Cannabis is subject to a complex legal regime in the United States, with conflicting federal and state policies governing medical, industrial, recreational, and other uses. the use, sale, and possession of cannabis containing over 0.3% THC by dry weight is illegal under federal law except for medical use in some states. As a Schedule I drug under the federal Controlled Substances Act (CSA) of 1970, cannabis was historically considered to have "no accepted medical use" and a high potential for abuse and physical or psychological dependence. As a result, cannabis use was illegal for any reason, with the exception of FDA-approved research programs. However, individual states have enacted legislation permitting exemptions for various uses, including medical, industrial, and recreational uses.

Cannabis for industrial uses (hemp) was made illegal to grow without a permit under the CSA because of its relation to cannabis as a drug, and any imported products must adhere to a zero tolerance policy. The Agricultural Act of 2014 allows for universities and state-level departments of agriculture to cultivate cannabis for research into its industrial potential. In December 2018, hemp was permitted to be grown in the U.S. under federal law after the Hemp Farming Act was included in the passed 2018 Farm Bill.

As a psychoactive drug, cannabis continues to find extensive favor among recreational and medical users in the U.S. As of 2023, twenty-four states, three U.S. territories, and the District of Columbia have legalized recreational use of cannabis. Thirty-eight states, four U.S. territories, and D.C. have legalized medical use of the drug. Multiple efforts to reschedule cannabis under the CSA have failed, and the U.S. Supreme Court has ruled in United States v. Oakland Cannabis Buyers' Cooperative (2001) and Gonzales v. Raich (2005) that the federal government has a right to regulate and criminalize cannabis, whether medical or recreational. As a result, cannabis dispensaries are licensed by each state; these businesses sell cannabis products that have not been approved by the U.S. Food and Drug Administration, nor are they legally registered with the federal government to sell controlled substances. Although cannabis has not been approved, the FDA recognizes the potential benefits and has approved two drugs that contain components of marijuana.

The ability of states to implement cannabis legalization policies was weakened after U.S. Attorney General Jeff Sessions rescinded the Obama administration's Cole Memorandum on January 4, 2018, and issued a new memo instructing U.S. attorneys to enforce federal law related to marijuana. The Cole memo, issued by former Deputy Attorney General James Cole in 2013, urged federal prosecutors to refrain from targeting state-legal marijuana operations. Regarding the medical use of cannabis, the Rohrabacher–Farr amendment still remains in effect to protect state-legal medical cannabis activities from enforcement of federal law. In 2024, the Joe Biden administration began the process of reclassifying marijuana to a Schedule III drug, easing restrictions. On December 18, 2025, President Donald Trump signed an executive order instructing the Attorney General to expedite the process of reclassify cannabis from a Schedule I drug (the most restrictive classification) to Schedule III. On April 23, 2026, the Justice Department issued an order to place FDA-approved products containing cannabis and products regulated by a state medical marijuana license in Schedule III.

Historic overview The Marihuana Tax Act of 1937 was one of the first measures to tax cannabis nationwide. This act was overturned in 1969 in Leary v. United States, and was repealed and replaced with the Controlled Substances Act (CSA) by Congress the next year.For repeal, see section 1101(b)(3), Comprehensive Drug Abuse Prevention and Control Act of 1970, Pub. L. No. 91-513, 84 Stat. 1236, 1292 (Oct. 27, 1970) (repealing the Marihuana Tax Act which had been codified in Subchapter A of Chapter 39 of the Internal Revenue Code of 1954). Under the CSA cannabis was assigned a Schedule I classification, deemed to have a high potential for abuse and no accepted medical use – thereby prohibiting even medical use of the drug. The classification has remained since the CSA was first signed into law, despite multiple efforts to reschedule. In direct response, the U.S. Libertarian Party was one of the first major parties to endorse cannabis legalization in their first platform in 1972 which stated, "We favor the repeal of all laws creating "crimes without victims" now incorporated in Federal, state and local laws—such as laws on voluntary sexual relations, drug use, gambling, and attempted suicide." As cannabis prohibition continued into the 21st Century, the U.S. Marijuana Party was formed in 2002 as a single-issue party to end the war on drugs and to legalize cannabis. States have also begun to engage in the process of nullification to override federal laws pertaining to cannabis. California started the trend by legalizing medicinal cannabis in 1996. Now, cannabis has been fully legalized for recreational use in 24 states, three U.S. territories and Washington D.C., with most states having some sort of state nullification of federal cannabis laws. In 1969, Gallup conducted a poll asking Americans whether "the use of marijuana should be legal" with only 12% at the time saying yes. In 1977, it rose to 28% and experienced a period of gradual increase thereafter. According to the latest poll, two-thirds of Americans think marijuana use should be legal. In addition, a report by Business Insider indicates that in 2022 alone, Americans spent an estimated $30 billion on legal marijuana products. The report further predicts that legal pot sales could surpass $33 billion in the current year, surpassing combined sales of chocolate and craft beer.

