US State Recreational and Medical Cannabis Delivery Laws, 2024

Abstract

Objectives. To provide a legal epidemiology review of state-level policies that regulate the direct delivery of recreational and medical cannabis in the United States.

Methods. We conducted a comprehensive review to identify all relevant policies as of July 1, 2024. Specifically, we developed a coding scheme to capture laws governing (1) direct delivery of recreational cannabis, (2) licensing for direct delivery of recreational cannabis, (3) direct delivery of medical cannabis to qualifying patients, and (4) medical cannabis delivery solely from caregivers to qualified patients.

Results. Fourteen states authorized the direct delivery of recreational cannabis to adults. Twenty-six states and the District of Columbia permitted the direct delivery of medical cannabis to qualifying patients. Twelve states allowed the delivery of medical cannabis to patients exclusively through caregivers. There were numerous variations in the licensing and authorization of recreational and medical cannabis delivery.

Conclusions. States varied in how the delivery of cannabis was regulated.

Public Health Implications. A comprehensive review of state-level policies on cannabis delivery highlights the diverse approaches and their implications for recreational and medical cannabis access. (Am J Public Health. 2025;115(2):178–190. https://doi.org/10.2105/AJPH.2024.307874)

The cannabis policy landscape has seen substantial changes in recent years. Despite cannabis still being federally restricted, a significant number of states have passed laws legalizing its medical and recreational use among adults.¹ It is estimated that 74% of people in the United States reside in a state where cannabis is legal for recreational use, medical use, or both, as of 2024.¹ Scholars have noted that the existing situation, where state cannabis laws conflict with federal regulation, poses challenges to rational drug control and cooperative federalism.^2,3 However, in May 2024, the US Justice Department proposed regulations to ease federal restrictions on cannabis,⁴ which could potentially resolve the conflict and allow more permissive state legislation.

The rapid evolution of cannabis legalization in the United States has introduced some ambiguity regarding the public health impact of its regulatory status.⁵ Evidence suggests that cannabis use is associated with health risks, including respiratory symptoms, potential development of schizophrenia, and immediate effects such as impaired cognition and driving.^6–10 Prolonged cannabis use can lead to cannabis use disorder, a psychiatric condition characterized by the inability to stop consuming cannabis even when it causes physical or psychological harm to an individual’s life.⁶ Cannabis use disorder affects nearly 1 in 3 cannabis users in the United States, with a higher risk among individuals who start using cannabis early and those who use it more frequently.^6,11–13 By one estimate, cannabis use disorder accounted for approximately 690 000 disability-adjusted life years globally in 2019.¹⁴ There are also cannabis use risks to youths and young adults, such as neurodevelopmental decline, poor school performance, and adverse mental health outcomes.^15–17

Notwithstanding the potential risks associated with using cannabis, there are also reported medical benefits. A national report and systematic reviews support the use of cannabinoids (i.e., chemicals found in cannabis) and tetrahydrocannabinol (THC) for treating chronic pain and spasticity in adults.^12,18,19 In addition, oral cannabinoids have been used to treat chemotherapy-induced nausea and vomiting, as well as patient-reported multiple sclerosis spasticity symptoms. Other studies suggest that cannabinoids may not be highly effective in managing chronic noncancer pain, but they could potentially serve as a modest therapeutic option.^20,21 As of 2024, 38 states and the District of Columbia allow the medical use of cannabis products to treat certain conditions such as cancer, Crohn’s disease, epilepsy, multiple sclerosis, anxiety disorders, and terminal illnesses.¹

A crucial factor to consider in regulating products that pose health risks yet offer certain health or social benefits is the method of sale. In contrast to brick-and-mortar outlet sales, where consumers purchase products from vendors in person, “direct-delivery” sales involve placing an order with a vendor remotely through phone, online, or apps such as Leafly and receiving the product directly at the user’s location. A significant regulatory challenge for direct-delivery sales is the ability of consumers to place orders remotely.²² The direct delivery of recreational cannabis products, similar to tobacco products, can inadvertently enhance access for youths and young adults if regulations do not adequately cover various policy dimensions, such as age verification requirements and delivery-specific licensing and enforcement.^23–26 Indeed, a recent study found that most online dispensaries lack adequate age verification measures.²⁷ Furthermore, consumer habits may have been modified by the regular direct delivery of some substances, such as cannabis, during the COVID-19 pandemic, thereby influencing policy considerations.²³ There has been a growing concern about the home delivery of substances that are prone to misuse, with a call to investigate further the potential health implications and preventive measures associated with this emerging trend.²³

At the same time, direct delivery of medical cannabis allows qualifying patients to order medical cannabis to be delivered from medical dispensaries or through means similar to those for recreational use. Almost all states that permit medical cannabis use have mandated a statewide registry for patients with qualifying conditions. Direct delivery of medical cannabis can enhance patient access by providing patients with additional choices about when and how they can order and receive their medication, particularly those who are homebound because of certain illnesses.²⁸ Some states have recognized this and passed legislation allowing direct delivery from medical dispensaries to patients to improve patient access. The extent to which direct delivery of cannabis to consumers may affect patterns of cannabis access and use within states is unclear, given that our understanding of its regulation remains limited.

In the rapidly changing landscape of cannabis policy in the United States, where legalization and access are expanding, we investigated the underexplored legal epidemiology area of state-level direct-delivery laws for both recreational and medical cannabis. Through a systematic legal analysis, we identified and coded relevant statutes and regulations, focusing on elements that potentially have significant implications for public health. This research contributes to a deeper understanding of specific policy dimensions surrounding cannabis direct-delivery legalization, which is particularly important given the ongoing changes in cannabis policy across the United States. The findings from our study could guide further research into the health impacts of these laws and their enforcement.

