Table 1.

Summary and Depiction of Federal (National) Medical and Recreational Cannabis Laws for the Growth, Distribution, Sale, and Possession at the Time of the ITC 4CV2 (2018) Survey.

	Medical Cannabis	Recreational Cannabis
More Permissive Cannabis Regulatory Frameworks
United States	•  Cannabis is strictly prohibited by federal law but the federal government has followed a policy of tolerance regarding state-legalized cannabis. • Medical cannabis was first legalized in California in 1996, and then in 1998 in Colorado and We Washington. Several other states proceeded in subsequent year (see timelinec) •  Although the specifics of the laws vary co sidf,ably, at the time of the 2018 survey, cannabis was legal for medical use in 28 states and the District of Columbia. • The Federal Drug Administration (FDA) has formally approved prescription drugs that contain synthetic THC and CBD, and in June 2018, containing cannabis-derived CBD for the treatment of two severe pediatric seizure disorders (Epidiolex).	• Illegal at the federal level to grow, distribute, sell, or possess. • Colorado and Washington became the first two states to legalize recreational cannabis in 2012. By 2018, 8 states and the District of Columbia had legalized cannabis for recreational use. • Some other US states have decriminalized recreational cannabis for personal use.
Canada	• July 2001: Medicinal use of cannabis was legalized nationwide under conditions outlined in the Marihuana Medical Access Regulations Act (MMARd). The MMAR allowed patients to possess dried flower/bud with a government issued license, signed off by a physician. • 2014: MMAR later superseded by the Marihuana for Medical Purposes Regulations (MMPR)e issued by Health Medical cannabis could be prescribed by a physician and a government license was no longer required, and allowed legal medical cannabis production by authorized licensed producers. • 2014–2015: Amendments were made to the MMPR which granted wider access to medical cannabis (e.g., health care providers had greater flexibility over diagnoses for which they were permitted to prescribe cannabis, a broader scope of cannabis products became legally available). • Registered patients allowed to grow cannabis in their residence.	• Illegal at the federal level to grow, distribute, sell, or possess. • Although recreational cannabis was not federally legal at the time of this survey, Canada was in a major transition period as a law to legalize recreational use (Cannabis Act, Bill C-45) was passed in June 2018. The federal Cannabis Act came into effect in October 2018.
Less Permissive Cannabis Regulatory Frameworks
Australia	• February 2016: Australia’s parliament passed the Narcotics Drugs Amendment Bill 2016, which set the framework for medicinal cannabis cultivation. Medical marijuana became legal on a federal level in November 2016.f • Although Can.abis use has been legal in all states for medicinal use (with a medical prescription) and for scientific purposes si, ~e F bruary 2016, access to medical cannabis has been limited. • Qualifying conditions and other details vary by state.	• Illegal at the federal level to grow, distribute, sell, or possess •  Decriminalized for possession of small quantity in the Northern Territory, South Australia, and the Australian Capital Territory, but remains a criminal offence in the other states.g
Englandh	• Illegal at the federal level to grow, distribute, sell, or possess. • Note: Cannabis became legal for specific medical conditions in November 2018 (after survey collection. Prescriptions must be provided by a specialist physician.	•  Illegal at the federal level to grow, distribute, sell, or possess. •  It is a Class B drug under the Misuse of Drugs Act 1971, with penalties for unlicensed dealing, production and trafficking. •  Cannabidiol (CBD) oil is legal for use and sale (with a maximum of 0.2% THC mg/ml)