Marijuana Moment: New Hampshire Medical Marijuana Expansion Bills Head To Governor’s Desk As Recreational Legalization Measure Fails

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Though New Hampshire’s House of Representatives this week defeated a bill that would have legalized adult-use cannabis, lawmakers agreed on two bills Thursday to expand the state’s existing medical marijuana program: one to allow doctors to recommend it for any condition they believe would be improved through cannabis use, and the other to expand the pool of healthcare professionals who can recommend the drug.

The bills now proceed to the desk of Gov. Chris Sununu (R).

Both measures were revised in bicameral conference committees after the House and Senate passed separate versions of the legislation earlier this session.

On the qualifying conditions bill, HB 1278, members of the conference committee agreed to go with the version of the legislation passed by the House in March, recommending that its language be adopted by both chambers.

“The Senate has receded from their amendment and acceded to the House position,” Rep. Erica Layon (R) wrote in a House conference committee report, “which empowers providers to certify adults 21 and older for therapeutic cannabis through their own discretion rather than a limited list of conditions.”

The report was adopted on a voice vote in both chambers on Thursday.

Sponsored by Rep. Wendy Thomas (D), a cancer survivor and medical marijuana patient, the bill would add to the state’s qualifying conditions for medical marijuana “any debilitating or terminal medical condition or symptom for which the potential benefits of using therapeutic cannabis would, in the provider’s clinical opinion, likely outweigh the potential health risks for the patient.”

“If the governor signs this bill, it opens up the therapeutic program to more residents of New Hampshire who could benefit from having access to cannabis medicine,” Thomas told Marijuana Moment in an email on Friday.

A medical marijuana patient herself, Thomas said at a Senate committee earlier this year that cannabis has helped her manage chronic pain, insomnia, eating issues, gastrointestinal issues, PTSD and anxiety.

“I found relief from all of these symptoms,” she said, “some of which are not covered in the program.”

She said in her email that other examples of symptoms that could be effectively managed with marijuana that are not specifically listed as qualifying conditions include severe menstrual cramps, symptoms of long COVID and pre-dentist anxiety and post-surgical pain control.

The proposal would not do away with the enumerated list of qualifying conditions, which Thomas said was a useful way for clinicians who are less familiar with cannabis to navigate the system. “The point of this is that they would be allowed to…refer a patient to the program for any condition that they think would fit and benefit the patient,” she explained.

“This bill sets up two paths for health providers,” Thomas told Marijuana Moment. “For those who are not familiar with cannabis, they can use the legislated symptom and conditions list. For those providers who are cannabis literate, they will be able to recommend the program for a health condition that they think cannabis may be able to help, but that might not be on the list.”

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The other measure, SB 357, from Sen. Becky Whitley (D), would expand the authority to recommend medical marijuana to any New Hampshire healthcare provider “who is licensed to prescribe drugs to humans and who possesses an active registration from the United States Drug Enforcement Administration [DEA] to prescribe controlled substances.” Those providers would need to be “primarily responsible for the patient’s care related to his or her qualifying medical condition.”

It, too, was passed by both chambers on voice votes Thursday.

“I am pleased that the House and the Senate came together today to pass my SB 357 out of the Legislature and send it on to the governor’s desk,” Whitley told Marijuana Moment in a statement Friday.

“By responsibly expanding who can certify a patient for a therapeutic cannabis prescription, we will ensure that individuals who qualify to therapeutic cannabis will have further access to needed care,” she said. “Therapeutic cannabis has proven to help patients suffering from a number of health issues, and today we took a step forward in ensuring patients are able to access health care in the Granite State.”

After that bill was passed by senators earlier this year, House lawmakers made an amendment to the bill that the Senate later rejected. The final bill uses new compromise language, adjusting a previous version passed by the Senate.

As passed by the legislature, it would allow out-of-state physician assistants to certify patients for the New Hampshire’s medical marijuana program, and it would update an “outdated reference” in the law’s existing section on physician assistants, according to a House conference committee report from Layon.

As for the legislation to legalize marijuana for adults, HB 1633, that proposal was effectively killed when House lawmakers voted narrowly to table the legislation after the Senate’s adoption of the compromise earlier in the day.

As negotiated by the conference committee, it would have allowed 15 stores to open statewide beginning in 2026 through a novel state-run franchise system. Though stores would be privately run, the government would have overseen operations, including setting final prices on products. Purchases would incur a 15 percent “franchise fee”—effectively a tax—that would apply to both adult-use and medical marijuana purchases.

Rep. Jared Sullivan (D), who spoke out against House members accepting the negotiated version of the bill, described the proposal as “the most intrusive, big-government marijuana program proposed anywhere in the country.”

Some legalization advocates said they were disappointed to see pro-legalization lawmakers vote to scuttle the bill.

“It’s a sad day to see legalizers kill legalization,” Karen O’Keefe, director of state policies for the Marijuana Policy Project, told Marijuana Moment in an email after the House action. “While HB 1633 was an imperfect bill, it is far easier to revise a law than to pass a bill from scratch—especially if the next governor is a prohibitionist.”

Marijuana possession wouldn’t have become legal under the bill until 2026, once the state’s licensed market is up and running. In the meantime, possession of up to one ounce of cannabis would carry a $100 maximum civil fine.

Home cultivation of cannabis for personal use would remain illegal, and the state’s Liquor Commission would have the authority to enforce that provision.

Both leading Republican candidates running to replace Sununu have said they would oppose legalization, though the top Democratic contender says she would support it.

New Hampshire lawmakers worked extensively on marijuana reform issues last session and attempted to reach a compromise to enact legalization through a multi-tiered system that would include state-controlled shops, dual licensing for existing medical cannabis dispensaries and businesses privately licensed to individuals by state agencies. The legislature ultimately hit an impasse on the complex legislation.

Bicameral lawmakers also convened the state commission tasked with studying legalization and proposing a path forward last year, though the group ultimately failed to arrive at a consensus or propose final legislation.

The Senate defeated a more conventional House-passed legalization bill last year, HB 639, despite its bipartisan support.

Last May, the House defeated marijuana legalization language that was included in a Medicaid expansion bill. The Senate also moved to table another piece of legislation that month that would have allowed patients and designated caregivers to cultivate up to three mature plants, three immature plants and 12 seedlings for personal therapeutic use.

After the Senate rejected the reform bills in 2022, the House included legalization language as an amendment to separate criminal justice-related legislation—but that was also struck down in the opposite chamber.

This story has been updated to add additional comments from Rep. Wendy Thomas.

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Photo courtesy of Mike Latimer.

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