The potential medical value of marijuana has been a continuing debate. Implementation in Oregon, Alaska, Hawaii, and California

Oregon, Alaska, Hawaii, and California laws allow medical use of marijuana under certain conditions. All four states require a patient to have a physician’s recommendation to be eligible for medical marijuana. States and Some Local California Jurisdictions Maintain Medical Marijuana Registries

To document their eligibility to engage in medical marijuana use, applicants in Oregon, Alaska, and Hawaii must register with state agencies charged with implementing provisions of the medical marijuana laws in those states (hereinafter referred to as registry states). Allowable Amounts of Marijuana for Medical Use

Statutes in Oregon, Alaska, and Hawaii define the maximum amount of marijuana and the number of plants that an individual registrant and their caregiver may possess under medical marijuana laws, while California’s statute does not provide such definitions. In the absence of state specified amounts, a number of the state’s 58 counties and some cities have informally established maximum allowable amounts of marijuana for medical purposes. Small Number of Medical Marijuana Registrants

Relatively few people are registered as medical marijuana users in Alaska, Hawaii and Oregon. In these states, registry data showed that the number of participants registered was below 0.05 percent or less of the total population of each respective state. Hawaii and Oregon were the only states that provided gender information; in both cases approximately 70 percent of registrants were men. In Alaska, Hawaii, and Oregon state records showed that over 70 percent of all registrants in each state were 40 years of age or older. Low Physician Participation

Only a small percentage of physicians in Hawaii and Oregon were identified by state registries as having made recommendations for their patients to use marijuana as medicine. In Oregon, the physician recommending marijuana to over 800 patients was disciplined. Difficult to Measure the Impact of State Medical Marijuana Laws on Law Enforcement Activities

Data are not readily available to show whether the introduction of medical marijuana laws have affected marijuana-related law enforcement activities. On page 1 of our report, we specifically state that federal law does not recognize any accepted medical use for marijuana and individuals remain subject to federal prosecution for marijuana possession regardless of state medical marijuana laws. Specifically, for selected states, our objectives were to provide information on (1) their approach to implementing their medical marijuana laws and how they compare, and the results of any state audits or reviews, (2) the number of patients that have had doctors recommend marijuana for medical use in each state, for what medical conditions, and by age and gender characteristics, (3) how many doctors are known to have recommended marijuana in each, and what guidance is available for making these recommendations, and (4) perceptions of federal and state law enforcement officials, and whether data are available to show how law enforcement activities have been affected by the exceptions provided by these states’ medical marijuana laws.
What GAO Found

A number of states have adopted laws that allow medical use of marijuana. Federal law, however, does not recognize any accepted medical use for marijuana and individuals remain subject to federal prosecution for marijuana possession. Debate continues over medical effectiveness of marijuana, and over government policies surrounding medical use. State laws in Oregon, Alaska, Hawaii, and California allow medical use of marijuana under specified conditions. All four states require a patient to have a physician's recommendation to be eligible for medical marijuana use. Alaska, Hawaii, and Oregon have established state-run registries for patients and caregivers to document their eligibility to engage in medical marijuana use; these states require physician documentation of a person's debilitating condition to register. Laws in these states also establish maximum allowable of marijuana for medical purposes. California's law does not establish a state-run registry or establish maximum allowable amounts of marijuana. Relatively few people had registered to use marijuana for medical purposes in Oregon, Hawaii, and Alaska. As of Spring 2002, 2,450 people, or about 0.05 percent of the total population of the three states combined, had registered as medical marijuana users. Statewide figures for California are unknown. In Oregon, Alaska, and Hawaii, over 70 percent of registrants were over 40 years of age, and in Hawaii and Oregon, the two states where gender information is collected, 70 percent of registrants were men. Statewide figures on gender and medical conditions were not available for Alaska or California. Hawaii and Oregon were the only two states that had data on the number of physicians recommending marijuana. As of February 2002, less than 1 percent of the approximately 5,700 physicians in Hawaii and 3 percent of Oregon's physicians out of 12,900 had recommended marijuana to their patients. Oregon was also the only state that maintained data on the number of times individual physicians recommended marijuana--as of February 2002, 62 percent of the Oregon physicians recommending marijuana made one recommendation. Data were not readily available to measure how marijuana-related law enforcement has been affected by the introduction of medical marijuana laws. Officials from over half of the 37 selected federal, state, and local law enforcement organizations GAO interviewed in the four states said that the introduction of medical marijuana laws had not greatly affected their law enforcement activities.