Updated on May 13, 2021. Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer
On November 03, 1998, Ballot Initiative I-692 was approved (effective the same day), removing state-level criminal penalties on the use, possession and cultivation of marijuana by patients who possess “valid documentation” from their physician affirming that he or she suffers from a debilitating condition and that the “potential benefits of the medical use of marijuana would likely outweigh the health risks.”
In 2007, Senate Bill 6032, amended the rules to be defined by the Legislature.
On November 02, 2008, the Final Rule was amended to include, Crohn’s disease, Hepatitis C with debilitating nausea or intractable pain, or diseases, including anorexia, which result in nausea, vomiting, wasting, appetite loss, cramping, seizures, muscle spasms, or spasticity, when those conditions are unrelieved by standard treatments or medications, to the list of qualifying medical conditions.
On January 21, 2010, in the State vs. Fry, the Washington Supreme Court ruled that Ballot Initiative “i-692 did not legalize marijuana, but rather provided an authorized user with an affirmative defense, where the user shows compliance with the requirements for medical marijuana possession”:
“The Department of Health has a limited role related to medical marijuana in the state of Washington. Specifically, we were directed by the Legislature to determine the amount of a 60 day supply and conduct a study of issues related to access to medical marijuana. Both of these tasks have been completed. We have maintained the medical marijuana webpage for the convenience of the public.
The department has not received ‘any instructions’ in light of State v. Fry. That case does not change the law or affect the 60 day supply. Chapter 69.51A RCW, as confirmed in Fry, provides an affirmative defense to prosecution for possession of marijuana for qualifying patients and caregivers.”
On August 31, 2010, chronic renal failure was approved as a qualifying medical condition, for the state’s medical marijuana program.
On July 22, 2011, SB 5073 was amended, however, Governor Christine Gregoire chose to sign only some, of the bill’s sections, vetoing among other things, the instruction for creating state-licensed medical marijuana dispensaries, and voluntary patient registry.
On November 06, 2012, voters approved Initiative 502, allowing the state to legally “license and regulate marijuana production, distribution, and possession for persons over 21 and tax marijuana sales.” A statement on the Department of Health’s website states that it “does not amend or repeal the medical marijuana laws (Chapter 69.51A RCW) in any way. The laws relating to authorization of medical marijuana by healthcare providers are still valid and enforceable”.
In April 2015, SB 5052 passed both the House and the Senate; and on April 24, 2015, was signed by Governor Jay Inslee, with partial vetoes:
“Beginning July 1, 2016, patients and designated providers who are entered into the Medical Marijuana Authorization Database will receive a recognition card which will entitle the patient to additional rights and protections under SB 5052:
Patients and designated providers who hold valid authorizations but aren’t entered into the database will have an affirmative defense to criminal prosecution if they possess no more than four plants and six ounces of usable marijuana. They may purchase only in accordance with the laws and rules for non-patients.”
On July 24, 2015, post-traumatic stress disorder (PTSD), and traumatic brain injury were added to the state’s list of qualifying medical conditions.
On July 01, 2016, Washington’s new medical marijuana regulation bill, the Cannabis Protection Act, goes into full effect in an effort to integrate, the medical and regulated recreational markets. The Act aims to clarify the definition of “medical use of marijuana”, in addition to creating a voluntary state patient authorization database — medical marijuana patients who register with the database will be afforded a tax break on the cost of the medical marijuana.
The Washington Department of Health (DOH) is responsible for implementing the infrastructure and rules for regulation of, the Consultant Certification Program, Authorization Database, and Product Compliance. The DOH is also responsible for consulting with the Liquor and Cannabis Board about the requirements for retail store’s medical marijuana endorsements; as well as for preparing and structuring the continuing education material for health practitioners authorizing the medical use of marijuana by patients with a debilitating medical condition. Finally, the DOH is also responsible for making recommendations to the legislature, on the requirements for establishing medical marijuana specialty clinics.
“Washington’s Medical Marijuana Law” — CHAPTER 69.51A RCW
69.51A.005 Purpose and intent.
69.51A.030 Acts not constituting crimes or unprofessional conduct—Healthcare professionals not subject to penalties or liabilities.