METHODS

We conducted a comprehensive search of state laws related to the direct delivery of recreational and medical cannabis using the Westlaw legal database. In 2023, we compiled an archive of pertinent statutory and regulatory enactments. We subsequently updated the archive to include all laws in effect as of July 1, 2024.

Legal Variable Coding

The study team reviewed each section within every enactment to identify explicit laws related to cannabis delivery or laws with implicit language on delivery (e.g., “transportation of marijuana”). Laws that did not focus on intrastate direct-delivery sales of recreational and medical cannabis to consumers or qualifying patients were deemed irrelevant to the study and removed from the archive. We also excluded laws addressing only cross-state (interstate) delivery sales or delivery further up the supply chain (e.g., to distributors).

After compiling and reviewing the relevant laws, we developed a coding scheme to capture several salient characteristics: (1) laws permitting direct delivery of recreational cannabis to consumers; (2) licensing laws for direct delivery of recreational cannabis; (3) laws permitting direct delivery of medical cannabis to qualified individuals, including licensing and authorization laws; and (4) laws permitting caregivers to deliver medical cannabis to registered qualified patients in states without laws permitting other forms of direct delivery. Although we use the term “cannabis” in general, we align with the terminology used by individual states in their laws when discussing policy components. For instance, the findings in our tables refer to “marijuana” as used in Massachusetts, or the alternate spelling “marihuana” as used in Michigan statutes. Because of the differences between state-mandated qualifying patient registries for medical consumers and the absence of registry requirements for recreational consumers, our measures focus on slightly different legal domains for recreational versus medical direct delivery.

Measures

Recreational cannabis direct-delivery laws

We identified laws that permit the direct delivery of recreational cannabis to consumers and coded the following aspects: (1) age verification requirements, (2) school and university restrictions, and (3) preemption of local laws prohibiting delivery. Age verification requirements specify procedures for authorized recreational cannabis delivery agents to ensure delivery to legal adults. School and university restrictions prohibit the delivery of recreational cannabis on school or university premises to reduce access to recreational cannabis on institutional grounds. Preemption of local laws restricts municipal governments from prohibiting the direct delivery of recreational cannabis within their jurisdictions.

Recreational cannabis direct-delivery licensing laws

Our research team coded specific provisions related to the licensing of direct delivery of recreational cannabis. These provisions included (1) delivery licensing, (2) penalties for license violations, and (3) local authority. Delivery licensing refers to the types of licenses or permits required to initiate the direct delivery of recreational cannabis, allowing states to monitor delivery activities and ensure compliance. Penalties for license violations consist of fines or sanctions imposed on licensees or delivery agents to deter illicit behavior. Local authority provisions relate to whether states allow or prohibit local laws governing delivery, including whether local licenses are explicitly permitted, whether local approval is required for state licensing, or whether local zoning (i.e., time, place, and manner regulations) applies to licensees. Documenting whether local regulation is permitted is crucial for understanding the scope of state laws, their impact, and the potential for local involvement in cannabis delivery activities.

Medical cannabis direct-delivery laws

We identified laws that permitted the delivery by or from medical cannabis establishments, capturing provisions addressing (1) delivery licensing or authorization, (2) delivery access specification, and (3) local authority. Delivery licensing or authorization relates to the types of licenses or authorizations necessary for delivery. The delivery access specification captures the specified individuals who have obtained authorization to receive direct delivery of medical cannabis. Local authority refers to whether states allow or prohibit local laws governing delivery.

Medical cannabis delivery from caregivers to qualified patients

Lastly, we identified laws that allow caregivers to deliver medical cannabis to qualified patients in states where there are no laws permitting the direct delivery of recreational cannabis to consumers or medical cannabis to qualifying individuals. While caregivers can deliver medical cannabis to assist patients in the states identified, patients in these states do not have the legal option of direct delivery. In these states, we also coded explicit prohibitions on statewide direct delivery.

RESULTS

States varied widely in how the delivery of cannabis was regulated.

Recreational Cannabis Direct-Delivery Laws

Table 1 lists the 14 states that allowed direct recreational cannabis delivery to adult consumers. These states were California, Colorado, Connecticut, Maine, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New Mexico, New York, Oregon, and Rhode Island. States varied in how they regulated age verification. For instance, New Jersey required a signature upon delivery, while Connecticut permitted the use of an online age verification interface. Massachusetts mandated that delivery personnel undergo age verification training and permitted preverification through approved electronic means. Nine of these states, including California, had laws prohibiting the direct delivery of recreational cannabis to schools or universities. Eleven states had laws that explicitly preempted local prohibitions on recreational cannabis direct delivery. Some states, like Connecticut, specifically preempted local prohibitions on cannabis delivery. Others, such as New Mexico, adopted a broader approach by banning local control over cannabis transportation within local jurisdictions, which could include delivery.

