Alabama’s Draft MMJ Rules

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MONTGOMERY, Ala. (WPMI) — New proposed rules for doctors in Alabama wanting to recommend medical marijuana.

The state board of have been released for medical examiners that are essentially the “do’s and don’ts” for doctors recommending medical marijuana patients.

Physicians will have to try other medical treatments for the patient before recommending medical marijuana.

The Board is set begin allowing processors and growers to apply for licenses by September 2022.


The Alabama State Board of Medical Examiners Monday announced draft rules to govern how physicians can recommend medical cannabis to eligible patients. The draft rules were developed in accordance with the state’s new law on medical cannabis, which was approved earlier this year by the state Legislature and signed into law by the governor.

The public can read the draft rules and find information on how to submit comments by visiting The agency will accept comments until Jan. 4, 2022.

At that time, the public comment period will be closed, and the Board will consider the comments received and take further action at a subsequent meeting.

The draft rules include provisions on physician and patient certification, registration, and physician training. The Alabama Medical Cannabis Commission is addressing other aspects of the new law, such as the licensing of cultivators, manufacturers, and dispensaries.

Once fully implemented, Act 2021-450, approved by the Legislature and signed into law by the governor earlier this year, will permit the use of medical cannabis to treat the following qualifying medical conditions:

  • Autism Spectrum Disorder (ASD)
  • Cancer-related cachexia, nausea or vomiting, weight loss, or chronic pain
  • Crohn’s Disease
  • Depression
  • Epilepsy or a condition causing seizures
  • HIV/AIDS-related nausea or weight loss
  • Panic disorder
  • Parkinson’s disease
  • Persistent nausea that is not significantly responsive to traditional treatment, except for nausea related to pregnancy, cannabis-induced cyclical vomiting syndrome, or cannabinoid hyperemesis syndrome
  • Post Traumatic Stress Disorder (PTSD)
  • Sickle Cell Anemia
  • Spasticity associated with a motor neuron disease, including
  • Amyotrophic Lateral Sclerosis (ALS)
  • Spasticity associated with Multiple
  • Sclerosis (MS) or a spinal cord injury
  • A terminal illness
  • Tourette’s Syndrome
  • A condition causing chronic or intractable pain in which conventional therapeutic intervention and opiate therapy is contraindicated or has proved ineffective

Draft Eligibility Rules for Physicians to Certify Patients and Recommend the Use of Medical Cannabis in Alabama

Annual Certifications and Renewals:
Physicians must obtain an annual certification permit from the Alabama Board of Medical Examiners if they want to recommend a patient to use medical cannabis. Obtaining this permit requires the physician to:

  • complete an application
  • be licensed to practice medicine in Alabama and been engaged in the active practice of medicine for at least 3 years or at least 1 year if certified by a medical specialty board
  • have an Alabama Controlled Substances Certificate
  • be registered with the U.S. Drug Enforcement Administration (DEA), the Alabama Prescription Drug Monitoring Program maintained by Alabama Department of Public Health, and the Alabama Medical Cannabis Patient Registry System maintained by the Alabama Medical Cannabis Commission
  • complete a 4-hour continuing medical education course on medical cannabis and pass an examination
  • pay a $300 application fee to the Board of Medical Examiners

A physician’s application for a permit must be approved by the Alabama Board of Medical Examiners. Applicants denied a permit may petition the Board for reconsideration within 30 days.

Physician permits must be renewed annually on or before Dec. 31 each year. Certification permit renewals require:

  • completion of a renewal application
  • registrations with the DEA, the Alabama Medical Cannabis Patient Registry, and the
  • Alabama Prescription Drug Monitoring Program
  • completion of a 2-hour refresher continuing education course on medical cannabis
  • payment of a $200 application renewal fee to the Board of Medical Examiners


Certifying physicians cannot:

  • receive payments from medical cannabis dispensaries
  • hold any economic interest in a licensee of the Alabama Medical Cannabis Commission
  • serve on the board or be an employee of a licensee of the Alabama Medical Cannabis Commission
  • refer patients to a specific medical cannabis dispensary
  • advertise in a medical cannabis dispensary
  • advertise their status as a registered certifying physician other than stating they are qualified to certify patients for medical cannabis use
  • locate in same office space as a medical cannabis dispensary
  • certify or recommend use of medical cannabis to any patient who is pregnant, breastfeeding, or attempting to conceive a child
  • recommend medical cannabis with a potency greater than 3% of tetrahydrocannbinol to any qualifying minor and other dosage limitations based on the qualifying medical condition of the patient

Draft Rules for Patient Certification

The certifying physician must establish a bona fide physician-patient relationship with the patient during an in-person visit, with an expectation that the physician will provide ongoing care to the patient.

Prior to certifying a patient for the use of medical cannabis, the physician must have first attempted conventional medical treatments or therapies for the patient’s qualifying condition or affirm that the use of medical cannabis is the current standard of care for the patient’s qualifying condition.

In order for an eligible physician to certify a patient for the use of medical cannabis, both the physician and patient must be physically located in Alabama during an in-person examination and any examination, visit or other consultation for medical cannabis must occur while both are physically located in Alabama.

Eligible physicians must create and maintain medical records in accordance with state law.

Additional Draft Provisions
Certifying physicians must submit an annual report to the Board which describes the physician’s observations regarding the effectiveness of medical cannabis.

Permits for Registered Certifying Physicians will not be issued until the Alabama Medical Cannabis Commission has begun issuing licenses for the growing, processing, and dispensing of medical cannabis.