Next year, Oklahomans will vote on State Question 788, a ballot initiative to legalize medical marijuana. As of 2017, 29 states have approved measures legalizing the drug for medical purposes. We often think of legalization in binary terms — either medical marijuana is allowed, or it isn’t — but in practice, the systems put in place by those 29 states to regulate the drug vary greatly. Each state has many choices to make about how patients can be prescribed marijuana, how much they can have, and where they get it from. Some states choose permissive systems that lead to higher numbers of patients and dispensaries; other states restrict prescriptions to people with specified conditions and few or no dispensaries.

In contrast with the states that left the design of most of those regulations to state agencies, the language of SQ 788 is specific on many details. It would put in place laws that decide how a person applies for and receives a license to use medical marijuana; the quantities that a license holder can possess; the qualifications and licensing process for retailers, growers, processors, and transporters; and the tax rate and distribution of revenue from sales. When compared to other systems, SQ 788 would put in place a system that is on the permissive side, but well within the current spectrum of laws.

Researchers at the University of California-San Francisco reviewed the policies of each state that had passed comprehensive medical marijuana laws as of 2014 and assigned restrictiveness scores based on the ease of patient access; the quantity allowed to license holders; and the method of distribution. The overall restrictiveness scores are shown on the map below.

Here’s how Oklahoma’s medical marijuana system would compare to these states if SQ 788 passes:

Patient access

Under SQ 788, Oklahoma residents can apply to the Department of Health for a medical marijuana user license. Applicants would pay a fee of $100 ($25 for those on Medicare or SoonerCare), and applications would have to be approved by a board certified physician “according to the accepted standards a reasonable and prudent physician would follow when recommending or approving any medication.” Other than approval by a physician, SQ 788 would not require a diagnosis of a specific condition to prescribe medical marijuana.

Among the states that permit medical marijuana already, only California does not specify conditions that qualify a person for access to the drug. The rest limit access mostly to people with severe conditions like cancer, glaucoma, HIV/AIDS, and severe and chronic pain. Applicants in those states need to have their diagnosis certified by a physician in order to qualify for a license.

While specifying qualifying conditions is meant to limit access to those with relatively serious conditions, there is evidence that this is not always effective. In some states, doctors’ offices have sprung up that certify the applications of just about anyone. In Arizona, for example, six physicians wrote 61 percent of all medical marijuana certifications in the state, according to a 2013 study. Some states have countered this trend by requiring an established relationship between patient and physician for a period of time (for example, three months in New Hampshire and six months in Vermont).

Quantity

All states limit how much marijuana a person can possess at one time and in what form. The quantity of useable marijuana allowed by state regulations differs widely from 1 to 24 ounces. In addition, many states allow license holders to grow marijuana at home, limiting the number of plants from as few as 6 in Colorado, Alaska, and Maine to as many as 24 in Oregon.

SQ 788 would allow license holders to possess up to 8 ounces of marijuana, 6 mature marijuana plants, and 6 seedling plants, as well as 1 ounce of concentrated marijuana and 72 ounces of edible marijuana. These amounts are toward the high end of the range but considerably less that what’s allowed in places like Washington state.

Dispensaries

Although some states initially allowed only home-grown marijuana, most now allow retail dispensaries to sell the drug to license holders. In some states, the number of licenses for such businesses is strictly limited — Maine and Minnesota, for example, each allow only 8 dispensaries throughout their entire states, New Hampshire only 4. Other states, like California, leave most regulations to local governments. Some states prohibit dispensaries from operating within a certain distance from a school.

In this area as well, the proposal before Oklahomans next year will be on the permissive side, though not out of step with other states. Although it restricts dispensaries from opening within 1,000 feet of any school entrance (further than many other states with zoning provisions), it also prohibits local governments from changing their own zoning laws “to prevent the opening of a retail marijuana establishment” and places no limit on how many establishments would be allowed to operate.

Legislators could make changes after SQ 788’s passage

SQ 788 is by no means radical. It is on the permissive side of the medical marijuana regulation spectrum, but that shouldn’t be surprising given that the proposal was drafted by activists. Since it was approved as a statutory rather than constitutional measure, the Legislature would be able to amend the law with a simple majority vote. Lawmakers will hold an interim study on SQ 788 in October to clarify details of the proposal and hear from states that have already implemented medical marijuana.

While many Oklahoma legislators are likely skeptical of the idea of marijuana as medicine, they’re right to prepare for the possibility of SQ 788 passing. In a 2013 poll, over 70 percent of Oklahomans supported “allowing seriously ill patients to possess marijuana for medical purposes with a physician’s recommendation.” Recent national polls show 88 percent of all Americans in favor of medical marijuana and 60 percent in favor of legalizing recreational marijuana, a trend of support that has been increasing over time.

States have experimented with loosening marijuana laws for over two decades, and the pace of liberalization has quickened in recent years. We’ll know next year if Oklahomans decide that we’re ready to try it for ourselves.