TABLE 1—

Recreational Cannabis Direct-Delivery Laws: United States, as of July 1, 2024

Statea	Laws Permitting Recreational Cannabis Direct Delivery	Age Verification Requirements	School and University Delivery Restrictions	Preemption of Local Delivery Prohibitions
CA	Cal. Bus. & Prof. Code § 26001	Cal. Bus. & Prof. Code § 26140; Cal. Code Regs. tit. 4, §§ 15404, 15415	Cal. Code Regs. tit. 4, § 15416	Cal. Bus. & Prof. Code § 26090
CO	Colo. Rev. Stat. § 44-10-601	Colo. Rev. Stat. § 44-10-601; 1 Colo. Code Regs. § 212-3:3-615	Colo. Rev. Stat. §§ 44-10-501, 601; 1 Colo. Code Regs. § 212-3:3-615	NA
CT	Conn. Gen. Stat. § 21a-420	Conn. Gen. Stat. § 21a-420z	NA	Conn. Gen. Stat. § 21a-422 g
ME	Me. Stat. tit. 28-B, § 102	Me. Stat. tit. 28-B, § 504	Me. Stat. tit. 28-B, § 504; 18-691 Me. Code R. Ch. 1, § 1.4	Me. Stat. tit. 28-B, § 504
MA	Mass. Gen. Laws Ch. 94G, §§ 1, 9	Mass. Gen. Laws Ch. 94G, § 4; 935 Mass. Code Regs. 500.105, 500.145	935 Mass. Code Regs. 500.145	Mass. Gen. Laws Ch. 94G, § 3
MI	Mich. Admin. Code r. 420.207	Mich. Admin. Code r. 420.207	Mich. Admin. Code r. 420.207	Mich. Comp. Laws § 333.27956
MN	Minn. Stat. § 342.10	Minn. Stat. §§ 342.27, 342.42	NA	Minn. Stat. § 342.13
MO	Mo. Const. Art. 14 § 2	Mo. Code Regs. Ann. tit. 19, § 100-1.140	NA	Mo. Const. Art. 14 § 2
NV	Nev. Admin. Code § 453D.572	Nev. Admin. Code §§ 453D.572, 453D.558	Nev. Admin. Code § 453D.578	NA
NJ	N.J. Stat. Ann. § 24:6I-33	N.J. Stat. Ann. § 24:6I-44; N.J. Admin. Code § 17:30-15.2	N.J. Admin. Code § 17:30-14.8	N.J. Stat. Ann. § 24:6I-44; N.J. Admin. Code § 17:30-5.1
NM	N.M. Stat. Ann. § 26-2C-2	N.M. Code R. §§ 16.8.2.40, 41	NA	N.M. Stat. Ann. § 26-2C-12
NY	McKinney’s Cons. Laws of N.Y. Ann., Cannabis Law § 61	McKinney’s Cons. Laws of N.Y. Ann., Cannabis Law § 85; N.Y. Comp. Codes R. & Regs. tit. 9, § 123.20	N.Y. Comp. Codes R. & Regs. tit. 9, § 123.20	McKinney’s Cons. Laws of N.Y. Ann., Cannabis Law § 131
OR	Or. Rev. Stat. § 475C.009	Or. Rev. Stat. § 475C.109; Or. Admin. R. 845-025-2880	Or. Admin. R. 845-025-2880	NA
RI	21 R.I. Gen. Laws § 21‒28.11-24	21 R.I. Gen. Laws § 21‒28.11-5	NA	21 R.I. Gen. Laws § 21‒28.11-16

Note. NA = not applicable.

^a Arizona, per Ariz. Rev. Stat. § 36-2854, will adopt rules allowing and regulating recreational delivery by marijuana establishments by January 1, 2025.

Recreational Direct-Delivery Licensing Laws

Table 2 indicates that states permitting direct delivery of recreational cannabis to consumers had varying regulations concerning authorization and licensees, penalties for license violations, and local authority. For example, Colorado required a “delivery permit” for recreational cannabis delivery, whereas Oregon mandated a “marijuana handler permit” for the same purpose. Other states had unique licensing requirements based on their specific systems. In Massachusetts, there were 2 types of licenses related to cannabis delivery: a “Marijuana Courier” licensee, who could transport marijuana from a retailer to a consumer but could not sell it, and a “Marijuana Delivery Operator” licensee, who had broader privileges, including the ability to purchase wholesale cannabis, store it in a warehouse, and sell and deliver it directly to consumers. Connecticut required a license for any “delivery service” that transported cannabis from licensed microcultivators, retailers, and hybrid retailers to end consumers. Penalties for license infractions varied by state, with fines ranging from $500 for minor infractions in New Jersey to $100 000 for violations that affected public safety in states like Colorado and Maine. These penalties often involved additional sanctions such as license suspensions, revocations, or further restrictions. Provisions involving local authority also differed by state. Some states, like California, allowed local licensing, while others, such as Connecticut, required proof of local zoning approval for state licensure.

TABLE 2—

Recreational Cannabis Direct-Delivery Licensing Laws: United States, as of July 1, 2024

