State medical marijuana laws are typically created in one of two ways: either through a voter backed initiative like in California or through a state’s legislative body as in the case of Pennsylvania. While voter initiatives must be approved to be added to ballots only on election years, state lawmakers can introduce a medical marijuana bill whenever the state legislatures are in session.

So far, 33 states have established medical marijuana programs. These states include: Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Utah, Vermont, Washington, and West Virginia. In addition, Washington, DC and Puerto Rico allow medical marijuana for patients.

Medical marijuana is only legally available in the states and territories that have established medical marijuana programs. The conditions and ailments that are approved for medical marijuana treatment vary, so you’ll need to first determine whether your condition is included on your respective state’s list of qualifying conditions. For up to date information on state marijuana laws, visit our Where is Marijuana Legal? page.

The rules and requirements for acquiring legal medical marijuana also fluctuate widely between each individual state and territory.

In general, you’ll need to visit your doctor who, if feeling that you and your condition would benefit from medical marijuana, will write you a recommendation. Because the FDA does not consider marijuana an approved medication, your doctor cannot prescribe it and your insurance will not cover it. Your doctor’s recommendation, however, authorizes you to move forward in the approval process.

In some states, like California, a signed doctor’s recommendation (and a state photo ID) is enough to gain access to medical marijuana dispensaries (authorized marijuana distributors) and offers some protections for patients when purchasing and transporting their marijuana.

Other states will require you to obtain a state issued medical marijuana “card”. Often this will include being placed in the state’s respective record system. You will then be allowed to buy marijuana from a state approved dispensary or (in some states) delivery service. Depending on your state of residence, there may be an enrollment fee needed to apply for a medical marijuana card, costing up to $200.

Once you have access to a marijuana distributor, you’ll have the option between a number of different options for using legal medical cannabis. Dried marijuana flower is still the most popular form, but a growing number of states have banned smokable marijuana in their programs. Other choices include tincture sprays, capsules, vapes, concentrated extracts, and edibles. For those looking for external applications, balms, salves, and lotions can be rubbed directly into the muscles, joints, and skin for focused relief. There are even dermal patches that can be placed on the skin for delayed release through the day.

With medicinal marijuana uses and benefits covered, let’s dive into how it’s consumed.

Smoking has historically been the most common method for consuming marijuana. Devices like rolling papers, hand pipes, water pipes and hookahs are used to ignite the dry herb, releasing its cannabinoids and other natural compounds. With smoking, the cannabinoids reach the bloodstream and elicit effects very quickly.

Cannabis material can also be infused into various foods to make medical marijuana edibles. Popular among those who prefer to avoid smoking, edibles are now available in an array of food products, including chocolate bars, chews, and cookies. Because edibles are metabolized, their effects take longer to kick in and can last several hours.

While cannabis is thought to be safe, there are some preventative safety measures you can take to lower your side of adverse events.

Cannabis users may need to take some precautions because of the euphoric side effects that some marijuana products can elicit. Products containing THC can temporarily cause drowsiness, as well as impaired memory and reaction time. It’s therefore recommended that those using marijuana not operate machinery or drive a vehicle after consuming cannabis.

Marijuana consumers also need to be careful about purchasing products that come from cannabis that has been treated by pesticides. Pesticide residue has been discovered in cannabis products ranging from flower to concentrates to edibles. The danger with pesticide residue is that it can make its way into your bloodstream, increasing the risk of some health problems. With the legal cannabis industry being relatively young, many regulations, including those regarding testing standards, are still being fleshed out. Check to see whether an ISO-certified laboratory has tested any cannabis products you purchase.

If you’re taking other medications, it’s a good idea to consider potential drug interactions.

Additionally, marijuana may increase the risk of bleeding when taken with other drugs, herbs or supplements that also increase the risk of bleeding.

Find out more about medical marijuana’s side effects.

Learn about the growth trends, market segments of cannabis, and its impact on health care and politics.