Is Medical Marijuana Legal in North Carolina? (2026 Update)

January 29, 2026
Posted by edocmmj on

Current Legal Status — Medical Marijuana Remains Illegal

As of 2026, North Carolina does not operate a medical marijuana program under state law. That means:

  • There is no legal system for medical marijuana cards issued by the state.

  • Doctors cannot prescribe or recommend marijuana for qualifying conditions statewide.

  • There are no licensed dispensaries where patients can legally purchase medical cannabis.

  • Patients and physicians who operate outside the few legal exceptions remain at risk of arrest or criminal penalties under North Carolina law.

The state still classifies marijuana as a controlled substance with strict penalties for possession, cultivation, and distribution outside narrowly defined exceptions.

Limited Exception — Extremely Restricted Use for Epilepsy

North Carolina does have one very narrow statutory medical exception: the Epilepsy Alternative Treatment Act. This law allows registered patients with intractable epilepsy to use low-THC cannabis extract (hemp-derived oil) that contains less than 0.9% THC and at least 5% CBD.

However:

  • This exception does not create a broader medical marijuana program.

  • There are no state-issued medical marijuana cards, dispensaries, or regulated cannabis markets tied to it.

  • Patients still generally must obtain products from outside the state, as a regulated in-state supply does not exist.

What Is Not Legal in North Carolina

North Carolina’s marijuana laws remain strict:

  • Medical marijuana with standard levels of THC (similar to most states’ MMJ programs) is not legal.

  • Doctors cannot legally recommend or prescribe cannabis as part of treatment.

  • Possession of marijuana remains a criminal offense outside the narrow CBD/low-THC exception.

Even possession of small amounts can carry fines or criminal penalties, depending on the quantity and prior convictions.

What’s Happening with Reform Efforts

There continues to be legislative activity around medical marijuana in North Carolina:

  • Support for North Carolina medical marijuana reform is high among residents, with polls showing that a majority favor legalization.

  • Various bills, such as versions of the North Carolina Compassionate Care Act, have been introduced in recent legislative sessions but have not been passed into law.

  • A State Advisory Council on Cannabis was created in 2025 to recommend cannabis regulatory policy, but its work does not yet change the legal status of medical marijuana statewide.

A Unique Exception — Tribal Sovereignty

One notable exception inside North Carolina involves the Eastern Band of Cherokee Indians (EBCI):

  • Because the tribe is a sovereign nation, it can set its own cannabis laws on tribal land within the state.

  • The EBCI has legalized medical (and adult-use) marijuana on tribal territory, and dispensaries operating there have issued medical marijuana cards for use within the Qualla Boundary.

  • However, this legal status applies only on tribal land, and cannabis purchased there remains illegal elsewhere in the state.

What This Means for Patients Today

For most North Carolina residents outside of tribal lands:

  • You cannot legally obtain a traditional medical marijuana card.

  • You cannot legally use or possess cannabis for medical purposes beyond the limited low-THC extract exception.

  • Doctors cannot certify or recommend cannabis under state law.

If you’re seeking legal medical cannabis treatment in North Carolina today, it’s important to understand these restrictions and watch for potential future changes in legislation.

Final Thoughts

North Carolina remains one of the few states without a full state wide medical marijuana program as of 2026. While public support and legislative efforts continue to grow, real legal access for patients does not yet exist statewide. Limited allowances for low-THC hemp extract or sovereign tribal programs provide narrow exceptions, but they fall far short of a comprehensive medical marijuana system like those in many other states.

If you or someone you know can use the medicinal benefits of medical marijuana, contact All Natural Health Certifications North Carolina medical marijuana doctors today.