State	Delivery Licensing	Penalties for License Violations	Local Authority
CA	Cal. Bus. & Prof. Code §§ 26001, 26090; Cal. Code Regs. tit. 4, §§ 15000, 15415, 15415.1 Licensed retailers and microbusinesses by delivery employees only, may contract with technology platform service to take orders	Cal. Bus. & Prof. Code §§ 26031, 26031.5; Cal. Code Regs. tit. 4, § 17802 License suspension and revocation, up to $5 000 per violation (each day is a separate violation)	Cal. Bus. & Prof. Code § 26200; Cal. Code Regs. tit. 4, § 15018 Local licensing, local zoning
CO	Colo. Rev. Stat. §§ 44-10-601, 605; 1 Colo. Code Regs. §§ 212-3:3-105, 615, 1105 Licensed retail marijuana store, accelerator store, and licensed retail marijuana transporter (retail marijuana delivery permit required)	1 Colo. Code Regs. § 212-3:8-235 License suspension, revocation, or additional restrictions, up to $10 000 (infraction), $50 000 (violation), $100 000 (violation affecting public safety)	Colo. Rev. Stat. §§ 44-10-203, 601, 605; 1 Colo. Code Regs. §§ 212-3:3-135, 615 Local licensing, local approval is required for retail marijuana delivery permit
CT	Conn. Gen. Stat. §§ 21a-420, 420c Licensed delivery service, microcultivators, retailers, and hybrid retailers	Conn. Gen. Stat. § 21a-421p License or registration suspension or revocation, fines up to $25 000 per violation, compromise offer or renewal refusal, license probation or conditions	Conn. Gen. Stat. § 21a-422f Local zoning
ME	Me. Stat. tit. 28-B, §§ 501, 504; 18-691 Me. Code R. Ch. 1 § 2.2 Limited delivery service including by Tier 1 (not more than 500 square feet of mature plant canopy) and Tier 2 (not more than 2 000 square feet) cultivation facility	Me. Stat. tit. 28-B, § 802; 18-691 Me. Code R. Ch. 1 § 10.3 License suspension or revocation, not more than $10 000 per minor violation, not more than $50 000 per major violation, and not more than $100 000 per major violation affecting public safety	Me. Stat. tit. 28-B, §§ 206, 402, 403; 18-691 Me. Code R. Ch. 1 § 2.7 Local conditions cause for denial, local authorization of establishments required
MA	Mass. Gen. Laws Ch. 94G, § 19; 935 Mass. Code Regs. 500.002, 500.145 Delivery licensees, marijuana establishments with delivery endorsement, marijuana retailers (done by a delivery operator or marijuana courier), may contract with third-party technology platforms	935 Mass. Code Regs. 500.360 Administrative fine of up to $50 000 for each violation (each day is a separate violation)	935 Mass. Code Regs. 500.103 Local compliance for approval
MI	Mich. Admin. Code r. 420.207 Marihuana sales locations licensed under MRTMA (recreational), may only deliver to customers upon approval by the agency of the licensee’s delivery procedures	Mich. Comp. Laws § 333.27958; Mich. Admin. Code r. 420.806 License suspension, revocation, or restriction, up to $10 000 (each day is a separate violation)	Mich. Comp. Laws § 333.27956 Local zoning
MN	Minn. Stat. §§ 342.41, 342.42 Licensed cannabis delivery service may purchase from licensed businesses and deliver to customers	Minn. Stat. § 342.19 Up to $10 000, an amount that deprives the business of any economic advantage gained by the violation, or both	Minn. Stat. § 342.13 Local zoning
MO	Mo. Const. Art. 14 § 2; Mo. Code Regs. Ann. tit. 19, §§ 100-1.010, 1.180, 1.190 Licensed comprehensive marijuana dispensary facilities or microbusiness dispensary facilities	Mo. Const. Art. 14 § 2; Mo. Code Regs. Ann. tit. 19, § 100-1.030 Authorized administrative fines (up to an amount equal to the average daily gross receipts of the previous calendar month of the facility per day) and suspension, revocation, or restriction of a license	Mo. Const. Art. 14 § 2 Local zoning is permitted but must not conflict with state laws
NV	Nev. Rev. Stat. §§ 678A.065, 678A.250; Nev. Admin. Code § 453D.572 Licensed adult-use retail marijuana store via marijuana establishment agent with registration card; store must get preapproval for delivery procedures	Nev. Admin. Code § 453D.905 License suspension and revocation, scalar fines $750‒$35 000 (categories I‒V)	Nev. Rev. Stat. §§ 678B.300, 678B.320; Nev. Admin. Code § 453D.282 Local business license, local zoning for approval
NJ	N.J. Stat. Ann. §§ 24:6I-43, 44; N.J. Admin. Code § 17:30-1.2 Licensed delivery service, certified cannabis handler, approved contractor	N.J. Stat. Ann. § 24:6I-29 License suspension or revocation, not less than $500 nor more than $10 000	N.J. Stat. Ann. § 24:6I-44, 45; N.J. Admin. Code § 17:30-5.1 Local delivery licensing is optional, local may prohibit delivery licensing but may not prohibit delivery
NM	N.M. Stat. Ann. §§ 26-2C-2, 6, 9; N.M. Code R. § 16.8.2.40 Licensed vertically integrated cannabis establishment, cannabis retailer, and integrated cannabis microbusiness via cannabis couriers (with delivery agreement)	N.M. Stat. Ann. § 26-2C-8 Not exceed $10 000 per violation, license suspension, or revocation	N.M. Stat. Ann. § 26-2C-12; N.M. Code R. §§ 16.8.2.36, 42 Local business license is required, local zoning but must not conflict with state laws
NY	McKinney’s Cons. Laws of N.Y. Ann., Cannabis Law § 74; N.Y. Comp. Codes R. & Regs. tit. 9, § 123.20 Licensed retailers and microbusinesses but independent contractors must disclose deliveries. The delivery license allows the delivery of cannabis and cannabis products independent of other licenses, but licensees are prohibited from selling	N.Y. Comp. Codes R. & Regs. tit. 9, §§ 133.7, 114.17 License suspension or revocation. Up to $1 000 for the first violation, $5 000 for a second violation within 3 years, $10 000 for a third violation, and each subsequent violation within 3 years	McKinney’s Cons. Laws of N.Y. Ann., Cannabis Law §§ 76, 131; N.Y. Comp. Codes R. & Regs. tit. 9, § 119.3 Municipal opinions on licensure, local zoning
OR	Or. Rev. Stat. §§ 475C.117, 269 Licensed retailer via agent with marijuana handler permit	Or. Rev. Stat. § 475C.405; Or. Admin. R. 845-025-8590 License suspension or revocation, scalar fines varied (categories I‒V)	Or. Rev. Stat. §§ 475C.113, 117, 449, 950 City or county ordinance may permit or prohibit delivery; local zoning
RI	21 R.I. Gen. Laws § 21‒28.11-3 Licensed retailer	21 R.I. Gen. Laws § 21‒28.11-9 License suspension or revocation, fines established by the department of business regulation, cease and desist or compliance order, or penalty combination	21 R.I. Gen. Laws § 21‒28.11-16 Local zoning recognized

