Key takeaways:
Medical cannabis (marijuana) and adult-use (recreational) weed are two categories of cannabis.
Medical and adult use are legal categories, not different kinds of cannabis plants or products.
To purchase medical cannabis products through a state's medical program, you must have a healthcare professional’s authorization and approval (a “card”) from the state.
Anyone aged 21 and over can purchase adult-use cannabis products.
Medical and adult-use (recreational) cannabis are the two categories of state-regulated cannabis in the U.S. The differences between them can be confusing. And while one or both are legal in some states, all cannabis is still illegal at the federal level.
Here’s a breakdown of the differences between medical and adult-use cannabis and what they’re used for.
What is medical marijuana?
Medical marijuana (or the preferred term, medical cannabis) is state-regulated cannabis that’s intended for medical purposes. Medical cannabis regulations vary between states. Some have a specific list of health conditions that determine who’s eligible for medical cannabis. Others leave it up to your prescriber to decide if medical cannabis may help your specific health condition.
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Most states require both the healthcare professional and the person consuming the cannabis to register with the state medical cannabis program. This process also differs between states, as does which healthcare professionals are allowed to recommend medical cannabis.
Despite its name, medical cannabis products aren't regulated by the FDA the way pharmaceutical medications are. Instead, they’re regulated by the state they’re sold in. And there aren’t approved doses or formulations of medical cannabis for specific health conditions.
This means that legally, healthcare professionals can’t prescribe medical cannabis. They can only certify that you qualify for it or “recommend” it as a possible treatment option. This can make it hard for people to know what products to purchase and what dosage to take when they go to a medical cannabis dispensary.
Good to know: There is one FDA-approved cannabis-based medication: Epidiolex (cannabidiol). It’s a prescription medication for rare forms of childhood epilepsy.
What do people use medical cannabis for?
Cannabis is one of the oldest medicines in the world. Millions of people in the U.S. currently use medical cannabis for conditions like epilepsy, multiple sclerosis, and nausea from chemotherapy.
Chronic pain seems to be the most common reason people turn to medical cannabis. According to a 2020 survey of over 9,000 people, anxiety, insomnia, and depression are also common reasons for consuming it.
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Other conditions that people use medical cannabis for include:
Post-traumatic stress disorder
Anorexia and weight loss
Irritable bowel syndrome
Inflammatory bowel disease
Substance use disorders
Traumatic brain injury
Huntington’s disease
Parkinson’s disease
Alzheimer’s disease
Keep in mind: Just because people use cannabis for these conditions doesn’t mean there’s clinical evidence that it actually helps. And like any substance, it has drug interactions and side effects to consider. So it’s best to discuss medical cannabis with your healthcare team to see if it’s a safe option for your specific needs.
What is recreational weed?
Adult-use (recreational) cannabis refers to laws that allow anyone over the age of 21 to buy cannabis products. As of April 2023, 24 states, two territories, and the District of Columbia have legalized adult-use cannabis. These laws treat cannabis like alcohol by allowing adults to buy it without a doctor’s recommendation.
Adult-use dispensaries are also state-regulated.
Keep in mind: It’s common for unlicensed adult-use shops to open after states pass legalization laws. So knowing how to identify licensed dispensaries in your area is important to protect your safety.
How do people use recreational cannabis?
Most people associate recreational cannabis use with “getting high.” But the preferred term is now “adult use” instead of “recreational use,” because there are many reasons people consume cannabis other than just for recreation.
U.S. adults are increasingly turning to cannabis to improve their overall health and wellness. And many people purchase cannabis at recreational dispensaries for medical reasons, too.
Some of the reasons people consume cannabis are:
To help with motivation and recovery related to exercising
To help with stress relief
For creative inspiration
Keep in mind: It’s possible to consume cannabis without getting high. Low doses (1 mg to 2 mg) of tetrahydrocannabinol (THC) or products that have more cannabidiol (CBD) than THC are less likely to cause a euphoric effect. But everyone responds to cannabis differently, so it may take some trial and error to find the product that works best for you without making you feel intoxicated.
Is there a quality difference between medicinal and recreational marijuana?
It depends. The cannabis plants used to make medical and adult-use cannabis products are the same. But each state has different regulations for the products sold in cannabis dispensaries. A state’s regulations are usually the same for both medical and adult-use locations, but not always.
Here are the main ways medical and adult-use cannabis products can differ:
Potency: Some states have a cap on how potent cannabis products can be. Others allow more potent products in medical dispensaries, since they’re only accessible with a healthcare professional’s approval.
Dosage forms: Cannabis comes in many different forms, from smokable plant material to edible candy. Different products may be available at different types of dispensaries. Often, things like capsules and tinctures are more common at medical dispensaries, and things like joints and gummies are more common at adult-use dispensaries.
Contaminants: Cannabis products can contain contaminants like pesticides and heavy metals. So states often have regulations that limit the amount of contaminants in regulated products. Sometimes, these regulations are stricter for medical products, since people with medical conditions may be more sensitive to contaminants.
Accessibility: You can only purchase medical cannabis with approval from a healthcare professional. And many states won’t allow you to purchase medical cannabis with an out-of-state medical card. Adult-use dispensaries are generally open to anyone, whether they’re a state resident or not.
