been proposed by his administration.

Voters In Slovenia Approve Marijuana Ballot Measures

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Connecticut is on track to allow access to medical cannabis for the treatment of female orgasmic disorder (FOD) following a decision on Friday by the state Medical Marijuana Program Board of Physicians.

Doctors on the state panel unanimously agreed that cannabis is more likely than not to have a beneficial effect on FOD, which they acknowledged as a debilitating condition. Orgasms in people with FOD are delayed, infrequent or entirely absent.

The body also signed off on a separate proposal to add autism spectrum disorder as a qualifying condition for Connecticut’s medical cannabis program.

The push to add FOD as a condition for marijuana access stems from a petition submitted last year by Suzanne Mulvehill, a clinical sexologist who’s working to expand access to cannabis for people with FOD.

The executive director of the Female Orgasm Research Institute and the related Women’s Cannabis Project, Mulvehill has published research indicating that cannabis use increased orgasm ease and frequency in more than 70 percent of patients with FOD. Her study also found that marijuana improved sexual satisfaction in about two thirds (67 percent) of those with FOD.

Despite the promising results, Mulvehill told the panel, discussing women’s sexual satisfaction still carries stigma.

“We rarely talk about this topic, but I think it’s time,” she said, “because up to 41 percent of women suffer from it, and that statistic has not changed for more than 50 years.”

Referencing drugs for erectile dysfunction, such as Viagra, Mulvehill argued that “there is a solution for men, you know, but there really isn’t one for women.”

“This can be that solution,” she said of medical marijuana.

“When a woman can actually overcome a problem that is stigmatized and shamed, and no longer carry that around as a burden,” she added, “there’s a there’s a dimension of confidence.”

After a few questions from members of the board, the body approved adding FOD to Connecticut’s list of qualifying conditions.

One member asked about dosing, wondering whether effects were observed “only at psychoactive doses” or also when lower doses of marijuana were administered.

Mulvehill replied that women she’s talked to “knew exactly how much they needed to use.”

“Some women said, ‘I take one hit.’ Some women said, ‘I use a quarter of a brownie,'” she explained, noting that lower doses are typically recommended at first.

“If we were to approve this, then a doctor was going to say, ‘Listen, yes, how do we start?'” Mulvehill said. “We start with small doses, very small doses. And it’d be recommended that they would start on their own.”

Pressed on whether she was able to ascertain what dose was typical for patients in her study, Mulvehill replied: “Not specifically, other than saying what the research across the board has said: low doses.”

Another board member asked Mulvehill how patients with FOD would go about obtaining cannabis given that therapists aren’t authorized to recommend marijuana in Connecticut.

“Typically, a woman would go to a therapist first,” Mulvehill replied, explaining that marijuana would be “an adjunct to therapy.” They would then go to a doctor, ideally one with an understanding of therapeutic cannabis.

The board was clear that it was approving medical marijuana as a treatment for FOD specifically—not, as one member put it, “someone who just wants to use marijuana, you know, for pleasure or for intimacy.”

The vote to accept FOD as a qualifying condition doesn’t itself enact the change. The recommendation will be reviewed by the commissioner of the Department of Consumer Protection to make a final determination.

Mulvehill has been one of the leaders behind state-level efforts to recognize female orgasmic disorder as a qualifying condition for medical marijuana.

Connecticut was in the first group of states where she and others tried to add FOD as qualifying conditions. In March, officials in Illinois voted in favor of the addition, she told the panel on Friday.

Ohio officials, meanwhile, rejected the addition of FOD—along with autism spectrum disorder—at a meeting last month.

As for how marijuana might benefit people with FOD, a report in the journal Sexual Medicine by Mulvehill and Jordan Tishler—a doctor at the Association of Cannabinoid Specialists and the company inhaleMD—identified a few possible theories.

Among them is dishabitation theory, the idea that cannabis “lessens the routine of habits, such as cognitive distraction, a known FOD cause.”

Neuroplasticity theory, meanwhile, “proposes that some women learn to orgasm while using cannabis, as seen in comments in this study and anecdotally.”

“Cannabis and endocannabinoids, the cannabinoids created by the human body, are increasingly recognized for their roles in neural development processes, including brain cell growth and neuroplasticity,” the study says.

The research found that cannabis use did not help all women orgasm. “Among survey respondents,” it says, “4% reported never having an orgasm, even though they used cannabis before partnered sex.”

There’s growing evidence that marijuana can improve sexual function, regardless of sex or gender. A study last year in the Journal of Cannabis Research found that more than 70 percent of surveyed adults said cannabis before sex increased desire and improved orgasms, while 62.5 percent said cannabis enhanced pleasure while masturbating.

Because past findings indicated women who have sex with men are typically less likely to orgasm than their partners, authors of that study said cannabis “can potentially close the orgasm in equality gap.”

A 2020 study in the journal Sexual Medicine, meanwhile, found that women who used cannabis more often had better sex.

Numerous online surveys have also reported positive associations between marijuana and sex. One study even found a connection between the passage of marijuana laws and increased sexual activity.

Yet another study, however, cautions that more marijuana doesn’t necessarily mean better sex. A literature review published in 2019 found that cannabis’s impact on libido may depend on dosage, with lower amounts of THC correlating with the highest levels of arousal and satisfaction. Most studies showed that marijuana has a positive effect on women’s sexual function, the study found, but too much THC can actually backfire.

“Several studies have evaluated the effects of marijuana on libido, and it seems that changes in desire may be dose dependent,” the review’s authors wrote. “Studies support that lower doses improve desire but higher doses either lower desire or do not affect desire at all.”

Part of what cannabis appears to do to improve orgasms is interact with and disrupt the brain’s default mode network, Tishler, Mulvehill’s co-author, told Marijuana Moment in an interview earlier this year.

