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To: Public Health and
Welfare; Accountability,
Efficiency, Transparency
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026
By: Senator(s) Blackwell
SENATE BILL NO. 2438
AN ACT TO AMEND SECTION 41-137-3, MISSISSIPPI CODE OF 1972, 1
TO REVISE THE DEFINITION OF "QUALIFYING PATIENT" TO INCLUDE A 2
PERSON FOR WHOM A PRACTITIONER HAS DETERMINED, AFTER CONVENTIONAL 3
TREATMENT OPTIONS HAVE PROVEN INEFFECTIVE, THAT THE PATIENT MAY 4
BENEFIT FROM MEDICAL CANNABIS; TO AMEND SECTION 41-137-5, 5
MISSISSIPPI CODE OF 1972, TO AUTHORIZE MEDICAL CANNABIS USE BY A 6
PERSON DIAGNOSED BY A PRACTITIONER, WITH WHOM THE PERSON HAS A 7
BONA FIDE PRACTITIONER-PATIENT RELATIONSHIP WITHIN HIS OR HER 8
SCOPE OF PRACTICE, AS A PATIENT FOR WHOM OTHER CONVENTIONAL 9
TREATMENT OPTIONS HAVE PROVEN INEFFECTIVE; AND FOR RELATED 10
PURPOSES. 11
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 12
SECTION 1. Section 41-137-3, Mississippi Code of 1972, is 13
amended as follows: 14
41-137-3. For purposes of this chapter, unless the context 15
requires otherwise, the following terms shall have the meanings 16
ascribed herein: 17
(a) "Artificially derived cannabinoid" means a chemical 18
substance that is created by a chemical reaction that changes the 19
molecular structure of any chemical substance derived from the 20
plant Cannabis family Cannabaceae. Such term shall not include: 21
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(i) A naturally occurring chemical substance that 22
is separated from the plant Cannabis family Cannabaceae by a 23
chemical or mechanical extraction process; 24
(ii) Cannabinoids that are produced by 25
decarboxylation from a naturally occurring cannabinoid acid 26
without the use of a chemical catalyst; or 27
(iii) Any other chemical substance identified by 28
MDOH. 29
(b) "Allowable amount of medical cannabis" means an 30
amount not to exceed the maximum amount of Mississippi Medical 31
Cannabis Equivalency Units ("MMCEU"). 32
(c) "Bona fide practitioner-patient relationship" 33
means: 34
(i) A practitioner and patient have a treatment or 35
consulting relationship, during the course of which the 36
practitioner, within his or her scope of practice, has completed 37
an in-person assessment of the patient's medical history and 38
current mental health and medical condition and has documented 39
their certification in the patient's medical file; 40
(ii) The practitioner has consulted in person with 41
the patient with respect to the patient's debilitating medical 42
condition; and 43
(iii) The practitioner is available to or offers 44
to provide follow-up care and treatment to the patient. 45
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(d) "Cannabis" means all parts of the plant of the 46
genus cannabis, the flower, the seeds thereof, the resin extracted 47
from any part of the plant and every compound, manufacture, salt, 48
derivative, mixture or preparation of the plant, its seeds or its 49
resin, including whole plant extracts. Such term shall not mean 50
cannabis-derived drug products approved by the federal Food and 51
Drug Administration under Section 505 of the Federal Food, Drug, 52
and Cosmetic Act. 53
(e) "Cannabis cultivation facility" means a business 54
entity licensed and registered by the Mississippi Department of 55
Health that acquires, grows, cultivates and harvests medical 56
cannabis in an indoor, enclosed, locked and secure area. 57
(f) "Cannabis disposal entity" means a business 58
licensed and registered by the Mississippi Department of Health 59
that is involved in the commercial disposal or destruction of 60
medical cannabis. 61
(g) "Cannabis processing facility" means a business 62
entity that is licensed and registered by the Mississippi 63
Department of Health that: 64
(i) Acquires or intends to acquire cannabis from a 65
cannabis cultivation facility; 66
(ii) Possesses cannabis with the intent to 67
manufacture a cannabis product; 68
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(iii) Manufactures or intends to manufacture a 69
cannabis product from unprocessed cannabis or a cannabis extract; 70
and 71
(iv) Sells or intends to sell a cannabis product 72
to a medical cannabis dispensary, cannabis testing facility or 73
cannabis research facility. 74
(h) "Cannabis products" means cannabis flower, 75
concentrated cannabis, cannabis extracts and products that are 76
infused with cannabis or an extract thereof and are intended for 77
use or consumption by humans. The term includes, without 78
limitation, edible cannabis products, beverages, topical products, 79
ointments, oils, tinctures and suppositories that contain 80
tetrahydrocannabinol (THC) and/or cannabidiol (CBD) except those 81
products excluded from control under Sections 41-29-113 and 82
41-29-136. 83
(i) "Cannabis research facility" or "research facility" 84
means a research facility at any university or college in this 85
state or an independent entity licensed and registered by the 86