Note. MRTMA = Michigan Regulation and Taxation of Marihuana Act.

Medical Cannabis Direct-Delivery Laws

Table 3 presents the states with laws permitting direct delivery of medical cannabis. All 14 states that allowed direct delivery of recreational cannabis also permitted medical cannabis delivery to qualified patients. In addition to these, 13 more jurisdictions—Arizona, Arkansas, Delaware, the District of Columbia, Florida, Kentucky, Louisiana, Maryland, Montana, New Hampshire, Utah, Vermont, and Virginia—allowed medical cannabis direct delivery. The type of authorizations that permitted medical cannabis direct delivery and the recipients of this service varied by state. For instance, most states allowed medical cannabis delivery from registered medical dispensaries, compassion centers, or treatment centers to registered qualifying patients and caregivers. States like Colorado, Massachusetts, Montana, New Jersey, New Mexico, and Utah permitted direct delivery through couriers. The District of Columbia, New Hampshire, and New Mexico even allowed nonresident cardholders to receive medical cannabis direct delivery. Local licensing provisions also differed by state. Some states, such as Colorado, allowed local licensing, and others, like Utah, required compliance with local zoning for state approval.

TABLE 3—

Medical Cannabis Direct-Delivery Laws From Medical Cannabis Establishments: United States, as of July 1, 2024