“For many of these women, who cannot or do not have an orgasm, there’s some complex interplay between the frontal lobe—which is kind of the ‘should have, would have, could have [part of the brain]’—and then the limbic system, which is the ’emotional, fear, bad memories, anger,’ those sorts of things,” he said. “That’s all moderated through the default mode network.”

Modulating the default mode network is also central to many psychedelic-assisted therapies. And some research has indicated that those substances, too, may improve sexual pleasure and function.

A paper earlier this year in the journal Nature Scientific Reports, which purported to be the first scientific study to formally explore the effects of psychedelics on sexual functioning, found that drugs such as psilocybin mushrooms and LSD could have beneficial effects on sexual functioning even months after use.

“On the surface, this type of research may seem ‘quirky,’” one of the authors of that study said, “but the psychological aspects of sexual function—including how we think about our own bodies, our attraction to our partners, and our ability to connect to people intimately—are all important to psychological wellbeing in sexually active adults.”

Most Consumers Use Marijuana To Treat Health Issues, But Very Few Call It ‘Medical,’ AMA Study Finds

Photo courtesy of Mike Latimer.

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Lawmakers from New Hampshire’s Senate and House of Representatives have reached a deal on a long-debated piece of legislation that would legalize marijuana for adults, advancing a compromise bill out of a bicameral conference committee on Thursday and returning the amended measure to both chambers for final up-or-down votes.

If majorities from both houses approve it, the bill would next go to Gov. Chris Sununu (R), who’s said in the past that while he does not personally support legalization, he sees the reform as inevitable and has indicated he will sign something like the current legislation, which is largely based on a Senate plan he endorsed.

Enactment would make New Hampshire the 25th U.S. state to legalize adult-use cannabis.

The panel previously met Tuesday and Wednesday of this week, but its seven members—three Senators and four House representatives—didn’t reach agreement until Thursday’s hearing, hours before a conference committee deadline.

As the final meeting opened, Sen. Tim Lang (R) unveiled a proposal from senators that incorporated some of the House members’ suggested changes from earlier in the week while modifying others.

The proposal amends a version of the legislation passed by the Senate last month. At the request of House lawmakers, it adds a representative from the state’s existing medical marijuana industry to the Cannabis Control Commission, which would have rulemaking authority over the regulated market. It also removes proposed penalties for a vehicle passenger’s consumption of cannabis in forms besides smoking and vaping. And it adjusts rules under which medical marijuana operators, known in New Hampshire as alternative treatment centers (ATCs), could transition from nonprofit to for-profit businesses.

Another key change would expand the state’s current decriminalization limit from three quarters of an ounce to one full ounce, effective immediately upon the bill’s passage. While possession wouldn’t become fully legal until 2026—at which point it would be limited to two ounces—the change would remove the risk of criminal penalties for people who might, for example, bring an ounce of marijuana legally purchased in a neighboring state back into New Hampshire. House members had pushed to decriminalize two ounces immediately, but senators were only willing to go up to one ounce prior to legalization taking effect.

After a nearly two-hour break, the conference reconvened and unanimously approved the bill.

Members from both the House and the Senate said they weren’t thrilled with the compromise but were nevertheless willing to sign off.

“I do want to be clear that…I’m signing this with a lot of angst and a lot of deliberation on my part, and I think some of my colleagues will feel the same way,” said Rep. Anita Burroughs (D), “However, I think that it’s time that we legalize cannabis, and I think that this is the right move.”

Senate President Jeb Bradley (R), who’s said repeatedly during the session that he personally opposes legalization, indicated that despite signing the conference committee report, he plans to vote against the final bill on the Senate floor.

“I’m gonna vote against it, but I am gonna sign off,” he told colleagues.

“The key element of it is he’s signing it for today,” added Rep. John Hunt (R).

The House and Senate now have until next Thursday, June 13, to vote on whether to send the negotiated proposal to the governor. It remains to be seen if a majority of House lawmakers will vote to approve the compromise that is largely based on a Senate bill they rejected in a floor vote last month.

For now, Karen O’Keefe, director of state policies for the advocacy group Marijuana Policy Project, told Marijuana Moment that she was pleased the conference committee fared better than skeptics had expected.

“I’m relieved and grateful that the Senate president negotiated in good faith on behalf of the Senate and did not kill HB 1633 despite his opposition to legalization,” she said in an email. “House members should be proud that they improved the bill to preserve the viability of dispensaries (ATCs) and to remove unnecessary criminalization. Now it’s time to get this past the finish line so the Live Free State can live up to its name.”

Based largely on language passed last month by the Senate, the revised measure, HB 1633, would allow allow 15 stores to open statewide beginning in 2026 through a novel state-run franchise system. Though stores would be privately run, the government would oversee operations, including setting final prices on products. Purchases would incur a 15 percent “franchise fee”—effectively a tax—that would apply to both adult-use and medical marijuana purchases.

Marijuana possession wouldn’t become legal until 2026, once the state’s licensed market is up and running. That same year, possession of up to two ounces of marijuana would become fully legal. In the meantime, possession of up to one ounce of cannabis would carry a $100 maximum civil fine.

The proposal would limit each municipality to only a single cannabis retail establishment unless it’s home to more than 50,000 people. Only two cities in the state, Manchester and Nashua, meet that threshold. Local voters would also need to pre-approve the industry in order for businesses to open in that jurisdiction.

Home cultivation of cannabis for personal use would remain illegal, and the state’s Liquor Commission would have the authority to enforce that provision.

Smoking or vaping marijuana in public would be a violation on the first offense and an misdemeanor for second or subsequent offenses within five years, a charge that could carry jail time. Consuming cannabis in other forms in public—for example, drinking a THC-infused beverage—would carry no punishment, unlike open container rules around alcohol.