Mississippi Department of Health pursuant to this chapter that 87
acquires cannabis from cannabis cultivation facilities and 88
cannabis processing facilities in order to research cannabis, 89
develop best practices for specific medical conditions, develop 90
medicines and provide commercial access for medical use. 91
(j) "Cannabis testing facility" or "testing facility" 92
means an independent entity licensed and registered by the 93
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Mississippi Department of Health that analyzes the safety and 94
potency of cannabis. 95
(k) "Cannabis transportation entity" means an 96
independent entity licensed and registered by the Mississippi 97
Department of Health that is involved in the commercial 98
transportation of medical cannabis. 99
(l) "Cannabis waste" means plant debris of the plant of 100
the genus cannabis, including dead plants and all unused plant 101
parts. This term shall not include seeds, roots, stems and 102
stalks. 103
(m) "Cannabinoid" means any of the chemical compounds 104
that are the active constituents derived from THC. 105
(n) "Canopy" means the total surface area within a 106
cultivation area that is dedicated to the cultivation of flowering 107
cannabis plants. The surface area of the plant canopy must be 108
calculated in square feet and measured and must include all of the 109
area within the boundaries where the cultivation of the flowering 110
cannabis plants occurs. If the surface area of the plant canopy 111
consists of noncontiguous areas, each component area must be 112
separated by identifiable boundaries. If a tiered or shelving 113
system is used in the cultivation area the surface area of each 114
tier or shelf must be included in calculating the area of the 115
plant canopy. Calculation of the area of the plant canopy may not 116
include the areas within the cultivation area that are used to 117
cultivate immature cannabis plants and seedlings, prior to 118
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flowering, and that are not used at any time to cultivate mature 119
cannabis plants. 120
(o) "Cardholder" means a registered qualifying patient 121
or a registered designated caregiver who has been issued and 122
possesses a valid registry identification card. 123
(p) "Chronic pain" means a pain state in which the 124
cause of the pain cannot be removed or otherwise treated, and 125
which in the generally accepted course of medical practice, no 126
relief or cure of the cause of the pain is possible, or none has 127
been found after reasonable efforts by a practitioner. 128
(q) "Concentrate" means a substance obtained by 129
separating cannabinoids from cannabis by: 130
(i) A mechanical extraction process; 131
(ii) A chemical extraction process using a 132
nonhydrocarbon-based or other solvent, such as water, vegetable 133
glycerin, vegetable oils, animal fats, food-grade ethanol or steam 134
distillation; or 135
(iii) A chemical extraction process using the 136
hydrocarbon-based solvent carbon dioxide, provided that the 137
process does not involve the use of high heat or pressure. 138
(r) "Debilitating medical condition" means: 139
(i) Cancer, Parkinson's disease, Huntington's 140
disease, muscular dystrophy, glaucoma, spastic quadriplegia, 141
positive status for human immunodeficiency virus (HIV), acquired 142
immune deficiency syndrome (AIDS), hepatitis, amyotrophic lateral 143
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sclerosis (ALS), Crohn's disease, ulcerative colitis, sickle-cell 144
anemia, Alzheimer's disease, agitation of dementia, post-traumatic 145
stress disorder (PTSD), autism, pain refractory to appropriate 146
opioid management, diabetic/peripheral neuropathy, spinal cord 147
disease or severe injury, or the treatment of these conditions; 148
(ii) A chronic, terminal or debilitating disease 149
or medical condition, or its treatment, that produces one or more 150
of the following: cachexia or wasting syndrome, chronic pain, 151
severe or intractable nausea, seizures, or severe and persistent 152
muscle spasms, including, but not limited to, those characteristic 153
of multiple sclerosis; or 154
(iii) Any other serious medical condition or its 155
treatment added by the Mississippi Department of Health, as 156
provided for in Section 41-137-17. 157
(s) "Designated caregiver" means a person who: 158
(i) Has agreed to assist with a registered 159
qualifying patient's medical use of medical cannabis; 160
(ii) Assists no more than five (5) registered 161
qualifying patients with their medical use of medical cannabis, 162
unless the designated caregiver's registered qualifying patients 163
each reside in or are admitted to a health care facility or 164
facility providing residential care services or day care services 165
where the designated caregiver is employed; 166
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(iii) Is at least twenty-one (21) years of age 167
unless the person is the parent or legal guardian of each 168
qualifying patient the person assists; and 169
