For some Ohioans, cannabis is a controversial topic. For others, it is a regular part of conversation. Despite cannabis being legal in Ohio, controversy continues. This raises the question: does the controversy around medical cannabis hinder its potential to help people?
In 2016, medical marijuana, product from the cannabis plant, was legalized in Ohio through House Bill 523. As a result, patients can purchase medical marijuana if recommended by an Ohio-licensed physician for certain medical conditions. In 2023, Ohio legalized adult-use cannabis, also known as recreational cannabis, after citizens voted in favor of Issue 2. Now, individuals aged 21 and older can legally purchase, possess, use, transport and grow cannabis.
After Issue 2 passed, lawmakers have been redefining Ohio’s cannabis regulations. The most recent change comes from Senate Bill 56, passed in February 2025. Bill 56 limits THC content, possession, use, transport, and home cultivation of adult-use cannabis while removing Issue 2 social equity programs and allowing expungement for convictions legal under Issue 2. Bill 56 will go to the Ohio House for consideration.
As lawmakers shape cannabis legislation, Ohio maintains distinct regulations for medical and adult-use cannabis through testing, taxes, and policies. Ohio’s Division of Cannabis Control (DCC) oversees testing laboratories, processors, dispensaries and cultivators (businesses that grow cannabis plants) for medical cannabis. Testing laboratories require a DCC Certificate of Operation or Provisional License. Lab employees take random samples of medical cannabis from cultivators and processors to test for contaminants and cannabinoid potency. Samples are tracked from cultivation to distribution. If containments are found, the sample batch is destroyed; if cleared, samples are packaged by potency levels.
“One hundred percent of our products are tested,” said Michele Minehart, minority owner of the Ohio Cannabis Company. “You have to send it to an independent lab, and no owner of a license to test can have any sort of ownership or share in a cultivation license.”
Testing protocols protect Ohio businesses and citizens by ensuring medical cannabis available for purchase is safe.
The purchasing process for medical cannabis differs from adult-use cannabis. To purchase medical cannabis, patients need an active registry card, which is issued after visiting a physician certified to recommend (CTR) medical cannabis, according to the Ohio Department of Commerce. Becoming a CTR physician requires candidates to apply through the State Medical Board of Ohio and complete yearly trainings and license renewals once accepted.
“The way these things have been set up, we're not technically prescribing marijuana," said Dr. Peter W. Howison, an Ohio CTR physician. “We're just recommending that it might be helpful in the particular case of the patients that were being evaluated, and they have a qualified diagnosis.”
If the patient qualifies, the CTR physician sends a link to register for the patient and caregiver registry. Once registered, patients will acquire an active registry card and can purchase medical cannabis. Medical patients need to be 18 years or older unless they have parental approval. To purchase adult-use cannabis, consumers must be 21 years or older, have an Ohio identity document and visit a licensed Ohio dispensary.
How these purchases are taxed is noticed in the 2023 bill. Medical cannabis follows sales tax regulations, usually between 5.25 percent and 7.5 percent, while adult-use cannabis has a 10 percent excise tax in Ohio. Not having an excise tax, which are common for products like cigarettes and alcohol, on medical cannabis helps make it more affordable to patients in need.
“All state-legal cannabis businesses are paying an extra high tax rate because of a special provision in the federal tax code that says if you're involved in illegal drugs, essentially, you can't deduct the cost of being involved with illegal drugs,” said Douglas Berman, executive director of the Drug Enforcement and Policy Center at Moritz College of Law.
Conflicting federal and state laws make it challenging for consumers and businesses.
For example, Ohio State students cannot use, possess, or distribute cannabis products on campus property because cannabis is illegal under federal law and the university follows federal rules.
“How are you able to navigate a world in which your state tells you it's legal to do this, but the federal government says, no, that's technically illegal,” Berman said.
Outside of legal complexities, medical cannabis patients must navigate what type to use.
Medical patients are typically advised to seek cannabis products with a higher ratio of cannabidiol (CBD) and lower levels of Delta-9-tetrahydrocannabinol (THC) for benefits without psychoactive effects. According to the Association of American Medical Colleges, CBD can help with pain, sleep, anxiety, and various other conditions, while THC causes users to feel high.
“There's a whole system with our bodies where there are these receptors throughout our body that respond to cannabinoids, both psychoactive and not,” Dr. Howison said. “I just tell people to know what you're getting, and you have to experiment a little bit.”
This happens because cannabis is an individualized treatment.
“It's because our endocannabinoid systems are all very different,” said Karen Jaynes, Integrative Health Professional with a Master of Science in Medical Cannabis Science and Therapeutics. “Just as different as our faces are.”
Healthline defines the endocannabinoid system as a complex cell signaling system that helps regulate your body’s functions; meaning it reacts differently to cannabis forms like edibles, oils, capsules, topicals, sprays, patches and products that are smoked.
“Just like a lot of medicines that we take they say don't take it on an empty stomach or take it with a meal. Cannabis is the same way,” Jaynes said, referring to edibles.
Beyond the variety of forms, how cannabis is referred to has also evolved.
“Cannabis is the proper name for the plant,” Berman said. “Historically, when we referred to marijuana and especially when we talked about illegal marijuana, we were generally talking about the parts of the plant that had a lot of THC.”
Today, both terms are acceptable within the industry, while slang is generally avoided.
Overall, medical cannabis is more regulated and researched, and it takes more steps for patients to get access to it. However, navigating cannabis reform in Ohio and at the federal level can be challenging due to its rapidly moving pace.
“I do believe Ohio is doing it right and trying to take care of its citizens,” Minhart said. “I think it’ll destigmatize purchasing products that previously were only available on the street, which was a very, very unsafe situation.”
So, does the controversy around medical cannabis hinder its potential to help people?
While systematic obstacles and public perceptions push some people away, 57% of U.S. adults say marijuana should be legal for medical and recreational use, according to a 2024 Pew Research Center study.
Just as medical cannabis is individualized medicine, the choice to use it is individual
Credits:
Samantha Graber