For someone driving a car, the bill would outlaw consumption of cannabis by any means. Passengers would be forbidden from smoking or vaping cannabis. Driving under the influence of marijuana would remain a crime regardless of where the cannabis was consumed.

Sununu, for his part, has previously said that he would accept legislation based on the Senate-passed version of the bill—as long as House lawmakers make no major adjustments.

Going in to the conference committee, even some of the bill’s supporters predicted the bicameral panel would likely fail to reach a compromise.

For most of the session, they noted, Bradley himself had been vocally opposed to legalization, at one point saying that he hoped the bill would fail to even make it out of the Senate.

“The odds aren’t great,” the bill’s sponsor, Rep. Erica Layon (R), told Marijuana Moment ahead of the first conference committee meeting. “I’m gonna go into it optimistic, but I don’t really expect much to come of it.”

Sen. Daryl Abbas (R), who chaired a state commission on legalization last year and introduced a sweeping Senate floor amendment last month that made major changes to Layon’s bill, also told Marijuana Moment before the panel met that he was “not optimistic” that the bill “would survive a committee of conference.”

By contrast, the version of the bill passed by the House in April would have legalize through a so-called “agency store” model preferred by sponsor Layon and colleagues in that chamber. Under that approach, the state would oversee a system of privately run stores, with strict limits on marketing and advertising. That version also included a higher personal possession limit of four ounces, and medical marijuana would be been exempt from the state surcharge. Further, personal possession would have become legal immediately.

Most legalization and criminal justice advocates preferred the House bill, though they did welcome some licensing provision changes in the Senate version.

New Hampshire lawmakers worked extensively on marijuana reform issues last session and attempted to reach a compromise to enact legalization through a multi-tiered system that would include state-controlled shops, dual licensing for existing medical cannabis dispensaries and businesses privately licensed to individuals by state agencies. The legislature ultimately hit an impasse on the complex legislation.

Bicameral lawmakers also convened the state commission tasked with studying legalization and proposing a path forward last year, though the group ultimately failed to arrive at a consensus or propose final legislation.

The Senate defeated a more conventional House-passed legalization bill last year, HB 639, despite its bipartisan support.

Last May, the House defeated marijuana legalization language that was included in a Medicaid expansion bill. The Senate also moved to table another piece of legislation that month that would have allowed patients and designated caregivers to cultivate up to three mature plants, three immature plants and 12 seedlings for personal therapeutic use.

After the Senate rejected the reform bills in 2022, the House included legalization language as an amendment to separate criminal justice-related legislation—but that was also struck down in the opposite chamber.

Louisiana Lawmakers Make Big Changes To State’s Medical Marijuana And Hemp Laws

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Some purchases of medical marijuana in Washington State will no longer be subject to the state’s 37 percent cannabis tax under a new law taking effect on Thursday. The exemption, signed into law in March by Gov. Jay Inslee (D), applies specifically to products that have been certified to higher testing standards than typical state-legal products.

Medical marijuana cardholders were already eligible for exemptions from Washington’s sales and use taxes on cannabis, but they were not exempt from the state’s excise tax, one of the highest in the country.

The bill, sponsored by Rep. Sharon Wylie (D) and two other Democrats allows state-registered patients and caregivers to avoid the tax when purchasing products that are compliant with Department of Health (DOH) testing standards, which are more rigorous than typical state cannabis standards. Manufacturers in the state are required to submit all medical and adult-use products to labs for testing, but producers can voluntarily have additional testing done—to screen for heavy metals, for example—that isn’t otherwise required.

Marijuana that passes the additional testing can be labeled with a DOH-developed logo, which now also serves as an indication that the product is tax-free for patients and caretakers.

Many states with both adult-use and medical marijuana already exempt patients from taxes.

Washington’s tax break is only temporary. As written, the new law is set to expire on June 30, 2029. A report by the Joint Legislative Audit and Review Committee on the revenue impacts of the change is due in 2028.

One of the bill’s co-sponsors, Rep. Shelley Kloba (D) also sponsored a cannabis homegrow bill this session—the latest in a series of such measures introduced over the past several years—but the proposal ultimately died in committee. If passed, HB 2194 would have allowed adults 21 and older to grow up to four plants per person, with no more than 10 allowed per household. Home cultivation of marijuana without a medical marijuana card remains a felony in the state.

Kloba told Marijuana Momentthat she’s co mmitted to continued advocacy for the policy change and plans to introduce yet another homegrow measure next year.

“I am committed to this issue, and plan to run a bill again next session,” she said. “Every session has its own character and constraints, which so far have meant that the bill has not advanced to the Senate. But I am not giving up.”

Washington voters legalized marijuana for adult use through a ballot measure in 2012.

Another cannabis bill introduced in Washington this session would have rolled back recently enacted protections for job applicants who use marijuana, undoing anti-discrimination protections for people seeking to work in the drug treatment industry. It did not receive committee consideration in time to advance, however.

Lawmakers also introduced legislation to create a legal system to allow veterans and first responders to access psychedelic-assisted therapy. The measure would have built on a limited pilot program signed into law last year, but it also did not advanced after being filed.

Late last year, the state’s Department of Commerce issued recommendations regarding how $200 million should be spent to address racial, economic and social disparities created by the war on drugs. Washington has also approved $10 million in refunds for vacated drug convictions.

In April, meanwhile, state marijuana regulators began amending rules related to social equity ownership of cannabis businesses, an effort to encourage more diverse ownership and reduce obstacles to licensing, including from past drug-related convictions.

Teen Marijuana Use Has Declined In Washington Since Legalization, New State Research Shows

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Authors of a new study in Journal of the American Medical Association (JAMA) that looked at survey responses from more than 175,000 people say the typical medical–recreational binary may not adequately capture how people say they use marijuana, noting that “while most patients (76.1%) reported using cannabis to manage a health symptom, very few patients identified as medical cannabis users.”