State	Laws Permitting Medical Cannabis Delivery From Medical Cannabis Establishments	Delivery Licensing or Authorization	Delivery Access Specification	Local Authority
AZ	Ariz. Rev. Stat. § 36-2801	Ariz. Rev. Stat. §§ 36-2801, 2804 Registered nonprofit medical marijuana dispensary	Ariz. Rev. Stat. § 36-2806 Registered qualifying patients or through designated caregivers	Ariz. Rev. Stat. § 36-2806.01 Local zoning
AR	Ar. Const. Amend. 98 § 2	Ar. Const. Amend. 98 § 8 Licensed dispensary	Ar. Const. Amend. 98 § 8 Registered qualifying patients and designated caregivers	Ar. Const. Amend. 98 § 8 Local zoning
CA	Cal. Bus. & Prof. Code § 26321	Cal. Bus. & Prof. Code §§ 26050, 26321 Licensed medicinal cannabis business (M-License)	Cal. Bus. & Prof. Code § 26321 Registered qualified patients and primary caregivers	Cal. Bus. & Prof. Code §§ 26322, 26325 Medical cannabis patients’ right to access is “a matter of statewide concern and not a municipal affair”
CO	Colo. Rev. Stat. § 44-10-103	Colo. Rev. Stat. §§ 44-10-313, 301, 401 Licensed medical marijuana business or medical marijuana transporter licensee with medical marijuana delivery permit	Colo. Rev. Stat. § 44-10-501; Colo. Const. Art. 18 § 14 Delivery only to registered patients, parents, or guardians	Colo. Rev. Stat. § 44-10-301 Local licensing
CT	Conn. Admin. Code § 21a-408-1	Conn. Admin. Code § 21a-408-1 Licensed dispensary facility	Conn. Admin. Code § 21a-408-35 Registered qualifying patients and primary caregivers	Conn. Admin. Code § 21a-408-15 Local zoning and approval
DE	16 Del. Admin. Code § 4470-7.0	16 Del. Admin. Code § 4470-7.0 Registered compassion centers with approval of delivery plan	16 Del. Admin. Code § 4470-7.0 Registered patients and designated caregivers	16 Del. Admin. Code § 4470-7.0 Local zoning
DC	D.C. Mun. Regs. tit. 22-C, § 5703	D.C. Mun. Regs. tit. 22-C, § 5703 Dispensary	D.C. Mun. Regs. tit. 22-C, § 5703 Registered qualifying patients or caregivers, nonresident qualifying patients	No local provisions were identified
FL	Fla. Stat. § 381.986, Fla. Admin. Code Ann. r. 64ER22-7	Fla. Stat. § 381.986 Licensed medical marijuana treatment center	Fla. Stat. § 381.986 Registered qualifying patients	Fla. Stat. § 381.986 Local amendments to state building and fire prevention codes apply to compliance
KY	Ky. Rev. Stat. Ann. § 218B.110	Ky. Rev. Stat. Ann. § 218B.110 Licensed dispensaries may operate a delivery service	Ky. Rev. Stat. Ann. § 218B.110 Registered cardholders’ addresses	Ky. Rev. Stat. Ann. § 218B.130 Local zoning
LA	La. Admin. Code tit. 46, Pt. LIII § 2441	La. Stat. Ann § 40:1046; La. Admin. Code tit. 46, Pt. LIII § 2451 Licensed marijuana pharmacy	La. Stat. Ann § 40:1046; La. Admin. Code tit. 46, Pt. LIII § 2451 Required to offer home delivery to patients in each zip code within the region at least once per month; patients need a doctor’s signed certification as identification	La. Admin. Code tit. 46, Pt. LIII § 2441 Local zoning
ME	Me. Stat. tit. 22, § 2428	Me. Stat. tit. 22, § 2428; 18-691 Me. Code R. Ch. 2 § 7 Registered dispensary	Me. Stat. tit. 22, § 2428; 18-691 Me. Code R. Ch. 2 § 7 Registered qualifying patients and caregivers	Me. Stat. tit. 22, § 2429-D Municipal approval via conditional use or site plan approval
MD	Md. Code Regs. 10.62.30.04	Md. Code Regs. 10.62.30.04 Registered dispensary	Md. Code Regs. 10.62.30.01 Registered qualifying patients and caregivers with written certification of delivery request	Md. Code Regs. 10.62.27.02 Local zoning and planning conformity required
MA	935 Mass. Code Regs. 501.145	935 Mass. Code Regs. 501.145 Licensed marijuana treatment center by marijuana courier	Mass. Gen. Laws Ch. 94I, § 5935; 935 Mass. Code Regs. 501.050, 501.145 Registered qualifying patients and personal caregivers	935 Mass. Code Regs. 501.101 Local compliance, local licensing authority requirements in application
MI	Mich. Comp. Laws § 333.26423	Mich. Comp. Laws § 333.27504; Mich. Admin. Code r. 420.101 Provisioning center licensed under MMFLA (medical)	Mich. Comp. Laws § 333.27504 Registered qualifying patients and primary caregivers	Mich. Comp. Laws § 333.27205 Local authorization is required with local zoning compliance
MN	Minn. Stat. § 342.51	Minn. Stat. §§ 342.42, 342.51 Cannabis business with a medical cannabis retail endorsement and also must hold a cannabis delivery service license (also subject to recreational operations)	Minn. Stat. § 342.51 Registered person	Minn. Stat. § 342.13 Local zoning
MO	Mo. Const. Art. 14 § 1	Mo. Const. Art. 14 § 1 Licensed medical marijuana dispensary facility	Mo. Const. Art. 14 § 1 Registered qualifying patients and primary caregivers	Mo. Const. Art. 14 § 1 Local zoning is permitted but must not conflict with state laws
MT	Mont. Code Ann. § 16-12-222	Mont. Code Ann. § 16-12-222 Licensed marijuana transporter	Mont. Code Ann. §§ 16-12-222, 513 Registered cardholders and 2 authorized individuals to deliver from a licensed dispensary	Mont. Code Ann. § 16-12-207 Local zoning
NV	Nev. Rev. Stat. § 678C.450	Nev. Rev. Stat. §§ 678C.440, 678C.450 Licensed medical cannabis dispensary (may contract with third-party or intermediary business)	Nev. Rev. Stat. §§ 678C.420, 678C.450 An electronic verification system is required for registered cardholders or with a letter of approval	No local provisions were identified
NH	N.H. Rev. Stat. §§ 126-X:1, 2	N.H. Rev. Stat. §§ 126-X:1, 2; N.H. Code Admin. R. Ann. He-C 401.02 Registered not-for-profit alternative treatment center	N.H. Rev. Stat. § 126-X:8 Registered qualifying patients, designated caregivers, visiting qualifying patients	N.H. Rev. Stat. § 126-X:7; N.H. Code Admin. R. Ann. He-C 402.09 Local zoning and compliance
NJ	N.J. Stat. Ann. § 24:6I-1	N.J. Stat. Ann. § 24:6I-1, 20; N.J. Admin. Code § 17:30-7.1 Licensed alternative treatment center via medical cannabis handler with delivery certification, and unlicensed expanded alternative treatment center with certification including “plan for prioritizing and meeting the needs of” patients	N.J. Stat. Ann. § 24:6I-3 Registered qualifying patients, designated caregivers, or institutional caregivers	N.J. Stat. Ann. §§ 24:6I-7.2, 20 Local zoning approval is required; a municipality may not restrict or prohibit delivery
NM	N.M. Stat. Ann. § 26-2B-3	N.M. Stat. Ann. § 26-2C-2; N.M. Code R. § 16.8.2.41 Licensed cannabis courier	N.M. Stat. Ann. §§ 26-2B-3, 7, 7.1 Registered qualified patients and primary caregivers, reciprocal participants (out of state with proof to participate in medical cannabis program of another state)	N.M. Stat. Ann. § 26-2C-12; N.M. Code R. § 16.8.2.41 Local prohibitions on cannabis transportation are preempted, but the permitted time of delivery must comply with local laws
NY	McKinney’s Cons. Laws of N.Y. Ann., Cannabis Law § 31	McKinney’s Cons. Laws of N.Y. Ann., Cannabis Law § 31; N.Y. Comp. Codes R. & Regs. tit. 9, § 113.14 Registered organization (for-profit business or not-for-profit corporation)	McKinney’s Cons. Laws of N.Y. Ann., Cannabis Law § 34 Registered qualifying patients and designated caregivers	McKinney’s Cons. Laws of N.Y. Ann., Cannabis Law § 131; N.Y. Comp. Codes R. & Regs. tit. 9, § 113.7 Local zoning and local compliance
OR	Or. Rev. Stat. § 475C.205	Or. Rev. Stat. § 475C.205 Licensed retailer	Or. Rev. Stat. § 475C.205 Registered identification cardholders and designated primary caregivers	Or. Rev. Stat. §§ 475C.113, 117, 449, 950 City or county ordinance may permit or prohibit delivery, local zoning
RI	21 R.I. Gen. Laws § 21‒28.6-12	21 R.I. Gen. Laws § 21‒28.6-12; 230-80-05 R.I. Code R. § 1.6 Licensed compassion center	21 R.I. Gen. Laws § 21-28.6-12; 230-80-05 R.I. Code R. § 1.6 Patient cardholders, qualified patients’ primary caregivers, authorized purchasers	230-80-05 R.I. Code R. § 1.6 Local zoning
UT	Utah Code Ann. § 4-41a-102	Utah Code Ann. §§ 4-41a-1201, 1202, 1203 Medical cannabis pharmacy with approved home delivery designation via licensed medical cannabis courier	Utah Code Ann. §§ 4-41a-1202, 1205 Medical cannabis cardholder (at home through state electronic verification system or at a facility)	Utah Code Ann. § 4-41a-1105 Local zoning
VT	Vt. Stat. Ann. tit. 7, § 971	Vt. Stat. Ann. tit. 7, § 971 Licensed dispensary	Vt. Stat. Ann. tit. 7, § 971 Registered patients and caregivers	Vt. Stat. Ann. tit. 7, § 863; Vt. Admin. Code 26-1-2.14 Local control license, a municipality may not regulate an establishment that has the effect of prohibiting the operation of the establishment
VA	Va. Code Ann. § 4.1-600	Va. Code Ann. § 4.1-1603 Permitted pharmaceutical processor or cannabis dispensing facility	Va. Code Ann. § 4.1-1603 Resident patients or temporary resident patients, patients’ registered agents, patients’ parents or legal guardians	3 Va. Admin. Code §§ 10-30-130, 140 Local compliance

