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Cannabis Legalization

April 8, 2022
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WRITTEN BY Dr. Ramon Martinez III

Executive Summary 

To date, 47 states in the U.S. have legalized the use of cannabis in some form for medical and/or non-medical purposes. While cannabis has shown strong evidence for medicinal use for several chronic diseases, it may also have a low potential for substance abuse. States that have since legalized cannabis for non-medical use have also seen significant tax revenue from sales. Article XIV Section 1 of the Missouri Constitution guarantees the right to medical cannabis access to patients. Twenty-three bills have been introduced by both major political parties in the 2022 Missouri legislative session that change current laws related to cannabis, including: the legal use of medical cannabis, how medical facilities operate, and the criminality of medical and non-medical cannabis use. 


  • Cannabis contains two chemical compounds of therapeutic interest, and these have been shown to have a positive effect on pain, multiple sclerosis, and nausea. Two cannabis-derived drugs have been FDA-approved for epilepsy and chemotherapy-associated nausea.
  • Discrepancies exist in the legal status of cannabis sale, possession, and use between federal and state governments. This has led to variability in the enforcement of cannabis laws; more than half of states have decriminalized possession of small amounts of cannabis, and most allow a process to clear one’s criminal record.
  • Thirty-seven states have a legal medical cannabis program, and eighteen have also legalized cannabis for non-medical purposes.
    • Several of the states to legalize non-medical cannabis have collected tax revenues totaling over $100M annually.


  • Given the status of cannabis as a Schedule I drug, access and research on its effects and therapeutic potential are limited, and more studies are needed to make firm conclusions.
  • Given that no state has had legal non-medical use for more than a decade, the full long-term effects of cannabis legalization have yet to be determined.


This Note has been updated. You can access the previous version here (published in March 2022).

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