Among people who used marijuana, for instance, 15.6 percent said their use was for strictly medical reasons, while less than a third (31.1 percent) said their use was for both nonmedical and medical purposes. But more than three quarters of users “reported using cannabis to manage a range of symptoms” like pain, stress and sleep issues, the study found.

“Less than half the patients who used cannabis reported using it for medical reasons, even though the majority of patients reported cannabis use to manage a health-related symptom,” authors wrote. “Given these discrepant findings, it may be more useful for clinicians to ask patients what symptoms they are using cannabis for rather than relying on patient self-identification as a recreational or medical cannabis user.”

“This aligns with another study that found that this type of cannabis use is clinically underrecognized,” they added, “and without specifically screening for medical cannabis use, clinicians may not ask and patients often do not disclose their use.”

“While a minority of patients reported using cannabis for strictly medical reasons, most of those who reported cannabis use reported using it to manage a specific health symptom.”

The University of California, Los Angeles-based research team looked at records from “a large, university-based [healthcare] system in Los Angeles, California, and encompasses a geographically diverse area” that surveyed its patients during annual wellness visits between January 2021 and May 2023. Of the 175,734 patients screened, 25,278 (17.0 percent) reported using marijuana.

“As one of the first health systems to routinely ask about reasons for cannabis use, including health symptoms managed with cannabis,” the report says, “we provide a crucial point-of-care opportunity for clinicians to understand their patients’ risk for CUD [cannabis use disorder] given the association between reasons for cannabis use and the risk of disordered use.”

Notably, the study concluded that among self-reported marijuana users, more than a third were at moderate to high risk for cannabis use disorder—about 5.8 percent of all patients surveyed.

Of the 17.0 percent of those who said they used marijuana, just over a third 34.7 percent, “had results indicative of moderate to high risk for cannabis use disorder,” the report says.

Risk for CUD was measured through a World Health Organization screening called the Alcohol Substance Involvement Screening Test (ASSIST), which was modified by the National Institute of Drug Abuse. Authors of the study further modified the scoring algorithm in “consultation with the ASSIST developers and motivated by a desire to identify patients who were not just frequent users of cannabis but also experiencing health or social consequences as a result of their cannabis use.” Scoring thresholds for low and moderate risk were increased to reflect that goal; specifically, “low risk for CUD was defined as a score of 7 or less (compared with ≤3 in the original scoring algorithm)” and “moderate risk for CUD was defined as a score of 8 to 26 (compared with 4–26 in the original scoring algorithm).”

“The data from this study show that the prevalence of cannabis use and the risk of disordered use were highest among male patients and younger adults,” the study found. “Comparable with findings from a recent study, more than a third of patients were at moderate to high risk for CUD (5.8% of the overall sample). This group could benefit from a primary care clinician-based brief intervention to prevent those at moderate risk for cannabis use disorders from developing more serious CUD and to evaluate and refer high-risk users for possible addiction treatment.”

Clinicians should also “take note that if patients are using cannabis for 4 or more symptoms they might be more likely to be at risk of CUD,” authors wrote, adding, “Despite the commonplace use of cannabis to manage these symptoms, there is little evidence to guide clinicians on how to advise their patients regarding the benefits of cannabis for alleviating these symptoms.”

“Most patients reported that they used cannabis to manage symptoms including stress and pain.”

“Interestingly,” they continued, “while the prevalence of cannabis use was lowest among patients living in the most disadvantaged neighborhoods, risk for CUD was higher among this group. The influence of neighborhood on health outcomes has been well established; however, the influence of neighborhood on substance use and especially cannabis use is limited or conflicting.”

The study cautions, however, that its sample’s “underrepresentation of patients from the most disadvantaged neighborhoods prevents drawing strong conclusions on the specific links with risk of CUD.”

Overall, in light of “the high rates of cannabis use and medical cannabis use that we found in this large urban health care system, it is essential that health care system implement routine screening of all primary care patients,” the report, published on Wednesday in JAMA Network Open, advises. “Integrating screening efforts to include information regarding cannabis use for symptom management could help enhance the identification and documentation of medical cannabis usage, particularly in the health care context.”

“While 4,375 patients who reported using cannabis (15.6%) did so for medical reasons only, 21,986 patients (75.7%) reported using cannabis to manage symptoms including pain (9,196 [31.7%]), stress (14,542 [50.2%]), and sleep (16,221 [56.0%]).”

At the state level, most laws still draw a bright line between medical and nonmedical use, with laws commonly requiring a doctor’s recommendation and registration as a medical marijuana patient before someone can access medical cannabis. But in some jurisdictions, that’s slowly changing.

In Delaware, for example, the governor this year signed into law a bill that would significantly expand the state’s medical marijuana program, including allowing patients over the age of 65 to self-certify for medical cannabis access without the need for a doctor’s recommendation and by removing the list of specific qualifying conditions that patients need to have to gain legal access to the program.

The newly published findings follow a JAMA-published report in April that said there’s no evidence that states’ adoption of laws to legalize and regulate marijuana for adults have led to an increase in youth use of cannabis. That research indicated states’ adoption of recreational marijuana laws (RMLs) had no association with the prevalence of youth cannabis consumption.

“In this repeated cross-sectional study, there was no evidence that RMLs were associated with encouraging youth marijuana use,” it said. “After legalization, there was no evidence of an increase in marijuana use.”

Another JAMA-published study earlier that month that found that neither legalization nor the opening of retail stores led to increases in youth cannabis use. That study, published in the journal JAMA Pediatrics, concluded that the reforms were actually associated with more young people reporting not using marijuana, along with increases in those who say they don’t use alcohol or vape products either.

