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Americans for Safe Access (ASA) has just published its latest annual reportentitled: “State of the States Report 2021: An Analysis of Access to Medical Cannabis in the United States” where they rate how well each state MMJ Program made in patient care.

The ASA ranks states based on 100 categories, including affordability, civil protections, barriers to access, product safety, social equity, sanctions, and more. The report is given to state legislators every year in every state, including many patient and health care organizations.

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In addition, the report shares recommendations that programs can make, particularly regarding regulatory language and legislations. Their first edition was published in 2014, and since then, state legislators have relied on their insightful recommendations to improve their laws.

On February 22, 2022, a press briefing was held to discuss the report.

“With a decline in legislative improvements in state medical cannabis programs, millions of patients are left with limited or no access,” explained ASA Executive Director Debbie Churgai. “It is the ASA’s hope that the report will inspire a renewed commitment to patients by policymakers to improve state laws and end the federal ban once and for all.”

“Americans for Safe Access’s State of the States Report has been an important resource for me as I work to ensure that all Pennsylvanians have access to medical cannabis,” said State Representative Chris Rabb. Pennsylvania.


There was only 7 states which saw improved scores from 2020 to 2021: Arizona, Utah, Louisiana, Arkansas, North Dakota, New Hampshire and Rhode Island. Meanwhile, Maine earned the highest grade of any state: B, and Illinois a B-. They were the only two to earn grades above a C.

The two states with the lowest score were Nebraska and Idaho, as they received 0 points due to the ban.

Here’s a summary of the ASA’s recommendations for some of the top-selling states for cannabis:


California, home to one of the largest legal cannabis markets in the world, surprisingly only scored a C+. Their recommendations for this year include encouraging lawmakers to narrow civil protection gaps for employed patients, as well as addressing housing and DUI discrimination issues. Patients in California still face workplace discrimination simply because of their MMJ patient status and the fact that employers continue to make hiring and firing decisions based on employee usage.

RELATED: New Report Shows Medical Cannabis Users Are Spending More

Additionally, California residents still have rental issues since leases can be specified by tenants to prevent patients from consuming their cannabis at home. They also recommend that police be banned from discriminating against patients during roadside sobriety assessments, as the ASA believes patients should be exempt from roadside tests that want to assess how good one is. weakened. After all, they need their medication to function.


Colorado also scored a C+. In the report, the ASA explicitly expressed disappointment with the path Colorado lawmakers have chosen to take on cannabis law reform.

The ASA thinks policymakers should convene an emergency meeting to immediately repeal HB1317, which has been the biggest issue for MMJ patients in the state because it involves greater expense for the program, and patients are forced to go through several rounds of physician certification. Additionally, doctors will also be required to state a patient’s maximum dose, which will limit the sales a patient can purchase. On top of that, HB1317 limits cannabinoid levels because it places restrictions on potency so Colorado patients under 21 cannot purchase concentrates.

RELATED: Doctors no longer need the elderly to get medical marijuana in DC

For Colorado state lawmakers, protecting patients’ civil rights should be a priority for 2022. It’s bad enough that patients are still at risk of losing custody of their children as well as their jobs simply because ‘they are MMJ patients. They may also be denied organ transplants and may face unfair discrimination for roadside testing. Landlords can also customize leases to prevent patients from taking the drug from home.

seniors and cannabis
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Michigan scored a C on the report. The ASA recommends lawmakers stop preventing caregivers from growing their own medicine, as it is a critical way for them to make their medicine more affordable and accessible. Regulators should also consider other ways to make the drug more affordable, such as putting in place mechanisms such as discounts and waivers in the event of financial hardship.

Policymakers should also provide additional rights for patients, such as housing and employment protections. It is recommended that product recall processes be improved so that unaffected products are not affected by recalls, which can lead to supply issues for patients.


Florida landed a D+, and current laws clearly leave patients with little choice in many aspects, especially when it comes to protecting patients’ civil rights. Patients with MMJ in Florida have no protections against employers discriminating against them, and the ASA recommends that these protections be extended to all types of employees.

RELATED: Florida’s Roadmap to Cannabis Legalization

Additionally, Florida patients also face problems when taking medications at home. They also recommend that cannabis be treated like other types of prescription drugs in organ transplants and medical procedures. Nor should parents be disenfranchised because they are patients.


Washington got a C- on the report. The ASA recommends lawmakers address other gaps in civil protections as well, particularly with respect to impaired driving discrimination, housing and employment.

Patients in Washington should be exempt from any road tests, while lawmakers should look for strategies that can address patient resistance to accessing their medications, as there are many roadblocks in the state that prevent patients from get their medicine.

The full report can be seen here.

This article originally appeared on and has been republished with permission.

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