Is Medical-Only Weed Legal in Missouri?

Medically reviewed by Alexander Tabibi, MD
August 29, 2021
Missouri Legaal Cannabis
Missouri Legaal Cannabis

Recreational, adult-use cannabis remains illegal throughout Missouri, despite the fact that small possessions of weed have been decriminalized by The Show-Me State,  This state does operate a medical marijuana program which permits patients with certain qualifying conditions to apply for a medical marijuana card that is valid at licensed dispensaries in places like St. Louis or Jefferson City.


History of Weed Laws

In 2014, Missouri lawmakers passed HB 2238 in order to legalize hemp and establish a comprehensive oversight program under the supervision of the newly launched Missouri Hemp Extract Registration Program.  This legislation permitted Missouri residents with intractable epilepsy to purchase, possess and consume hemp extract products containing a maximum of 0.3% THC and at least 5% CBD


That same year, the state passed SB 491, effectively decriminalizing possession of up to 10 grams of marijuana by turning it into a misdemeanor charge resulting in a fine for first-time offenders.  The law remains, and anyone caught with higher quantities of cannabis in their possession can face felony charges.


In November of 2018, Amendment 2 was passed as part of the November ballot, thus legalizing medical marijuana.  Known as the Medical Marijuana and Veteran Health-Care Service Initiative, it went into effect after December of 2018, thus creating a state-run program in which medical patients could apply for approval to purchase cannabis from licensed dispensaries as long as they have been shown by their physicians to have certain qualifying conditions.  The program is currently regulated by the Missouri Department of Health and Senior Services (DHSS).


Where Can a Person Legally Purchase Weed in Missouri?

Because recreational marijuana is illegal in Missouri, only state-registered medical marijuana patients can legally purchase cannabis.  They can only do so from a state-licensed dispensary, where they can either purchase it in store or have it delivered to their homes.  They can also authorize a caregiver to do the purchasing for them.


Patients are permitted to purchase up to 4 ounces of flower every 30 days.  Limited amounts of concentrates and THC-infused products are also permitted.  If a higher amount is needed due to the patient’s medical circumstances, this must be approved by a physician and the state. 


Where Can Cannabis Legally Be Used?

Missouri strictly prohibits the use of cannabis in public, which means that residents can only use it when they are on private property.  They are free to use it in their own homes, and the state also has strict laws about using it on someone else’s private property.  Property owners are required to designate a space of their property for cannabis consumption, where they may only be accompanied by a caregiver, physician, or family member.  Property owners are allowed to prohibit the use of smokable marijuana by another individual on their own property.


Possession Laws

Patients and their caregivers are legally authorized to possess up to a 60-day supply of cannabis at any given time.  A patient who is caught exceeding this amount twice can have their medical card taken away.  Recreational users caught with 10 grams or less of cannabis can face misdemeanor charges and have to pay a $500 fine.


Can Residents Grow Their Own?

Medical patients are allowed to grow their own cannabis, but they must apply to do so through the state and allow the DHSS to inspect the garden.  Cultivation can only take place in a closed and locked facility, and two patients can share a single facility.  Patients can grow up to 6 flowering plants, 6 nonflowering plants and 6 clones below 14 inches at a time.  However, a maximum of 12 plants can be grown in a single space, unless a caregiver is involved in addition to a couple of patients, in which case up to 18 plants is permitted.  The plants are required to have the patient’s name on their label, and the state’s authorization to cultivate must also be visible.


Medical Marijuana

Their medical marijuana program is accessible to any patient who has a qualified condition as listed below.  The program allows a patient to apply for a medical marijuana card through the state, and then receive the card that is valid at any state-authorized dispensary.


Qualifying Conditions:

  • Alzheimer’s disease 
  • Amyotrophic lateral sclerosis, or Lou Gehrig’s disease 
  • Autism
  • Cachexia, or wasting syndrome
  • Cancer
  • Crohn’s disease
  • Epilepsy 
  • Glaucoma
  • Hepatitis C
  • Huntington’s disease
  • Inflammatory bowel disease
  • Intractable migraines
  • Neuropathy
  • Post-traumatic stress disorder (PTSD) and other debilitating psychiatric disorders
  • Sickle cell disease
  • Terminal illness
  • Any chronic condition treated with a medication that could lead to dependence
  • Chronic conditions causing severe, persistent pain or muscle spasms including:
    • Multiple sclerosis 
    • Parkinson’s disease
    • Seizures
    • Tourette syndrome


Patient Qualifications:

To qualify as a medical marijuana patient in Missouri, you must first receive a diagnosis of at least one of the above conditions by a physician.  From there, a physician must provide a certification that will be submitted to the state as part of the application process.


How to Register for Medical Marijuana in Missouri

You can apply for a medical marijuana card in Missouri by filling out the application form provided through the state’s official website.  You must prove your residency with a state-issued ID and include the certification from your physician.  Once approved, you will receive your medical card so that you can begin making marijuana purchases at a licensed dispensary in the state.


Qualifying as a Caregiver

A caregiver in Missouri must be at least 21 years of age and may only provide care to up to 3 patients at a time.  A patient may have up to 2 caregivers. 


Registering as a Caregiver

First, the patient must designate the caregiver as part of their patient application process.  From there, the caregiver will receive their own application form that they must submit along with a state-issued ID, and from there, if approved, they will be given a medical card that is valid at state-licensed dispensaries.


Reciprocity Laws

MO does not permit residents from out of state who have medical cards to purchase cannabis in Missouri dispensaries.  However, out-of-state patients will not be arrested for possessing within the amount of cannabis that is legal as determined by Missouri law.



All cannabis products sold through Missouri dispensaries must undergo a lab-testing process by a state-proved independent laboratory.  The testing process checks for the potency of products while also ensuring safety by searching for contaminants, impurities and other unwanted compounds.


Is CBD Oil Illegal in Missouri?

To access CBD oil legally in Missouri, a patient must be approved to participate in the Missouri Hemp Extract Registration Program (MHERP). Only patients diagnosed by a state-licensed neurologist with intractable epilepsy are eligible to participate in this program. Patients younger than 18 must register with a parent or guardian.  Patients with a MHERP card can purchase CBD oil from one of two state-licensed facilities. When the 2018 Farm Bill was passed, it removed hemp from the list of controlled substances and effectively legalized hemp and hemp products nationally.  Still, MHERP remains in place in MO.