Note. MMFLA = Michigan Medical Marihuana Facilities Licensing Act.

Caregiver-to-Patient Cannabis Delivery

Table 4 shows states that only permitted medical cannabis delivery from caregivers to qualified patients. Twelve states with recreational or medical cannabis legalization did not permit direct delivery of cannabis. Among the states that had legalized recreational cannabis use, Alaska, Illinois, Ohio, and Washington did not allow direct delivery. Similarly, among the states that had legalized medical cannabis use, Alabama, Hawaii, Mississippi, North Dakota, Oklahoma, Pennsylvania, South Dakota, and West Virginia did not permit direct delivery. However, they all allowed caregivers to deliver medical cannabis to registered qualified patients.

TABLE 4—

Medical Cannabis Delivery Laws From Caregivers to Qualified Patients: United States, as of July 1, 2024

State	Laws Permitting Medical Cannabis Delivery From Caregivers to Qualified Patients in States With No Recreational or Medical Direct-Delivery Laws	Delivery Prohibitions
AL	Ala. Code § 20-2A-3	Ala. Code § 20-2A-3 Licensed dispensaries are only “authorized to dispense and sell medical cannabis at dispensing sites.”
AK	Alaska Stat. § 17.37.040	Alaska Admin. Code tit. 3, § 306.990 Delivering “does not include transferring or transporting to a consumer off licensed premises.”
HI	Haw. Rev. Stat. § 329D-1	Haw. Rev. Stat. § 329D-6 Dispensary “prohibited from off-premises delivery of cannabis or manufactured cannabis products.”
IL	Ill. Admin. Code tit. 77, § 946.10	410 Ill. Comp. Stat. 705/15-70, 8 Ill. Admin. Code tit. 8, § 1300.40 Dispensing organizations may not “transport cannabis to residences or other locations where purchasers may be for delivery.” A cannabis business establishment may not “Sell, deliver, transport or distribute cannabis to any person or entity other than a cannabis business organization licensed by the Department.”
MS	Miss. Code Ann. § 41-137-3	35 Miss. Admin. Code Pt. XI, R. 24 A dispensary must not “Sell or distribute cannabis products using … a delivery service.”
ND	N.D. Cent. Code § 19-24.1-01	N.D. Cent. Code § 19-03.1-23 Marijuana delivery is prohibited as a controlled substance.
OH	Ohio Admin. Code 3796:6-3-22	Ohio Admin. Code 3796:6-3-22 “No medical marijuana shall be sold, dispensed, or distributed to a patient or caregiver via a delivery service or any other manner outside of a dispensary, except that a caregiver may deliver medical marijuana to the caregiver's registered patient.”
OK	Okla. Stat. tit. 63, § 427.11	Okla. Admin. Code § 442:10-5-16 “No commercial licensee shall allow for or provide the delivery of medical marijuana or medical marijuana products to licensed patients or caregivers.”
PA	28 Pa. Code § 1141a.21	28 Pa. Code § 1161a.27 A dispensary may not “deliver, or contract to a third party the delivery of, medical marijuana products to a patient or caregiver at the patient's or caregiver's home or any other location.”
SD	S.D. Codified Laws § 34-20G-1	S.D. Admin. Code 44:90:08:04 “No cannabis or cannabis product sale may take place at any location other than at a certified medical cannabis dispensary. All sales must take place at a certified medical cannabis dispensary in clear view of security cameras.”
WA	Wash. Rev. Code 69.51A.010	Wash. Admin. Code § 314-55-079 “Internet sales and delivery of product to customers is prohibited.”
WV	W. Va. Code § 16A-2-1	W. Va. Admin. Code § 64-112-4 “A dispensary may only dispense medical cannabis to a patient or caregiver who presents a valid identification card to an employee at the facility who is authorized to dispense medical cannabis at the facility.”

