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Medical Marijuana vs. Adult Use Marijuana

  • While medical marijuana is a legal distinction, so is adult-use (sometimes called “recreational”) marijuana. Importantly, there are key differences between these two legal statuses. There’s even a third category—decriminalization.
  • These legal nuances have real-life impacts on patients looking to unlock the plant-based healing power of cannabis.

Thinking of trying cannabis for anxiety or another chronic condition? During your research, you’ll likely encounter two terms that might describe your state’s legal stance on cannabis: medical marijuana and adult use marijuana.

Adult use is also commonly referred to as recreational legalization. This means that anyone over a certain age can legally purchase, possess, and use marijuana from legal dispensaries in your state. In states with medical marijuana legalization only, patients will need a recommendation from a healthcare provider to access regulated, dispensary-grade cannabis.

In this guide, we’re breaking down what these regulations look like in practical terms. We’ll also explore a third legal category (decriminalization) and answer other frequently asked questions.

What Is Medical Marijuana?

Let’s start with medical cannabis—our specialty here at TeleLeaf.

In states that have legalized medical marijuana:

  • Patients must receive a recommendation from a healthcare provider to qualify for medical marijuana.
  • Patients submit a medical marijuana card application and receive a physical or digital card to use at a dispensary (except in Louisiana, where pharmacies use a digital database).
  • To continue accessing medical cannabis, patients must renew their medical cards and visit their recommending provider as needed.

Depending on state laws, healthcare providers either:

  • Must only recommend cannabis to patients with certain conditions: In many states, patients must meet the criteria for a medical marijuana card; states often restrict medical card access to patients with debilitating conditions like anxiety, insomnia, migraines, chronic pain, glaucoma, and auto-immune diseases.


  • May recommend cannabis to any patient for any reason: In some states, providers have free reign to recommend cannabis for any condition they think could be treated with medical marijuana. This is the case in Louisiana. Louisiana residents can visit any provider to inquire about a medical cannabis recommendation.

What Is Adult Use Marijuana?

Alternatively, some states allow anyone over the age of 21 to purchase, possess, and use dispensary-grade marijuana—this is called “Adult Use Marijuana” or “Recreational Marijuana.”

In states with adult-use marijuana:

  • Anyone over the age of 21 can enter a cannabis dispensary with a valid photo ID and purchase regulated, lab-tested marijuana products.
  • Well-known legal infractions like driving under the influence (DUI) and public intoxication are still in effect, so there are still consequences for misuse of intoxicants, including marijuana.
  • Patients looking for a consultation about medical marijuana can still discuss their health concerns with cannabis-informed healthcare providers.

While adult-use marijuana legalization is still relatively uncommon in the US, states are continuing to develop legislation that generally supports responsible marijuana access for adults. This ongoing legalization opens doors for important research, provides economic boosts, and supports an ongoing dialogue about the Western medical model.

Legalization Discrepancies: Medical vs. Recreational vs. Decriminalization

In addition to medical and recreational legalization, there’s a third legal category to contend with: the decriminalization of marijuana (and other intoxicants).

Legally speaking, decriminalization means that the consequences of breaking a jurisdiction’s marijuana laws are either nonexistent or very mild—essentially, it extends grace to those who only show intent to personally use marijuana.

But decriminalization doesn’t have to happen at the state level. Smaller jurisdictions have decriminalized marijuana, including:

  • Atlanta, Georgia
  • Orlando, Florida
  • Cincinnati, Ohio
  • Austin, Texas

While decriminalization doesn’t improve access to regulated, lab-tested, dispensary-grade cannabis via legal purchase, it does decrease marijuana’s burden on the legal system and spark conversations that can decrease the stigma surrounding cannabis use. In states without medical or adult use access to marijuana, decriminalization for adults is an important step toward eventual progress.

Frequently Asked Questions

Medical marijuana, adult use marijuana, decriminalization—we’ve covered some of the basics related to legality. But if you’ve been reading up on the positive connections between cannabis and arthritis (or other medical issues), you likely have other questions about marijuana.