In March, meanwhile, JAMA published findings that teen use of delta-8 THC, a psychoactive cannabinoid commonly derived from hemp, was higher in states where marijuana was illegal. In states where marijuana remains prohibited, 14 percent of high-school seniors said they had used a delta-8 product in the past year, the federally funded research found. Where marijuana was legal, that figure was 7 percent.

Along with the study, JAMA published an editorial about the new findings meant to “assist health professionals in advocating for stronger regulatory oversight of cannabis products.”

In January, separate research appeared in JAMA concluding that safe drug consumption sites “save lives” by reducing risky behaviors and overdose deaths.

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A federal government watchdog agency says in a new report that the Drug Enforcement Administration should improve the process through which it considers granting religious exemptions for psilocybin and other controlled substances, asserting that the existing route lacks clarity on timing, evaluation and other matters.

The 80-page report from the U.S. Government Accountability Office (GAO) notes that although psilocybin remains a Schedule I controlled substance under the Controlled Substances Act (CSA), people may petition DEA for exemptions to use it—or other controlled substances—for religious purposes.

“DEA has established a process for these petitions, but its guidance doesn’t set clear timeframes for the decision-making,” it continues. “Exemption petitions have taken from 8 months to over 3 years to be resolved.”

GAO focused specifically on psilocybin use under the Religious Freedom Restoration Act (RFRA), which is meant to protect religious practices from undue government burdens. The agency found that the DEA exemption procedure itself was burdensome.

“Selected stakeholders reported several barriers to the legal access and use of psilocybin for religious practices under the Religious Freedom Restoration Act,” GAO says. “For example, DEA established a process for parties to petition for a religious exemption from the Controlled Substances Act to use controlled substances for religious purposes. However, DEA’s guidance does not inform petitioners on its timeframes to make determinations on completed petitions.”

Drug Control: DEA Should Improve Its Religious Exemptions Petition Process for Psilocybin (Mushrooms) and Other Controlled Substances https://t.co/bASkVkNk6Y

— U.S. GAO (@USGAO) May 30, 2024

In 2019, DEA began a rulemaking process around petitions for religious exemptions, the GAO report adds, “but there is no timeframe for issuance of the notice or final regulations.”

While some who’ve petitioned DEA for special drug-related exemptions have accused the agency of dragging its heels, the new report is noteworthy in that the federal government itself is now criticizing drug enforcement officials.

“Over an 8-year period—from fiscal year 2016 through January 2024—DEA reported that 24 petitioners requested a religious exemption for various controlled substances,” GAO wrote. “As of January 2024, DEA reported that none of these petitions had been granted an exemption.”

Six of the 24 petitions were for psilocybin. Of those, three were withdrawn, and another three were still pending a DEA determination, the GAO report says.

“The three pending religious exemption petitions related to psilocybin ranged from about 8 months to over 3 years from the date of receipt,” it notes. “DEA’s information also showed instances where finalized actions regarding exemption petitions related to other controlled substances have been pending a determination for an extensive period—one almost 5 years and one almost 8 years.”

As for how to address the issues, GAO made four main recommendations.

First, it says DEA “should more clearly communicate the types of information that the Religious Freedom Restoration Act petitioners should provide to allow DEA to evaluate petitions for religious sincerity.”

It also says the agency should “more clearly communicate the standards and relevant factors” when making a determination as well as “establish timeframes for DEA to make determinations on completed religious exemption petitions.”

It further encourages DEA to provide “information for petitioners to be able to receive updates on the agency’s process related to exemption reviews.”

Each of the four recommendations is attached to a status tracker. “When we confirm what actions the agency has taken in response to this recommendation,” it says, “we will provide updated information.”

The review results from a request from Congress in 2022. In a report attached to spending legislation, lawmakers said GAO should look at the impact of CSA enforcement in jurisdictions allowing for psilocybin, barriers to accessing the psychedelic for medical use, recommendations on how to remove research blockades and more:

Psilocybin Report.—The Committee directs GAO to report to Congress within one year of the date of enactment of this Act on the barriers to State, local, and Tribal programs that incorporate psilocybin products, including for therapeutic use and religious, Indigenous, or spiritual practices. The report shall: (1) review the impact of Controlled Substances Act enforcement on psilocybin use legally sanctioned by States, local governments, and Tribes; (2) identify barriers to accessing therapeutic use of psilocybin in States that have made such use legal under State law; (3) recommend ways to improve the processes used to obtain Federal authorization to conduct research with psilocybin-related substances; and (4) identify barriers to legal access to and use of psilocybin for religious, Indigenous, or spiritual practices under the Religious Freedom Restoration Act.

While exemptions from the Controlled Substances Act for religious use are rare, they’re not entirely unheard of. A legal settlement in April between several government agencies and an Arizona-based nonprofit, for example, permits the group to import and use ayahuasca as a religious sacrament.

The organization, the Church of the Eagle and the Condor (CEC), said at the time that it was “the first non-Christian church to receive protection for its spiritual practices regarding Ayahusca,” adding that the development under RFRA marks “the first time in history a church’s right to import and share its sacrament has been secured without going to trial.”

CEC sued DEA, the Department of Justice (DOJ), the Department of Homeland Security (DHS) and Customs and Border Protection (CBP) in 2022 over DHS’s seizures of shipments of ayahuasca intended for ceremonial use. The government had also threatened that the group and its members could face federal prosecution.

Last month, however, the federal government said that settlement was irrelevant in the case of a separate psychedelic church in Iowa that wants to incorporate ayahuasca into its ceremonies.

The Iowaska Church of Healing first sent its petition to the Drug Enforcement Administration (DEA) asking for an exemption around ayahuasca use in 2019. A separate request for a tax exemption with the Internal Revenue Service (IRS) initially received no response from the agency, according to court filings.

