Get a Medical Marijuana Card in North Carolina (2026)
Eastern Band of Cherokee Indians (EBCI) medical cannabis program is legal. Apply for a medical marijuana card in North Carolina today.
North Carolina does not currently have a comprehensive state-run medical marijuana program, and the state does not issue medical marijuana cards like many other states do.
However, there are very limited pathways for accessing medical cannabis — most notably through the Eastern Band of Cherokee Indians (EBCI) medical cannabis program and a narrow state exception for low-THC cannabis under the Epilepsy Alternative Treatment Act.
State Law: No Traditional Medical Marijuana Card
Under current North Carolina law:
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The state does not operate a medical marijuana card system where patients register with the Department of Health and Human Services and receive state-issued cards.
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Physicians cannot prescribe or recommend marijuana for general medical use statewide.
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There are no state-licensed dispensaries operating outside of tribal lands.
In other words, most residents cannot obtain a traditional medical marijuana card or legally purchase cannabis products under North Carolina state law.
Limited State Medical Exception: Low-THC Hemp Extract
North Carolina’s Epilepsy Alternative Treatment Act allows a very narrowly defined use of low-THC cannabis extract (hemp extract) for people diagnosed with intractable epilepsy. Conditions for this program include:
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A diagnosis by a neurologist licensed in North Carolina.
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Caregiver registration with the North Carolina Department of Health and Human Services (DHHS).
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Caregivers must carry written documentation when possessing the low-THC extract.
However:
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This exception does not involve state-issued medical marijuana cards.
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It applies only to hemp extract with very specific THC/CBD levels and for epilepsy, not broader medical cannabis use.
Eastern Band of Cherokee Indians (EBCI) Medical Cannabis Program
The only existing medical cannabis card process accessible to North Carolina residents is offered by the Eastern Band of Cherokee Indians (EBCI), a federally recognized tribe that operates its own medical cannabis system on tribal trust lands.
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Who Can Apply
To obtain an EBCI medical cannabis card, applicants generally must:
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Be 21 years or older.
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Be a resident of North Carolina.
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Submit documentation of a qualifying medical condition recognized by the EBCI program.
Steps in the EBCI Medical Cannabis Card Process
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Doctor Documentation: Provide a Doctor’s Attestation Form or medical summary confirming a qualifying condition.
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Proof of Residency & ID: Submit a government-issued ID and proof of North Carolina residency.
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Submit Application to the EBCI Cannabis Control Board (CCB): Applicants can apply online, by mail, email, or in person to the EBCI CCB.
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Pay Fees: Non-tribal North Carolina residents typically pay around $100 for the card and annual renewal fees, while enrolled tribal members may pay lower fees.
Card Use
The EBCI medical cannabis card allows holders to purchase medical cannabis products only from dispensaries located on tribal trust lands, such as the Qualla Boundary in western North Carolina.
Conditions Covered (EBCI Program)
Conditions recognized by the EBCI medical cannabis program include a range of chronic or debilitating diagnoses such as cancer, glaucoma, HIV/AIDS, PTSD, Crohn’s disease, Parkinson’s disease, and others.
What North Carolina Residents Should Know
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No statewide medical marijuana card system exists yet. The state itself does not issue medical marijuana cards or maintain a patient registry.
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Only EBCI tribal medical cannabis cards are currently issued. These cards are valid for obtaining cannabis in tribal marijuana dispensaries.
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The limited state hemp extract program is not equivalent to a traditional medical marijuana card and is restricted to low-THC products for epilepsy.
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Broader medical cannabis legalization and a statewide medical marijuana card system could be established in the future if pending bills like the North Carolina Compassionate Care Act become law, but they are not active programs right now.
In Summary
For most North Carolina residents in 2026, the process to get a “medical marijuana card” under state law does not exist. Instead:
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Low-THC hemp extract may be legally used under very narrow state exceptions for certain epilepsy patients.
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A separate tribal program operated by the Eastern Band of Cherokee Indians provides a path to a medical cannabis card that allows purchases at tribal dispensaries.
If you’re interested in future changes or want help navigating any available pathways, All Natural Health Certifications North Carolina can provide updates on proposed legislation and eligibility details as they evolve. Call 800-303-9916.