(iv) Has not been convicted of a disqualifying 170
felony offense. 171
(t) "Disqualifying felony offense" means: 172
(i) A conviction for a crime of violence, as 173
defined in Section 97-3-2; 174
(ii) A conviction for a crime that was defined as 175
a violent crime in the law of the jurisdiction in which the 176
offense was committed, and that was classified as a felony in the 177
jurisdiction where the person was convicted; or 178
(iii) A conviction for a violation of a state or 179
federal controlled substances law that was classified as a felony 180
in the jurisdiction where the person was convicted, including the 181
service of any term of probation, incarceration or supervised 182
release within the previous five (5) years and the offender has 183
not committed another similar offense since the conviction. Under 184
this subparagraph (iii), a disqualifying felony offense shall not 185
include a conviction that consisted of conduct for which this 186
chapter would likely have prevented the conviction but for the 187
fact that the conduct occurred before February 2, 2022. 188
(u) "Edible cannabis products" means products that: 189
(i) Contain or are infused with cannabis or an 190
extract thereof; 191
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(ii) Are intended for human consumption by oral 192
ingestion; and 193
(iii) Are presented in the form of foodstuffs, 194
beverages, extracts, oils, tinctures, lozenges and other similar 195
products. 196
(v) "Entity" means a corporation, general partnership, 197
limited partnership or limited liability company that has been 198
registered with the Secretary of State as applicable. 199
(w) "MMCEU" means Mississippi Medical Cannabis 200
Equivalency Unit. One unit of MMCEU shall be considered equal to: 201
(i) Three and one-half (3.5) grams of medical 202
cannabis flower; 203
(ii) One (1) gram of total THC in a medical 204
cannabis concentrate; or 205
(iii) One (1) gram of total THC in an infused 206
product. 207
(x) "MDOH" means the Mississippi Department of Health. 208
(y) "MDOR" means the Mississippi Department of Revenue. 209
(z) "Medical cannabis" means cannabis, cannabis 210
products and edible cannabis that are intended to be used by 211
registered qualifying patients as provided in this chapter. 212
(aa) "Medical cannabis dispensary" or "dispensary" 213
means an entity licensed and registered with the MDOR that 214
acquires, possesses, stores, transfers, sells, supplies or 215
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dispenses medical cannabis, equipment used for medical cannabis, 216
or related supplies and educational materials to cardholders. 217
(bb) "Medical cannabis establishment" means a cannabis 218
cultivation facility, cannabis processing facility, cannabis 219
testing facility, cannabis dispensary, cannabis transportation 220
entity, cannabis disposal entity or cannabis research facility 221
licensed and registered by the appropriate agency. 222
(cc) "Medical cannabis establishment agent" means an 223
owner, officer, board member, employee, volunteer or agent of a 224
medical cannabis establishment. 225
(dd) "Medical use" includes the acquisition, 226
administration, cultivation, processing, delivery, harvest, 227
possession, preparation, transfer, transportation, or use of 228
medical cannabis or equipment relating to the administration of 229
medical cannabis to treat or alleviate a registered qualifying 230
patient's debilitating medical condition or symptoms associated 231
with the patient's debilitating medical condition. The term 232
"medical use" does not include: 233
(i) The cultivation of cannabis unless the 234
cultivation is done by a cannabis cultivation facility; or 235
(ii) The extraction of resin from cannabis by 236
mechanical or chemical extraction unless the extraction is done by 237
a cannabis processing facility. 238
(ee) "Nonresident cardholder" means a person who: 239
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(i) Has been diagnosed with a debilitating medical 240
condition by a practitioner in his or her respective state or 241
territory, or is the parent, guardian, conservator or other person 242
with authority to consent to the medical use of medical cannabis 243
by a person who has been diagnosed with a debilitating medical 244
condition; 245
(ii) Is not a resident of Mississippi or who has 246
been a resident of Mississippi for less than forty-five (45) days; 247
and 248
(iii) Has submitted any documentation required by 249
MDOH rules and regulations and has received confirmation of 250
registration. 251
(ff) "Practitioner" means a physician, certified nurse 252
practitioner, physician assistant or optometrist who is licensed 253
to prescribe medicine under the licensing requirements of their 254
respective occupational boards and the laws of this state. In 255
relation to a nonresident cardholder, the term means a physician, 256
certified nurse practitioner, physician assistant or optometrist 257