The church found an unusual ally in anti-drug U.S. Sen. Chuck Grassley (R-IA), who court filings say was instrumental in expediting the regulatory appeals process back in 2021. A Grassley spokesperson told Marijuana Moment the following year that the senator’s help shouldn’t necessarily be viewed as an endorsement of the church’s point of view on psychedelics, however.

Some have also criticized DEA’s clarity on determinations and timelines for petitions unrelated to religious use.

A Washington State doctor seeking to legally use psilocybin to treat cancer patients in end-of-life care, for example, is currently suing DEA over delays and rejections related to a requested exemption under state and federal right to try (RTT) laws, which are intended to give patients with terminal conditions the opportunity to try investigational medications that have not been approved for general use.

“DEA has rejected each request,” lawyers for the doctor, Sunil Aggarwal, argued in an opening brief earlier this year, “but has never addressed the arguments that Dr. Aggarwal has raised in support of them.”

“If DEA wants to disclaim authority to grant Dr. Aggarwal access to psilocybin under the CSA and RTT,” the brief says, “it must provide a reasoned explanation for how that decision comports with the CSA and the agency’s own precedent.”

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Of the roughly 500 firearm permit applications denied by officials in Hawaii last year, more than 40 percent were rejected because of applicants’ status as medical marijuana patients, according to new data from the state attorney general’s office.

Across Hawaii, state-legal cannabis use was the leading cause of gun permits being denied (40.7 percent), with mental health issues responsible for about a quarter of rejections and domestic violence disqualifying about 7 percent.

That said, a relatively small portion of firearm registrations were rejected by law enforcement last year. Of 23,528 applications processed during 2023, only 519—about 2.2 percent—were denied.

Of the rejected applications, 211 resulted from medical marijuana. Those denials included not only patients currently enrolled in the state program but also former patients. As the AG report notes, “police departments allow former patients to apply for firearms no less than one year after the expiration of their medical marijuana card.”

Under federal law, being an “unlawful user” of a controlled substance, including marijuana, means a person cannot legally buy or possess a gun.

Notably, the report showed that rejection rates varied significantly by region. In Kauai County, for instance, just 0.2 percent of applications were denied in 2023, compared to about 6.9 percent in Hawaii County, which comprises the Big Island.

Of 332 denials in Hawaii County last year, 191—about 57.5 percent—were due primarily to medical marijuana.

Hawaii County Police Chief Benjamin Moszkowicz said he was initially surprised by the disparity.

“I got this report the same day that it was released out to the general public, and I immediately had kind of some of those same questions, like why are we denying so much more than the other counties?” he told Hawai’i Public Radio (HPR). “So in this particular set of circumstances, most of our application denials center around medical marijuana applicants.”

Hawaii County was unique in the state, Moszkowicz explained, because other counties didn’t consider a medical marijuana permit disqualifying if it’s been expired for a year or more. Hawaii County, by contrast, had considered a past permit an automatic disqualifier.

As of Monday, Hawaii County has reportedly stopped automatically denying firearm applications from people whose medical marijuana enrollment lapsed more than a year ago.

Moszkowicz also said that three quarters of applicants who were initially denied over past medical marijuana enrollments were eventually approved “after returning with documentation from a doctor or counselor saying they were no longer adversely affected,” according to HPR.

“I don’t think we were doing anything wrong by denying people’s applications under that section and asking them to, you know, basically redeem that right by providing what the statute suggests. But at the same time, because such a large percentage of those people were able to get that documentation so quickly, actually, we changed our policy,” Moszkowicz told the outlet. “So in the last day or two, we’ve changed our policy and our practice to align with the other counties. And that’s a direct result of this report.”

Overall, gun registrations are significantly up in Hawaii in recent decades.

“Firearm registration activity increased dramatically over the course of the 24 years for which these data have been systematically complied and reported,” the AG’s office said in a press release. “From 2000 through 2023, the number of statewide permit applications processed annually increased by 262.6%, the number of firearms annually registered leapt by 280.5%, and the number of firearms annually imported climbed 263.4%.”

The U.S. Supreme Court is expected to decide soon whether to hear a government appeal of a circuit court ruling that found the federal firearm restriction violates the Second Amendment.

That ruling came from the U.S. Court of Appeals for the Fifth Circuit, which examined the federal statute known as Section 922(g)(3) that prevents someone who is an “unlawful user” of an illegal drug from buying or possessing firearms. The circuit court found the policy unconstitutional as applied to a man who faced a conviction after admitting to having used cannabis while in possession of a gun.

Some states have passed their own laws either further restricting or attempting to preserve gun rights as they relate to marijuana. Last month, for example, a Pennsylvania lawmaker introduced a bill meant to remove state barriers to medical marijuana patients carrying firearms.

Colorado organizers are also working to qualify a prospective state ballot measure that would remove a barrier around the issuance of concealed handgun permits, specifying that whether someone is an “unlawful user of or addicted to marijuana” should be determined “only as provided in state law and regulations.”

At the federal level, enforcement of the rule against gun purchases or ownership by marijuana users has been inconsistent. Attorneys for President Joe Biden’s son Hunter Biden, for example, who’s been charged by the Department of Justice (DOJ) with illegally owning a firearm while a user of illegal drugs, have argued that millions of marijuana users in legal states already own guns.

The younger Biden’s legal team has alleged that even the prosecutor on the case has acknowledged that “an ordinary citizen would not be prosecuted for this offense,” which they argued “is borne out by DOJ’s policy and statistical evidence.”

While people who use cannabis are barred from owning firearms under the law, a little-notice FBI memo from 2019 that recently surfaced shows that the federal government generally does not consider it a violation of the law for medical cannabis caregivers and growers to have guns.