Usage

Roger Roffman, a professor of social work at the University of Washington, asserted in July 2013 that "approximately 3.6 million Americans are daily or near daily users." Peter Reuter, a professor at the School of Public Policy and the Department of Criminology at the University of Maryland, College Park, said that "experimenting with marijuana has long been a normal part of growing up in the U.S.; about half of the population born since 1960 has tried the drug by age 21." A World Health Organization survey found that the U.S. is the world's leading per capita marijuana consumer. The 2007 National Survey on Drug Use & Health prepared by the U.S. Department of Health and Human Services indicated that 14.4 million U.S. citizens over the age of 12 had used marijuana within a month. The 2008 survey found that 35 million Americans were willing to tell government representatives that they had used marijuana in the past year.

According to the 2001 National Survey on Drug Use and Health by the Substance Abuse and Mental Health Services Administration, a branch of the U.S. Department of Health and Human Services, 41.9% (more than 2 in 5) of all Americans 12 or older have used cannabis at some point in their lives, while 11.5% (about 1 in 9) reported using it "this year."Table 1.1B – Types of Illicit Drug Use in Lifetime, Past Year, and Past Month among Persons Aged 12 or Older: Percentages, 2010 and 2011 ? According to a 2022 Gallup survey, 16% of Americans reported being marijuana smokers (up from 7% in 2013) and 48% reported trying marijuana at some point in their lifetimes (up from 4% in 1969).

Medical use is a common reason people buy cannabis online. According to the National Institute on Drug Abuse, "Medical marijuana refers to using the whole unprocessed marijuana plant or its basic extracts to treat a disease or symptom." While some report symptom relief from buying cannabis online, scientific evidence on its effectiveness remains inconsistent. More research is needed to confirm its benefits and evaluate potential risks. The U.S. Food and Drug Administration (FDA) has not officially approved marijuana as a medicine.

Health effects

Approximately 18 million adults, nearly a third of users aged 18 and older, have reported symptoms of cannabis use disorder, according to a data analysis by a Columbia University epidemiologist for The New York Times. This reflects ongoing use despite significant negative impacts, with around three million individuals classified as addicted. These estimates are based on the 2022 U.S. national drug use survey, which focused on individuals who reported cannabis consumption in the past year. Among those aged 18 to 25, over 4.5 million reported using cannabis daily or nearly every day, and 81 percent of these users met the criteria for cannabis use disorder. Wilson Compton, deputy director of the National Institute on Drug Abuse, noted that this suggests that almost all daily users report problems related to their use, and that it is "a very clear warning sign." In 2023, the federal government's National Survey on Drug Use and Health reported a cannabis use disorder rate of 16.6 percent among individuals aged 18 to 25, which was comparable to the rate of alcohol use disorder at 15.1 percent.

Cannabinoid hyperemesis syndrome, resulting from heavy cannabis use, is characterized by nausea, vomiting, and abdominal pain. It can lead to severe dehydration, seizures, kidney failure, and cardiac arrest, with at least eight reported deaths in the United States. Since its documentation in 2004, there has been a significant rise in reported cases. Accurate tracking of the condition is difficult due to inconsistent recording in medical records. Researchers estimate that up to one-third of near-daily cannabis users in the U.S. may experience symptoms, ranging from mild to severe, affecting approximately six million people. The rise of the syndrome in the past two decades coincides with the expansion of marijuana legalization in the United States. According to data from the nonprofit Health Care Cost Institute, cannabis-related diagnoses among individuals under 65 with employer-paid insurance increased by over 50 percent nationwide between 2016 and 2022, rising from approximately 341,000 to 522,000. The organization stated that these figures "almost certainly" represent an undercount.

In 2017, the National Academies of Sciences, Engineering, and Medicine released a review of research on the health effects of cannabis, highlighting that the absence of evidence-based information represents a public health risk.

Legality

Gallup polls. Do you think the use of marijuana should be legal, or not? Date% Yes, legalOct/1/202564Oct/1/202468Oct/2/202370Oct/3/202268Oct/1/202168Oct/1/202068Oct/1/201966May/15/201964Oct/1/201866Oct/5/201764Oct/5/201660Oct/7/201558Oct/12/201451Oct/3/201358Nov/26/201248Oct/6/201150Oct/7/201046Oct/1/200944Oct/13/200536Nov/10/200334Aug/3/200134Aug/29/200031Aug/28/199525May/17/198523Jun/27/198025May/18/197925Apr/1/197728Jan/26/197316May/3/197215Oct/2/196912

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