69.51A.040 Compliance with chapter—Qualifying patients and designated providers not subject to penalties—Law enforcement not subject to liability.
69.51A.043 Failure to register—Affirmative defense.
69.51A.045 Possession of plants, marijuana concentrates, usable marijuana, or marijuana-infused products exceeding lawful amount—Affirmative defense.
69.51A.050 Medical marijuana, lawful possession—State not liable.
69.51A.055 Limitations of chapter—Persons under supervision.
69.51A.060 Crimes—Limitations of chapter.
69.51A.085 Collective gardens.
69.51A.090 Applicability of valid documentation definition.
69.51A.100 Qualifying patient’s designation of a specific designated provider—Provider’s service as designated provider—Termination—Department may adopt rules.
69.51A.110 Suitability for organ transplant.
69.51A.120 Parental rights or residential time—Not to be restricted.
69.51A.130 State and municipalities—Not subject to liability.
69.51A.210 Qualifying patients or designated providers—Authorization—Healthcare professional may include recommendations on amount of marijuana.
69.51A.220 Health care professionals may authorize medical use of marijuana—Qualifying patients under age eighteen.
69.51A.230 Medical marijuana authorization database—Recognition cards.
69.51A.240 Unlawful actions—Criminal penalty.
69.51A.250 Cooperatives—Qualifying patients or designated providers may form—Requirements—Restrictions on locations—State liquor and cannabis board may adopt rules.
69.51A.260 Housing unit—No more than fifteen plants may be grown or located—Exception—Civil penalties.
69.51A.270 Extracting or separating marijuana resin, producing or processing any form of marijuana concentrates or marijuana-infused products—State liquor and cannabis board to adopt rules.
69.51A.280 Topical, ingestible products—THC concentration.
69.51A.290 Medical marijuana consultant certificate.
69.51A.300 Continuing education programs for healthcare providers.
69.51A.900 Short title—1999 c 2.
69.51A.901 Severability—1999 c 2.
69.51A.902 Captions not law—1999 c 2.
69.51A.903 Severability—2011 c 181.
69.51A.005 Purpose and intent.
(1) The legislature finds that:
(a) There is medical evidence that some patients with terminal or debilitating medical conditions may, under their health care professional’s care, benefit from the medical use of marijuana. Some of the conditions for which marijuana appears to be beneficial include, but are not limited to:
(i) Nausea, vomiting, and cachexia associated with cancer, HIV-positive status, AIDS, hepatitis C, anorexia, and their treatments;
(ii) Severe muscle spasms associated with multiple sclerosis, epilepsy, and other seizure and spasticity disorders;
(iii) Acute or chronic glaucoma;
(iv) Crohn’s disease; and
(v) Some forms of intractable pain.
(b) Humanitarian compassion necessitates that the decision to use marijuana by patients with terminal or debilitating medical conditions is a personal, individual decision, based on their health care professional’s professional medical judgment and discretion.
(2) Therefore, the legislature intends that, so long as such activities are in strict compliance with this chapter:
(a) Qualifying patients with terminal or debilitating medical conditions who, in the judgment of their health care professionals, may benefit from the medical use of marijuana, shall not be arrested, prosecuted, or subject to other criminal sanctions or civil consequences under state law based solely on their medical use of marijuana, notwithstanding any other provision of law;
(b) Persons who act as designated providers to such patients shall also not be arrested, prosecuted, or subject to other criminal sanctions or civil consequences under state law, notwithstanding any other provision of law, based solely on their assisting with the medical use of marijuana; and
(c) Health care professionals shall also not be arrested, prosecuted, or subject to other criminal sanctions or civil consequences under state law for the proper authorization of medical use of marijuana by qualifying patients for whom, in the health care professional’s professional judgment, the medical use of marijuana may prove beneficial.
(3) Nothing in this chapter establishes the medical necessity or medical appropriateness of marijuana for treating terminal or debilitating medical conditions as defined in RCW 69.51A.010.
(4) Nothing in this chapter diminishes the authority of correctional agencies and departments, including local governments or jails, to establish a procedure for determining when the use of marijuana would impact community safety or the effective supervision of those on active supervision for a criminal conviction, nor does it create the right to any accommodation of any medical use of marijuana in any correctional facility or jail.