who is licensed to prescribe medicine under the licensing 258
requirements of their respective occupational boards and under the 259
laws of the state or territory in which the nonresident patient 260
resides. For registered qualifying patients who are minors, 261
"practitioner" shall mean a physician or doctor of osteopathic 262
medicine who is licensed to prescribe medicine under the licensing 263
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requirements of their respective occupational boards and the laws 264
of this state. 265
(gg) "Public place" means a church or any area to which 266
the general public is invited or in which the general public is 267
permitted, regardless of the ownership of the area, and any area 268
owned or controlled by a municipality, county, state or federal 269
government, including, but not limited to, streets, sidewalks or 270
other forms of public transportation. Such term shall not mean a 271
private residential dwelling. 272
(hh) "Qualifying patient" means a person who has been 273
diagnosed by a practitioner as having a debilitating medical 274
condition or for whom a practitioner has determined, after other 275
conventional treatment options have proven ineffective, that the 276
patient may benefit from medical cannabis, and has been issued a 277
written certification. 278
(ii) "Registry identification card" means a document 279
issued by the MDOH that identifies a person as a registered 280
qualifying patient, nonresident registered qualifying patient or 281
registered designated caregiver. 282
(jj) "School" means an institution for the teaching of 283
children, consisting of a physical location, whether owned or 284
leased, including instructional staff members and students, and 285
which is in session each school year. This definition shall 286
include, but not be limited to, public, private, church and 287
parochial programs for kindergarten, elementary, junior high and 288
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high schools. Such term shall not mean a home instruction 289
program. 290
(kk) "Scope of practice" means the defined parameters 291
of various duties, services or activities that may be provided or 292
performed by a certified nurse practitioner as authorized under 293
Sections 73-15-5 and 73-15-20, by an optometrist as authorized 294
under Section 73-19-1, by a physician as authorized under Section 295
73-25-33, or by a physician assistant under Section 73-26-5, and 296
rules and regulations adopted by the respective licensing boards 297
for those practitioners. 298
(ll) "THC" or "Tetrahydrocannabinol" means any and all 299
forms of tetrahydrocannabinol that are contained naturally in the 300
cannabis plant, as well as synthesized forms of THC and derived 301
variations, derivatives, isomers and allotropes that have similar 302
molecular and physiological characteristics of 303
tetrahydrocannabinol, including, but not limited to, THCA, THC 304
Delta 9, THC Delta 8, THC Delta 10 and THC Delta 6. 305
(mm) "Written certification" means a form approved by 306
the MDOH, signed and dated by a practitioner, certifying that a 307
person has a debilitating medical condition. A written 308
certification shall include the following: 309
(i) The date of issue and the effective date 310
of the recommendation; 311
(ii) The patient's name, date of birth and 312
address; 313
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(iii) The practitioner's name, address, and 314
federal Drug Enforcement Agency number; and 315
(iv) The practitioner's signature. 316
SECTION 2. Section 41-137-5, Mississippi Code of 1972, is 317
amended as follows: 318
41-137-5. (1) No person shall be authorized to use medical 319
cannabis in this state unless the person (a) has been diagnosed by 320
a practitioner, with whom the person has a bona fide 321
practitioner-patient relationship within his or her scope of 322
practice, as having a debilitating medical condition or as a 323
patient for whom other conventional treatment options have proven 324
ineffective, for which the practitioner believes, in his or her 325
professional opinion, that the person would likely receive medical 326
or palliative benefit from the medical use of medical cannabis to 327
treat or alleviate the person's * * * medical condition or 328
symptoms associated with the person's * * * medical condition, (b) 329
has received a written certification of that diagnosis from the 330
practitioner, and (c) has been issued a registry identification 331
card from the MDOH under Section 41-137-23. A person who has been 332
diagnosed by a practitioner as specified in paragraph (a) of this 333
subsection shall be a qualifying patient, and the practitioner who 334
has diagnosed the patient shall document that diagnosis with a 335
written certification. However, nothing herein shall require a 336
practitioner to issue a written certification. 337
(2) A written certification shall: 338
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(a) Affirm that it is made in the course of a bona fide 339