The statute behind the prohibition has been challenged in a number of federal courts in recent years, with more than one judicial body determining that the restriction is unconstitutional. DOJ has steadfastly defended the ban, however, contending that medical marijuana patients and everyday consumers pose unique dangers to society that justify withholding Second Amendment rights.

Last year, for example, the Justice Department told the U.S. Court of Appeals for the Third Circuit that historical precedent “comfortably” supports the restriction. Cannabis consumers with guns pose a unique danger to society, the Biden administration claimed, in part because they’re “unlikely” to store their weapon properly.

The federal government has repeatedly claimed that those analogues provide clear support for limiting gun rights for cannabis users. But several federal courts have separately deemed the marijuana-related ban unconstitutional, leading DOJ to appeal in several ongoing cases.

The Justice Department asserted similar points during oral arguments in a separate but related case before the U.S. Court of Appeals for the Eleventh Circuit in October. That case focuses on the Second Amendment rights of medical cannabis patients in Florida.

Attorneys in both cases have also touched on a U.S. Court of Appeals for the Fifth Circuit ruling from August, Daniels v. United States, that found the ban preventing people who use marijuana from possessing firearms is unconstitutional, even if they consume cannabis for non-medical reasons.

DOJ had already advised the Eleventh Circuit court that it felt the ruling was “incorrectly decided,” and the department’s attorney reiterated that it’s the government’s belief that “there are some reasons to be uncertain about the foundations” of the appeals court decision.

The U.S. District Court for the Western District of Oklahoma also ruled in February that the ban prohibiting people who use marijuana from possessing firearms is unconstitutional, with the judge stating that the federal government’s justification for upholding the law is “concerning.”

In U.S. District Court for the Western District of Texas, a judge ruled in April that banning people who use marijuana from possessing firearms is unconstitutional—and it said the same legal principle also applies to the sale and transfer of guns.

In August, meanwhile, ATF sent a letter to Arkansas officials saying that the state’s recently enacted law permitting medical cannabis patients to obtain concealed carry gun licenses “creates an unacceptable risk,” and could jeopardize the state’s federally approved alternative firearm licensing policy.

Shortly after Minnesota’s governor signed a legalization bill into law in May, the agency issued a reminder emphasizing that people who use cannabis are barred from possessing and purchases guns and ammunition “until” federal prohibition ends.

In 2020, ATF issued an advisory specifically targeting Michigan that requires gun sellers to conduct federal background checks on all unlicensed gun buyers because it said the state’s cannabis laws had enabled “habitual marijuana users” and other disqualified individuals to obtain firearms illegally.

Attorneys for Hunter Biden, who has been indicted on a charge of buying a gun in 2018 at a time when he’s disclosed that he was an active user of crack cocaine, have previously cited the court ruling on the unconstitutionality of the federal ban, arguing that it applies to their client’s case as well.

Republican congressional lawmakers have also filed bills that focus on gun and marijuana policy.

Rep. Brian Mast (R-FL), co-chair of the Congressional Cannabis Caucus, filed legislation last May to protect the Second Amendment rights of people who use marijuana in legal states, allowing them to purchase and possess firearms that they’re currently prohibited from having under federal law.

Senate Majority Leader Chuck Schumer (D-NY) committed to attaching that legislation to a bipartisan marijuana banking bill.

Meanwhile, Mast also cosponsored a separate bill from Rep. Alex Mooney (R-WV) that would more narrowly allow medical cannabis patients to purchase and possess firearms.

One place where the matter is particularly relevant is Jersey City, New Jersey, where Mayor Steven M. Fulop (D) is suing over a state policy that allows police officers to use marijuana while off duty.

That challenge, however, has sparked pushback from two police officers, who’ve since sued Jersey City over what they say is a politically motivated move by Fulop in service of a future gubernatorial campaign. A police union has also asked the judge in the city’s case to throw out the lawsuit, calling it “pure hogwash.”

Back in Hawaii, following the failure of a Hawaii bill to legalize cannabis for adults earlier this year, Gov. Josh Green (D) said last month that he has “a possible solution” to the issue: vastly expanding the state’s existing medical marijuana system to allow people to register based on any health concern rather than needing to have one of a specific list of conditions.

“This would make it very available—that’s marijuana—for those who choose it in their lives,” the governor said in an interview with Hawaii News Now, “and it would still keep kids safe, which has been everyone’s priority.”

At the same time, Green reiterated his support for full recreational legalization.

“I think for adults who can responsibly use marijuana, it should be legal,” he said.

The governor’s comments came immediately following House lawmakers’ decision to kill a Senate-passed cannabis legalization bill in April. That same month week, the Senate also voted to scuttle a separate measure that would have expanded the state’s existing marijuana decriminalization law.

In April 2023, meanwhile, Hawaii’s legislature approved a resolution calling on the governor to create a clemency program for people with prior marijuana convictions on their records.

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House lawmakers in New Hampshire have rejected Senate changes to a marijuana legalization bill, setting the stage for a conference committee to hammer out differences between versions of the legislation passed by either chamber. Many stakeholders think the development could spell the end for the proposal, however, because even a single member of the conference committee could block the path to final passage.

The House on Thursday voted 196–173 to send the legislation to a conference committee following an earlier vote to reject sweeping Senate-made changes to the bill.

Several representatives who back legalization urged colleagues not to sign off on the new Senate provisions just to get the broad reform enacted.

“Instead of rushing to pass a bill that we all know is flawed, let’s reject this amendment and insist on making better policies for our constituents,” Rep. Keith Howard (D) said before the House floor vote. “We will only get one chance to create a well regulated market for adult-use cannabis, and it’s important we get it right.”

“I know the vast majority of my constituents want legalized cannabis,” added Republican Kevin Verville (R). “They want it in New Hampshire and they want it sooner than later. But this is not the right approach for us.”