[ 2015 c 70 § 16; 2011 c 181 § 102; 2010 c 284 § 1; 2007 c 371 § 2; 1999 c 2 § 2 (Initiative Measure No. 692, approved November 3, 1998).]
Short title—Findings—Intent—References to Washington state liquor control board—Draft legislation—2015 c 70: See notes following RCW 66.08.012.
Intent—2007 c 371: “The legislature intends to clarify the law on medical marijuana so that the lawful use of this substance is not impaired and medical practitioners are able to exercise their best professional judgment in the delivery of medical treatment, qualifying patients may fully participate in the medical use of marijuana, and designated providers may assist patients in the manner provided by this act without fear of state criminal prosecution. This act is also intended to provide clarification to law enforcement and to all participants in the judicial system.” [ 2007 c 371 § 1.]
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1)(a) Until July 1, 2016, “authorization” means:
(i) A statement signed and dated by a qualifying patient’s health care professional written on tamper-resistant paper, which states that, in the healthcare professional’s professional opinion, the patient may benefit from the medical use of marijuana; and
(ii) Proof of identity such as a Washington state driver’s license or identicard, as defined in RCW 46.20.035.
(b) Beginning July 1, 2016, “authorization” means a form developed by the department that is completed and signed by a qualifying patient’s health care professional and printed on tamper-resistant paper.
(c) An authorization is not a prescription as defined in RCW 69.50.101.
(2) “CBD concentration” means the percent of cannabidiol content per dry weight of any part of the plant Cannabis, or per volume or weight of marijuana product.
(3) “Department” means the department of health.
(4) “Designated provider” means a person who is twenty-one years of age or older and:
(a)(i) Is the parent or guardian of a qualifying patient who is under the age of eighteen and beginning July 1, 2016, holds a recognition card; or
(ii) Has been designated in writing by a qualifying patient to serve as the designated provider for that patient;
(b)(i) Has an authorization from the qualifying patient’s health care professional; or
(ii) Beginning July 1, 2016:
(A) Has been entered into the medical marijuana authorization database as being the designated provider to a qualifying patient; and
(B) Has been provided a recognition card;
(c) Is prohibited from consuming marijuana obtained for the personal, medical use of the qualifying patient for whom the individual is acting as designated provider;
(d) Provides marijuana to only the qualifying patient that has designated him or her;
(e) Is in compliance with the terms and conditions of this chapter; and
(f) Is the designated provider to only one patient at any one time.
(5) “Health care professional,” for purposes of this chapter only, means a physician licensed under chapter 18.71 RCW, a physician assistant licensed under chapter 18.71A RCW, an osteopathic physician licensed under chapter 18.57 RCW, an osteopathic physicians’ assistant licensed under chapter 18.57A RCW, a naturopath licensed under chapter 18.36A RCW, or an advanced registered nurse practitioner licensed under chapter 18.79 RCW.
(6) “Housing unit” means a house, an apartment, a mobile home, a group of rooms, or a single room that is occupied as separate living quarters, in which the occupants live and eat separately from any other persons in the building, and which have direct access from the outside of the building or through a common hall.
(7) “Low THC, high CBD” means products determined by the department to have a low THC, high CBD ratio under RCW 69.50.375. Low THC, high CBD products must be inhalable, ingestible, or absorbable.
(8) “Marijuana” has the meaning provided in RCW 69.50.101.
(9) “Marijuana concentrates” has the meaning provided in RCW 69.50.101.
(10) “Marijuana processor” has the meaning provided in RCW 69.50.101.
(11) “Marijuana producer” has the meaning provided in RCW 69.50.101.
(12) “Marijuana retailer” has the meaning provided in RCW 69.50.101.
(13) “Marijuana retailer with a medical marijuana endorsement” means a marijuana retailer that has been issued a medical marijuana endorsement by the state liquor and cannabis board pursuant to RCW 69.50.375.
(14) “Marijuana-infused products” has the meaning provided in RCW 69.50.101.
(15) “Medical marijuana authorization database” means the secure and confidential database established in RCW 69.51A.230.