DISCUSSION

As the landscape of cannabis legalization continues to evolve, a critical yet underexplored aspect is the laws governing its direct delivery. This study is the first, to our knowledge, to document and categorize the direct-delivery laws for both recreational and medical cannabis at the state level. Our findings reveal a significant heterogeneity in the legal status of cannabis direct delivery across states. Among the 25 jurisdictions that had legalized recreational cannabis, 14 had permitted direct delivery to adult consumers. Of the 39 jurisdictions that had legalized medical cannabis, direct delivery to qualifying patients was permitted in 26 states and the District of Columbia. All states that allowed recreational cannabis direct delivery also allowed medical cannabis direct delivery. Twelve states allowed medical cannabis delivery to patients solely through caregiver delivery.

Furthermore, our results highlight wide variations in the regulation of cannabis direct-delivery laws. Regarding recreational cannabis delivery, there were variations in age verification requirements, restrictions on schools and universities, and the preemption of local prohibition of direct delivery. These laws also differed in delivery licensing, penalties for license violations, and whether local licensing was permitted or local zoning was recognized. State laws varied similarly for medical cannabis direct delivery, including which entities were authorized or licensed to make direct medical-use deliveries and whether local regulation was permitted. There were also differences in who is authorized to access and receive deliveries. In states that had legalized recreational or medical cannabis but did not permit direct delivery, only designated caregivers were allowed to deliver cannabis to registered qualifying patients to assist them in their medical use.

Public Health Significance

The rapidly evolving landscape of cannabis use warrants the need to catalog policies with potential public health ramifications for access, particularly those concerning direct delivery. Previous research has highlighted public health issues, such as underage access, associated with the direct delivery of substances like alcohol and tobacco.^22,25,29,30 It is plausible that cannabis direct delivery could present similar challenges. Our study provides a detailed catalog of existing cannabis policies and reveals significant variations in their legal status, content, and scope across states.

As recreational cannabis use becomes increasingly legal across the United States, it may be advisable to regulate its direct delivery to reduce underage access. States should consider mandating stringent age verification requirements to limit unauthorized access. Examples include preverification, identification checks before delivery, signatures upon delivery, and training requirements for delivery personnel. Age verification is particularly important in online delivery environments where youths may conceal their transactions.²⁷ Jurisdictions that have not explicitly prohibited delivery to schools and universities may also consider doing so, as this will also limit underage access on school and university grounds.

Although state preemption of local recreational cannabis regulation may streamline oversight, it also poses public health risks. Local authorities should retain the power to prohibit or regulate recreational cannabis direct delivery more stringently than minimum state standards. Potential conflicts may arise between state and local regulations because of variations in regulatory frameworks. However, establishing a minimum state standard with additional local safeguards permitted by states may benefit public health by allowing for tailored approaches that address specific community needs.^31,32 Moreover, state regulatory agencies’ issuance of delivery-specific licenses is crucial for effective monitoring. Evidence suggests that retail licensing laws can reduce substance availability and density.^26,33,34 Implementing such laws for recreational cannabis direct delivery and enforcing penalties for violations may help curtail underage access.

In contrast, states with legalized medical cannabis require patients with qualifying conditions to register in statewide medical cannabis registries. This facilitates compliance and enforcement for direct delivery to only legitimate patients, a process not feasible for recreational direct-delivery regulation. Accordingly, states with legalized medical cannabis typically permit direct delivery to qualifying patients eventually. For example, New Jersey initially legalized medical cannabis in 2010 allowing only caregiver assistance,³⁵ albeit later regulations allowed dispensaries to deliver medical marijuana to patients directly. California has also enabled medical cannabis direct delivery in the Medical Cannabis Patients’ Right of Access Act. States should consider adopting similar policies as this may enhance patient choice and health care access. As the cannabis policy landscape evolves, ongoing monitoring of delivery laws will benefit researchers and public health practitioners.

Limitations

While this study provides a detailed overview of the current state of cannabis delivery laws, a few study limitations should be noted. First, we focused on state provisions addressing local licensing, zoning, or approval but did not document specific municipal regulations that might impact direct delivery. Second, our study did not code the specifics of cannabis product types or delivery amount limits. Third, our research is based on state laws in effect as of July 1, 2024. As such, it provides a snapshot of existing delivery laws rather than a historical record of all amendments related to cannabis regulations. Fourth, the study did not consider the enforcement mechanisms present in the laws. Despite these limitations, our study offers valuable insights into an emerging policy issue with significant public health implications. As new laws evolve, future research could benefit from a more detailed analysis of these aspects.

Conclusions

Our study offers, to our knowledge, the first catalog and analysis of state-level cannabis delivery laws. The environment for recreational cannabis direct delivery appears to be more challenging in terms of preventing underage access compared with medical cannabis direct delivery, primarily because of the absence of an adult consumer registry similar to that for qualifying patients. Implementing certain provisions, such as mandatory age verification procedures or delivery-specific licensing, could potentially mitigate underage access to recreational cannabis. However, numerous states do not permit direct delivery of medical cannabis, which could limit the medical access of registered qualifying patients who have mobility restrictions. Striking a balanced policy approach is crucial to ensure protection for underage consumers from the potential hazards of recreational cannabis access while also ensuring optimal access to medical cannabis for registered qualifying patients.