The House last month passed an earlier version of the bill, HB 1633, which the Senate later made sweeping changes to via major amendments from Sen. Daryl Abbas (R) and Senate President Jeb Bradley (R), among others. Bradley, who himself opposes legalization, repeatedly said that if the legislation had the votes to pass, he intended to tailor it more to his and the governor’s liking.

Some House lawmakers urged colleagues to grit their teeth and sign off on the Senate version of the bill, warning that supporters of legalization are missing an opportunity to skip a conference committee and send the proposal immediately to Gov. Chris Sununu (R).

Sununu has indicated he’d support the bill with the Senate changes but would oppose the measure as passed by the House. He said this week that if the House passed the bill with the Senate’s changes, he’d sign it.

“I think the Senate version is OK,” Sununu told NH Journal. “They put some other stuff in there that I wasn’t necessarily looking for, but they’re not deal breakers.”

But if House lawmakers “want to make significant changes,” the governor added, “then it’s not going to pass. It’s that easy.”

One factor worrying some advocates is that the Republican candidates likely to replace Sununu when his gubernatorial term expires early next year have signaled that they’d oppose the reform. That means a failure to legalize marijuana this session could delay the policy change indefinitely.

Because the House and Senate have now passed different versions of the legislation, HB 1633, it next proceeds to a conference committee consisting of lawmakers from both chambers.

While finding compromise is panel’s the ostensible goal, reform advocates expect the bicameral committee will be set up to kill the bill, at least on the Senate side. Bradley, the Senate president, will not only pick the members of the committee from that chamber, but he also indicated this week that he might appoint himself to the panel.

Abbas told Marijuana Moment earlier this week that he’s “not optimistic” the bill “would survive a committee of conference.”

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Sununu, for his part, has said that while he personally opposes legalization, he believes the policy change is “inevitable.”

Polls indicate that upward of 70 percent of New Hampshire voters support legalizing and regulating marijuana.

While HB 1633 was initially introduced by Rep. Erica Layon (R), the Senate changes shifted its core regulatory approach to one discussed late last year by a state commission on legalization chaired by Abbas. Though that body ultimately failed at its charge of crafting legislation to enact the reform, Abbas and others in the Senate incorporated a number of provisions that were raised during discussions last year.

If the committee does undertake its work in earnest, its job will be to reconcile two complex bills that differ significantly on regulatory structure, criminal justice, licensing, personal possession and THC limits, tax rates, medical marijuana and sundry other issues.

As passed by the Senate, the bill would allow 15 franchise stores to open statewide. Purchases would incur a 15 percent “franchise fee”—effectively a tax—that would apply to both adult-use and medical marijuana purchases. Though stores would be privately run, the government would control their look, feel and operations. The Liquor Commission would have the authority, for example, to set final prices on cannabis products.

Marijuana possession wouldn’t become legal until 2026, once the state’s licensed market is up and running.

The proposal would limit each municipality to only a single cannabis retail establishment unless it’s home to more than 50,000 people, though only two cities in the state, Manchester and Nashua, meet that threshold. Local voters would also need to pre-approve the industry in order for businesses to open in that jurisdiction.

Adults could possess up to two ounces of marijuana under the Senate plan. Home cultivation of cannabis for personal use would remain illegal, and the state’s Cannabis Control Commission would have the authority to enforce that provision.

Smoking or vaping marijuana in public would be a violation on the first offense and an misdemeanor for second or subsequent offenses within five years, a charge that could carry jail time. Consuming cannabis in other forms in public—for example, drinking an THC-infused beverage—would carry no punishment, unlike open container rules around alcohol.

The bill would also outlaw consumption of cannabis by any means, including edibles, by any driver or passenger of a vehicle being driven in any way. That would also be an unclassified misdemeanor with the potential for jail time.

The version of the bill passed by the House in April, by contrast, would legalize through a so-called “agency store” model proposed by Layon, in which the state would oversee a system of privately run stores, with strict limits on marketing and advertising. That version also includes a higher personal possession limit of four ounces and a lower, 12 percent fee on purchases. Further, medical marijuana would be been exempt from the state surcharge, and personal possession would become legal immediately.

The House bill, like the Senate version, would not allow home cultivation of cannabis.

The Senate changes led supporters of the reform to disagree on how the House should proceed. Advocates with the state ACLU chapter and the Marijuana Policy Project (MPP), who poured hours into lobbying lawmakers on the bill, said the revised proposal represented an imperfect but nevertheless important reform in New Hampshire, urging House lawmakers to accept the Senate changes and move the legislation along.

Other advocates, however, including the New Hampshire Cannabis Association (NHCann) and the bill’s lead sponsor, Layon, argued the House shouldn’t sign off on the amendments, even if that meant derailing the bill.

New Hampshire lawmakers worked extensively on marijuana reform issues last session and attempted to reach a compromise to enact legalization through a multi-tiered system that would include state-controlled shops, dual licensing for existing medical cannabis dispensaries and businesses privately licensed to individuals by state agencies. The legislature ultimately hit an impasse on the complex legislation.

Bicameral lawmakers also convened the state commission tasked with studying legalization and proposing a path forward last year, though the group ultimately failed to arrive at a consensus or propose final legislation.

The Senate defeated a more conventional House-passed legalization bill last year, HB 639, despite bipartisan support.

Last May, the House defeated marijuana legalization language that was included in a Medicaid expansion bill. The Senate also moved to table another piece of legislation that month that would have allowed patients and designated caregivers to cultivate up to three mature plants, three immature plants and 12 seedlings for personal therapeutic use.

After the Senate rejected the reform bills in 2022, the House included legalization language as an amendment to separate criminal justice-related legislation—but that was also struck down in the opposite chamber.

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