practitioner-patient relationship; 340
(b) Remain current for twelve (12) months, unless the 341
practitioner specifies a shorter period of time; 342
(c) Be issued after an in-person assessment of the 343
patient by a practitioner, or after a telemedicine evaluation for 344
patients who are homebound or bedbound as certified by a 345
practitioner with whom the patient has a bona fide 346
practitioner-patient relationship within his or her scope of 347
practice other than the practitioner making the written 348
certification. For purposes of this paragraph (c), an individual 349
is homebound or bedbound if such individual is physically unable 350
to leave his or her residence without another person's aid because 351
the individual has lost the capacity of independent transportation 352
due to a medical, physical, or mental health condition or 353
infirmity as documented in writing by a practitioner who has a 354
bona fide practitioner-patient relationship with the patient; 355
(d) Only be issued on behalf of a minor when the 356
minor's parent or guardian is present and provides signed consent; 357
and 358
(e) Be limited to the allowable amount of cannabis in a 359
thirty-day period.. 360
(3) No state agency, department, political subdivision or 361
board shall require a practitioner to require a patient to submit 362
to a drug test as a condition to receiving a certification for a 363
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registry identification card. However, a practitioner may require 364
a drug test from a patient that is within his or her scope of 365
practice. 366
(4) After a practitioner has issued a written certification 367
to a qualifying patient, a practitioner may assist the patient in 368
registering for a registry identification card with the Department 369
of Health, in a manner provided by regulations of the Department 370
of Health. 371
(5) After a qualifying patient receives a written 372
certification from a practitioner, the patient shall be required 373
to make a follow-up visit with the practitioner not less than six 374
(6) months after the date of issuance of the certification for the 375
practitioner to evaluate and determine the effectiveness of the 376
patient's medical use of medical cannabis to treat or alleviate 377
the patient's debilitating medical condition or symptoms 378
associated with the patient's debilitating medical condition. 379
Qualifying patients may make a follow-up visit with a different 380
practitioner than the practitioner who originally issued their 381
written certification, provided that such practitioner is 382
otherwise registered and acting within their scope of practice and 383
the provisions of this chapter. 384
(6) Before dispensing medical cannabis to a cardholder, the 385
dispensary from which the cardholder is obtaining medical cannabis 386
shall verify the identity of the cardholder and the authority of 387
the cardholder to use medical cannabis as provided in Section 388
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41-137-39 and shall determine the maximum amount of medical 389
cannabis that a cardholder is eligible to receive and the amount 390
of medical cannabis that the cardholder has received from all 391
dispensaries during a specified period of time using the statewide 392
seed-to-sale tracking system under Section 41-137-11. 393
(7) (a) A practitioner shall be registered to issue written 394
certifications to qualifying patients by completing the required 395
application process as set forth by the MDOH. The MDOH shall 396
require a practitioner to complete a minimum of eight (8) hours of 397
continuing education in medical cannabis in order to issue written 398
certifications. After the first year of registration, these 399
practitioners shall complete five (5) hours of continuing 400
education in medical cannabis annually to maintain this 401
registration. 402
(b) A practitioner shall not be required to have any 403
additional qualifications to be authorized to certify a qualifying 404
patient for a registry identification card, other than such 405
requirements for practitioners as provided under the Mississippi 406
Medical Cannabis Act. 407
(c) A practitioner shall not be required to be 408
registered to certify patients with any state agency or board 409
other than the MDOH. 410
(8) Only physicians and doctors of osteopathic medicine may 411
issue written certifications to registered qualifying patients who 412
are minors. 413
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ST: MS Medical Cannabis Act; allow cannabis use
by certain persons when conventional treatment
options have proven ineffective.
(9) The requirements of this section shall not apply to a 414
person who is authorized to purchase topical cannabis provided 415
under Section 41-137-39(22), and such persons may possess and use 416
such products without being in violation of this chapter. 417
SECTION 3. This act shall take effect and be in force from 418
and after July 1, 2026. 419