Below, we offer a few answers to common inquiries.

Can You Still Get a Medical Card in a Recreational State?

Even if your state has legalized recreational/adult use marijuana, they may still operate a medical card program.

There are a few reasons why:

  • Medical programs offer access to providers. In many states, patients need a provider’s recommendation to get a medical card, even if recreational marijuana is legal. Thus, these programs encourage people to discuss their treatment plans with qualified providers instead of self-diagnosing and treating themselves.
  • Some states offer medical access for minors. While all state laws currently restrict recreational marijuana use to adults over 21, some states (like California) allow minors with major medical conditions to apply for a medical card.

While you can access dispensary-grade cannabis in states with recreational legalization, you may still opt to pursue the medical card route for additional professional guidance or expanded access.

Do You Have to Be an Adult to Get a Medical Marijuana Card?

Not always—some states allow minors or adults under 21 to apply for medical cards. In Louisiana, for instance, patients under the age of 18 may apply for medical cards with their parents’ permission.

However, it can be slightly more difficult for minors or people under 21 to apply and gain access.

States have enacted additional steps for these groups, including (but not limited to):

  • Seeking multiple providers’ signatures (in Florida)
  • Requiring parents to apply as caregivers for qualifying patients (in West Virginia)
  • Only allowing parents of qualifying children dispensary access (in Kentucky)

So, while your state might offer medical cannabis access to minors, you may have to jump through additional hoops to start treatment.

How Old Do You Have to Be to Buy CBD?

Products made from hemp (a high-CBD, low-THC subtype of marijuana) fall into a different legal categorization. The 2018 Farm Bill federally legalized the growth, sale, production, possession, and use of hemp-based products for anyone over the age of 18.

This landmark legislation exponentially expanded access to therapeutic cannabis products made from hemp.

Now, anyone over 18 can purchase CBD-forward:

  • Gummies and edibles
  • Tinctures and oil extracts
  • Smokeable products (including flower)

If you’re in a state without medical marijuana legalization, this is one potential place to start considering clinical applications until the tides turn in your state.

However, there are some caveats to note:

  • Hemp products aren’t well-regulated. We recommend researching individual manufacturers’ approaches to producing hemp-derived formulas. Many products that fall under the purview of the Farm Bill (like Delta-8 THC) aren’t tested by regulatory agencies or even the manufacturers themselves. While a lack of regulation doesn’t guarantee that these products are unsafe, it poses another layer of risk for users.
  • A conversation with your healthcare provider is still key. Before making any changes to your prescription list or adding CBD to your regimen, consider talking to your healthcare provider about CBD. While you may have to advocate for yourself and present research on your own, your provider should know about any over-the-counter or alternative formulas that you’re using day-to-day.

Medical Marijuana Isn’t Legal in My State—What Do I Do?

As mentioned above, talking to your healthcare provider about the possible applications of CBD is one option for people who live in states without any marijuana legalization.

Another option is trying to influence positive change. This is an opportunity to learn as much as you can about cannabis, talk to other voters in your community about their opinions on marijuana, and contact your representatives to express your desire for legal cannabis access.

TeleLeaf: Connecting Patients with All-Natural, Plant-Based Relief

If you’re ready to consider medical cannabis as a treatment avenue, TeleLeaf can help. As the best online medical marijuana card service out there, you can count on us to connect you with an expert provider who can answer all of your questions and help you apply for your medical card from the comfort of your own home.

Start your plant-based healing journey with TeleLeaf by scheduling an appointment today.


GoodRx. What’s the Difference Between Medical Marijuana and Recreational Weed?

Cato Institute. The Effect of State Marijuana Legalizations: 2021 Update

NORML. Decriminalization

California Department of Public Health. Medical Marijuana Identification Card Program

Tallahassee Democrat. How to Get a Medical Marijuana Card in Florida: Here’s Everything You Need to Know

West Virginia. Patients/Caregivers

US Food and Drug Administration. Hemp Production and the 2018 Farm Bill

American Chemical Society. Delta-8 THC Craze Concerns Chemists

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