How to determine the quality of your cannabis
The best way to learn about the quality of any legal cannabis product is to do your research:
Shop at regulated dispensaries. The best place to start is your state government website. Most states have an online registry of legal dispensaries. Your state may also have a license that regulated dispensaries are required to have on display.
Check the label. Regulated products should have the ingredients listed clearly, a lot number, and an expiration date. They should also include the manufacturer’s name and contact information.
Ask for a certificate of analysis. Regulated dispensaries should only sell products that have a certificate of analysis. This is a test result showing potency results and contaminant levels done by an independent laboratory. Every state has a different list of required tests. Often, it’s accessible via a QR code on the packaging, but the dispensary should also be able to provide it to you upon request.
Search for the lab name. It’s also worth doing a quick online search for the name of the lab that conducted the cannabis testing. Cannabis labs are frequently caught manipulating test results. An online search can help you find information about labs that have been fined for breaking rules.
What are the THC and CBD levels in medicinal vs. recreational weed?
It depends on your state laws. People often think that medical cannabis is higher in THC, but that’s not necessarily true.
Cannabis contains more than 100 active compounds, called cannabinoids. The two most common cannabinoids are THC and CBD. THC is the primary mind-altering chemical found in cannabis that gives people a “high” feeling. It’s also helpful for nausea and pain relief. CBD is not intoxicating but also has medical uses. Products may also contain other cannabinoids, such as cannabinol (CBN) and cannabigerol (CBG).
The majority of both medical and adult-use cannabis is high in THC and low in CBD, according to one nationwide study. But medical dispensaries may have a wider variety of products, including high CBD and balanced THC and CBD items. This helps meet a wider variety of medical needs. Sometimes, medical dispensaries also have products with a higher THC potency for the same reason. But as mentioned, this can vary from state to state. And sometimes the opposite is true, with adult-use dispensaries having a wider variety of potencies available.
The best way to know what’s available in the different dispensaries is to review your state regulations. You can also call or stop by a registered dispensary — the staff should be knowledgeable about your local regulations.
Is there a price difference between medical and adult-use cannabis?
Yes. Medical cannabis is often more affordable than adult-use cannabis. This is usually because medical cannabis often isn’t taxed as heavily as adult-use cannabis. And you may be able to purchase a larger quantity of cannabis with a medical card.
But prices can also vary widely between states. For example, some states require a pharmacist in medical cannabis dispensaries. And the cost of having a medical professional on-site results in more expensive medical cannabis products than in states without this requirement.
What is the legal status of medical and adult-use cannabis?
According to federal law, all cannabis is illegal. This includes both medical and adult-use cannabis that’s regulated at the state level. However, there is a growing movement in Congress to legalize cannabis nationwide.
Keep in mind that federal law overrides state laws. So until the legal status of cannabis changes at the federal level, there are some important things to consider:
Taking cannabis across state lines is illegal
Flying with cannabis is illegal
Testing positive for cannabis can lead to a employer denying you a job in most cases
Consuming cannabis can lead to losing housing, healthcare insurance, or child custody
It’s a good idea to weigh the benefits and risks before consuming cannabis. In many cases, you can minimize your risk of legal action by consuming cannabis responsibly according to your state laws.
How to get legal weed
The process for purchasing regulated cannabis, as with the previous topics covered, depends on your state regulations. But here are some general tips to consider.
Medical cannabis
If you want to purchase medical cannabis products, you must enroll in your state’s medical cannabis program. You’re usually required to be a resident of the state. And most states require a healthcare professional’s recommendation to become a medical cannabis patient. Visit your state’s medical cannabis regulator to learn more.
For example, these steps are required to receive a medical card from California’s Department of Cannabis Control:
Fill out a medical cannabis application.
Gather supporting documents, including proof of identity, residency, and a medical recommendation from a licensed healthcare professional.
Make an appointment at your local county health department.
File your application, and pay an application fee at the health department.
Keep in mind: Not all healthcare professionals may be willing or able to recommend medical cannabis. Your state should have information on what kinds of medical professionals can recommend it. But the best place to start is usually your primary care provider. You can also contact a local medical dispensary for information on how you can obtain a medical cannabis recommendation and the procedure in your state.
Adult-use cannabis
Anyone over the age of 21 can buy cannabis from an adult-use cannabis store. You do not need to be a state resident. However, remember that you cannot legally carry recreational cannabis across state lines.
The bottom line
Medical cannabis and adult-use cannabis are two different state-regulated categories of the same substance. Medical cannabis requires a healthcare professional’s recommendation. Adult-use cannabis is available to anyone ages 21 or over.
People consume both medical cannabis and recreational cannabis for a wide variety of reasons. And in most cases, regulated products have similar safety and quality. But there may be a difference in the available dosage forms, potencies, and purchase amounts between the two types of dispensaries. And in most cases, medical cannabis is more affordable, since it’s not taxed as heavily.
Why trust our experts?
If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-HELP (4357) to learn about resources in your area.
Keep in mind that cannabis is legal in some states for recreational and/or medicinal use, but not in others. Cannabis is still illegal under federal law. Before you use cannabis products, find out the laws in your state.
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