(16) “Medical use of marijuana” means the manufacture, production, possession, transportation, delivery, ingestion, application, or administration of marijuana for the exclusive benefit of a qualifying patient in the treatment of his or her terminal or debilitating medical condition.
(17) “Plant” means a marijuana plant having at least three distinguishable and distinct leaves, each leaf being at least three centimeters in diameter, and a readily observable root formation consisting of at least two separate and distinct roots, each being at least two centimeters in length. Multiple stalks emanating from the same root ball or root system is considered part of the same single plant.
(18) “Public place” has the meaning provided in RCW 70.160.020.
(19) “Qualifying patient” means a person who:
(a)(i) Is a patient of a health care professional;
(ii) Has been diagnosed by that health care professional as having a terminal or debilitating medical condition;
(iii) Is a resident of the state of Washington at the time of such diagnosis;
(iv) Has been advised by that health care professional about the risks and benefits of the medical use of marijuana;
(v) Has been advised by that health care professional that they may benefit from the medical use of marijuana;
(vi)(A) Has an authorization from his or her health care professional; or
(B) Beginning July 1, 2016, has been entered into the medical marijuana authorization database and has been provided a recognition card; and
(vii) Is otherwise in compliance with the terms and conditions established in this chapter.
(b) “Qualifying patient” does not include a person who is actively being supervised for a criminal conviction by a corrections agency or department that has determined that the terms of this chapter are inconsistent with and contrary to his or her supervision and all related processes and procedures related to that supervision.
(20) “Recognition card” means a card issued to qualifying patients and designated providers by a marijuana retailer with a medical marijuana endorsement that has entered them into the medical marijuana authorization database.
(21) “Retail outlet” has the meaning provided in RCW 69.50.101.
(22) “Secretary” means the secretary of the department of health.
(23) “Tamper-resistant paper” means paper that meets one or more of the following industry-recognized features:
(a) One or more features designed to prevent copying of the paper;
(b) One or more features designed to prevent the erasure or modification of information on the paper; or
(c) One or more features designed to prevent the use of counterfeit authorization.
(24) “Terminal or debilitating medical condition” means a condition severe enough to significantly interfere with the patient’s activities of daily living and ability to function, which can be objectively assessed and evaluated and limited to the following:
(a) Cancer, human immunodeficiency virus (HIV), multiple sclerosis, epilepsy or other seizure disorder, or spasticity disorders;
(b) Intractable pain, limited for the purpose of this chapter to mean pain unrelieved by standard medical treatments and medications;
(c) Glaucoma, either acute or chronic, limited for the purpose of this chapter to mean increased intraocular pressure unrelieved by standard treatments and medications;
(d) Crohn’s disease with debilitating symptoms unrelieved by standard treatments or medications;
(e) Hepatitis C with debilitating nausea or intractable pain unrelieved by standard treatments or medications;
(f) Diseases, including anorexia, which result in nausea, vomiting, wasting, appetite loss, cramping, seizures, muscle spasms, or spasticity, when these symptoms are unrelieved by standard treatments or medications;
(g) Posttraumatic stress disorder; or
(h) Traumatic brain injury.
(25) “THC concentration” has the meaning provided in RCW 69.50.101.
(26) “Usable marijuana” has the meaning provided in RCW 69.50.101.
[ 2015 c 70 § 17; 2010 c 284 § 2; 2007 c 371 § 3; 1999 c 2 § 6 (Initiative Measure No. 692, approved November 3, 1998).]
* Please note: As of November 02, 2008, qualified patients and designated caregivers, may possess up to twenty-four (24) ounces of usable cannabis, in addition to cultivating up to fifteen (15) mature marijuana plants. However, as per the Cannabis Protection Act, effective July 01, 2016, the possession amounts will change depending on whether or not the patient/provider, has been registered in the state’s marijuana database. Patients and caregivers/providers, who have registered with the state’s database, may legally possess up to eight(8) ounces of usable marijuana, and may cultivate up to six (6) cannabis plants – healthcare practitioners may authorize patients to cultivate up to fifteen (15) plants, and possess up to sixteen (16) ounces.