On May 17, 2021, Alabama Governor Kay Ivey signed the Compassion Act into law, legalizing medical marijuana and seemingly paving the way for patients in Alabama to access cannabis. Under Alabama's Compassion Act, all activities related to the sale and production of medical cannabis must be licensed by the Alabama Medical Cannabis Commission. The Commission's stringent licensing requirements are intended to protect the citizens of Alabama from what it identifies as the "dangers of recreational marijuana." However, four years later, there are no medical cannabis dispensaries in the state. This raises the question: where are we now?

As of July 2025, the Alabama Medical Cannabis Commission ("AMCC") has made significant progress toward providing medical cannabis in Alabama. The Compassion Act requires each layer of cannabis production to be independently licensed. The AMCC has successfully licensed cultivators, who grow the cannabis; processors, who transform the cannabis into usable products; and transporters, who move products through the supply chain. However, the AMCC has still failed to license any dispensaries; the critical final link where individuals with prescriptions could actually purchase cannabis.

The decision to withhold dispensary licenses has become the subject of extensive litigation and is currently scheduled for a hearing. This hearing will be conducted by the same judge who granted the administrative licenses, which offers hope that these proceedings may result in favorable rulings for license applicants. If the AMCC grants licenses following the judicial hearing, a series of events will be set into motion that may finally allow the first patients to obtain medical cannabis. Under the Compassion Act, the state will grant physician certifications that allow doctors to recommend medical cannabis to patients. These certifications, however, will not be granted until every stage of the medical cannabis supply chain is fully licensed. If the final dispensary licenses are approved, it is likely that the first patients in the state will finally be able to access medical cannabis.

When the licenses are granted, medical cannabis will be permitted to be manufactured and sold in the state. This will include gummies, capsules, oil, patches, and other non-smokable products. Medical cannabis in Alabama as of July 2025 will not include smokable cannabis products. Patients with cancer, nausea, epilepsy, PTSD, muscle spasms, neurological diseases, and other qualifying conditions will be able to obtain medical cannabis, under Alabama's Compassion Act if the licenses are fully granted. The potential activation of Alabama's medical cannabis program represents a significant milestone for patients who have waited nearly five years since the initial law was passed. The licensing bottleneck at the dispensary level has created a fully operational supply chain that cannot serve patients; a situation that highlights the complex regulatory challenges inherent in implementing medical cannabis programs.

The upcoming judicial hearing represents a crucial turning point for Alabama's medical cannabis program. If successful, it will complete the final piece of the regulatory puzzle that has prevented patients from accessing legal medical cannabis. The outcome of this hearing will determine whether Alabama joins the growing number of states providing legal medical cannabis access to qualifying patients, or whether the program will face continued delays and legal challenges. The stakes are particularly high for Alabama patients with qualifying conditions who have been waiting years for legal access to medical cannabis. The resolution of the dispensary licensing issue will either open the door to treatment options that have been available in other states for years or extend the frustrating wait that has characterized Alabama's medical cannabis program since its inception.

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