Becoming a Medical Marijuana Patient in New Hampshire

David Bowman

New Member
Patients and caregivers registered with the New Hampshire Department of Health's medical cannabis program are protected from arrest or prosecution and may not be denied any right or privilege on the basis of their status. If charged, registration provides an affirmative defense for patients or caregivers provided they were in possession of cannabis in a quantity and at a location permitted by the law.

What's Legal
To be protected under the law, patients and caregivers must be registered with the Rhode Island Department of Health and in possession of a registry ID card. Qualifying patients registered with the program will be allowed to possess up to two (2) ounces of cannabis. Possession of cannabis by a registered patient not in possession of the issued ID card is subject to a fine of $100. No cultivation of cannabis is allowed. Medicine must be obtained by the patient or registered caregiver from one of four "Alternative Treatment Centers" to be licensed by the state to dispense cannabis to patients. The law requires the Department of Health to issue rules for licensing dispensing centers by January 2014 and to issue licenses to two centers by January 2015. A patient may designate on ly one caregiver, but a caregiver may assist up to five (5) patients. Caregivers are limited to transporting medicine from licensed centers and assisting with administration. Until Rhode Island begins issuing registry ID cards, there are no legal protections for patients or caregivers.

Eligible Conditions
  • Cancer,
  • glaucoma,
  • positive status for human immunodeficiency virus (HIV),
  • acquired immune deficiency syndrome (AIDS),
  • hepatitis C currently receiving antiviral treatment,
  • amyotrophic lateral sclerosis (ALS or Lou Gehrig's Disease),
  • muscular dystrophy,
  • Crohn's disease,
  • agitation of Alzheimer's disease,
  • multiple sclerosis,
  • chronic pancreatitis,
  • spinal cord injury or disease,
  • traumatic brain injury, or
  • one or more injuries that significantly interferes with daily activities as documented by the patient's physician.
Also qualifying are any severely debilitating or terminal medical conditions or their treatment that has produced at least one of the following:
  • elevated intraocular pressure,
  • cachexia,
  • chemotherapy-induced anorexia,
  • wasting syndrome,
  • severe pain that has not responded to previously prescribed medication or surgical measures or for which other treatment
  • options produced serious side effects,
  • constant or severe nausea,
  • moderate to severe vomiting,
  • seizures, or
  • severe, persistent muscle spasms.
Additionally, the department may include, on a case by case basis, any condition determined to be severely debilitating or terminal, based upon the written request of the patient's recommending physician.

Application Process
The Department of Health will establish a registration process but has not done so as of September 2013. You must be a current New Hampshire resident to be eligible and have written certification of a diagnosis of one of the qualifying conditions from a medical provider with whom you have an ongoing patient-provider relationship at least three months long. Once the application process is established, the department is to issue your registry ID card within five (5) days of approving your application or renewal. Registration expires after one year, unless your medical provider has indicated a shorter period of time for cannabis therapy.

The registry ID cards will contain your name, address and birth date; a passport-sized photo; a random 10-digit registration number; and the identification of the designated Alternative Treatment Center from which you will obtain your medicine.

You need to update your registration every year.

Registry Card Changes
Once registered, if there is a change in your name or address, you must notify the department within ten (10) days. Failure to notify can result in a fine up to $150. You must notify the department in advance of any change of designated caregiver or Alternative Treatment Center.

If you lose your registry card, you must notify the department within ten (10) days. A new card will be issued within five (5) days of notice for a fee yet to be determined.

Medical Provider
Your certifying medical provider must be licensed to prescribe medication and have an established relationship with you of at least three months in duration. Your medical provider can only recommend medical cannabis after an in-person exam, a history, a diagnosis, and a treatment plan appropriate to his or her specialty.

You may designate a single caregiver to assist you with obtaining and using medical marijuana. Your designated caregiver must be at least twenty-one (21) years old and cannot have a felony drug-related conviction. A registered caregiver with a valid registry ID card may assist with up to five (5) qualifying patients. If both the caregiver and qualifying patients live more than 50 miles from an "alternative treatment center" licensed to dispense medical cannabis, the designated caregiver may assist up to nine (9) patients.

