Is Medical Marijuana Legal in South Carolina?

The legalization of medical marijuana in South Carolina is a hot-button issue, bringing both sides of the aisle together with a common goal: bringing relief to those in need. For years, medical cannabis bills have reached the Senate floor to no avail, but with the latest session, residents hope everything will change.

The South Carolina Senate voted on February 14, 2024, passing S.423, known as the South Carolina Compassionate Care Act, 24 to 19. After days of passionate debates, the Bill now heads to the House for approval. This isn’t the first time a similar version of the Bill has reached the House. In 2022, citing procedural grounds, it refused to even debate the Bill’s contents. Sen. Tom Davis took the original copy, revising it to remediate the noted issue, allowing it to advance past the committee but still failing to reach the Senate floor. Here, it sat in limbo, awaiting the new year, when it could once again make its way in front of the governing parties. As the Bill awaits debate in the House, residents can contact their state representatives to tell them to do their part and back this crucial piece of legislation.

What's Inside the Bill

South Carolina’s Compassionate Care Act (S.423) creates a medical marijuana program that is well-regulated and allows those with serious medical conditions to register with the recommendation of their physician to use medical cannabis. Currently, 38 other states, including Florida, Alabama, Mississippi, and Arkansas, have approved similar bills, setting an encouraging precedent for those awaiting a decision.

To be clear, the Compassionate Care Act is very strict about its wording regarding the purchase and dispensation of medical cannabis, making it clear that it does not allow home cultivation, raw cannabis, or cannabis smoking. Approved individuals must use state-sanctioned dispensaries and stay within their prescribed limits.

Who Qualifies?

To qualify for medical marijuana, a patient must have a specified medical condition, a registration provided by the health department, and a physician-issued written certification.

Qualifying conditions include:

  • Chronic medical conditions cause persistent and severe muscle spasms
  • An illness causing them to be homebound with persistent or severe nausea
  • A terminal illness
  • Cachexia
  • Ulcerative colitis
  • Crohn’s disease
  • Autism
  • PTSD
  • Sickle cell anemia
  • Epilepsy
  • Neurological disorder or disease
  • Multiple sclerosis
  • Cancer

For those with PTSD, special documentation and alternatives to opioids are required. If the patient’s condition can be treated with a prescribed opioid, their physician must:

  • Prove that they’ve reviewed with objective proof (an x-ray or MRI) the patient’s pain.
  • Attest to the patient’s diagnosis with the specified disease or medical condition causing their severe pain. These issues can include trigeminal neuralgia, shingles, fibromyalgia, spinal cord injuries, spinal cord disease, rheumatoid arthritis, residual limb pain, and complex regional pain syndrome. For this option, the physician must have verified the patient’s diagnosis with the treating physician or be the diagnosing physician.

For PTSD diagnosis, the physician must verify that there is evidence of trauma to the satisfaction of the health department. This verification can include showing proof of active military service inside a combat zone, that the patient is a victim of a sexual or violent crime, or that the patient was a first responder. In all cases, the patient must be debilitated by their medical condition.

The Creation of an Advisory Board

Within the Compassionate Care Act is the creation of a Medical Cannabis Advisory Board that would consider patient petitions to add or remove qualifying conditions. This board would include the health department director; the following governor appointees: two physicians who don’t authorize medical marijuana, two doctors who do authorize medical marijuana, one board-certified physician who authorizes medical marijuana, one research scientist expert in cannabinoid medicine, four pharmacists (two that dispense medical marijuana and two who don’t), one medical marijuana patient, one parent of a minor who qualifies to receive medical marijuana, one Senate president appointee and one appointee from the speaker of the House.

Patients will be required to renew their ID cards yearly. If the patient’s condition is expected to be approved before the year is over, the physician must note it so the card can expire earlier.

Physician Requirements

Only Dos, MDs, and podiatrists licensed in South Carolina and within their practice area can certify potential patients for the medical marijuana program. Before issuing certificates, they must register with the state’s health department. They must also complete an annual 3-hour cannabis medical education course. The certification form will be completed by the health department and completed by the physician for the patient before applying for medical marijuana.

Physicians must perform a thorough in-person evaluation of the patient, which includes documentation of therapies that failed to work, psychotic disorders, mental illness, a family history of addiction, social history, and an illness history overview. They must also develop a written treatment plan that includes previous measures that were attempted to ease suffering, the potential risks of medical marijuana products, including fractures and falls, advice on different treatment options, the risk of marijuana use during breastfeeding and pregnancy, all the importance of keeping marijuana products away from pets and children.

The physician must also follow up with the patient within the first six months and yearly thereafter. There must also be no conflict of interest, and the physician must not receive remuneration from the cannabis pharmacy.

Medical Marijuana Prohibitions and Limitations

  • No vaping and driving
  • No diversion
  • Specific purchase limits
  • No home growing
  • No smoking

For more information about South Carolina’s Compassionate Care Act, click here.

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