Obtaining Cannabis for Qualified Patients
Medical cannabis patients in New Hampshire are required to obtain their medicine from licensed Alternative Treatment Centers. Cultivation is prohibited. Two Alternative Treatment Centers are to be licensed by January 2015.

Patients are expressly forbidden to smoke cannabis in public areas, on school grounds, or in correctional, law enforcement, or recreational facilities.

Age Limits
If you are under 18 years of age, you must designate a custodial parent or legal guardian who is responsible for your health care decisions as your primary caregiver. That person must submit the application on your behalf as well as sign a written consent and agree to responsibility for your acquisition and use of medical cannabis. and submit written certification from two medical providers, one of whom must be a pediatrician.

Applications and supporting information is considered confidential and is not to be disclosed to anyone who is not an authorized employee of the department in the course of official duties or local or state law enforcement who have detained or arrested a registered patient or caregiver. If law enforcement submits a sworn affidavit alleging violations by an individual or at a location, the department will verify if the individual or location is registered.

New Hampshire's medical marijuana law does not require a governmental, private, or any other health insurance provider or health care service plan to be liable for any claim for reimbursement for the medical use of marijuana.

Out of State Patients
Non-resident patients with state-issued IDs from other states are entitled to protection under New Hampshire law but are prohibited from purchasing cannabis from an Alternative Treatment Center or a registered New Hampshire patient or caregiver.

Source: ASA: Becoming a Patient in New Hampshire

Use of Cannabis for Therapeutic Purposes creates an exemption in state law from criminal penalties for the therapeutic use of cannabis provided that its use is in compliance with RSA 126-X. State law does not exempt a person from federal criminal penalties for the possession of cannabis. The current federal administration has declared its intention not to pursue or target patients and their caregivers who possess or use small amounts of cannabis for therapeutic use that is part of and compliant with a well regulated state therapeutic cannabis program. However, federal law does not allow for the medical or therapeutic use of cannabis, and the federal government can enforce federal cannabis laws anywhere in the United States, including in states that allow the therapeutic use of cannabis. Federal criminal penalties for the possession of cannabis, in any amount, range from misdemeanors to felonies, and may include incarceration and fines. To decrease the risk of any federal law enforcement action, patients and caregivers should know and abide by New Hampshire law with regard to the possession and use of therapeutic cannabis at all times.

FEDERAL FIREARMS NOTICE The U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) has directed federal firearms licensees, in an open letter issued in 2011, not to transfer firearms or ammunition to users of a controlled substance, including marijuana, regardless of whether their state has passed legislation authorizing marijuana use for medicinal purposes. According to the federal directive, any user of marijuana "is an unlawful user of or addicted to a controlled substance, and is prohibited by Federal law from possessing firearms or ammunition." If a federal firearms licensee is aware that a person is in possession of a card authorizing the possession and use of marijuana under state law, that licensee has "reasonable cause to believe" that the person is an unlawful user of a controlled substance, and may not transfer firearms or ammunition to that person, even if the person answered "no" to question 11.e on ATF Form 4473.

Link to ATF open letter:
Link to ATF Form 4473:
Prime Alternative Treatment Center has received a registration certificate for its therapeutic cannabis dispensary in Merrimack, NH. Prime ATC's dispensary will begin operations on Thursday, August 11, at which point qualifying patients and designated caregivers registered with Prime ATC will be able to obtain therapeutic cannabis.
Prime's dispensary is the fourth and final dispensary to begin operations as part of the State's Therapeutic Cannabis program, which is now fully launched. Prime ATC joins Sanctuary ATC's dispensary in Plymouth and Temescal Wellness' dispensaries in Dover and Lebanon.
Qualifying patients and designated caregivers must select one of the four ATC dispensaries and can only obtain therapeutic cannabis at their designated ATC. Applications for potentially qualifying patients and designated caregivers, medical provider certification, and other important information can be found by following the links on this page.
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