Medical marijuana in South Carolina: How to get a card and more

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South Carolina’s relationship with cannabis is complex, marked by strict laws and a cautious approach to reform. While recreational marijuana remains illegal, the state has made limited provisions for medical use, primarily through low-THC CBD oil for specific conditions. Efforts to establish a broader medical marijuana program have gained traction, with the Compassionate Care Act (Senate Bill 53) reintroduced in 2025, aiming to legalize medical cannabis for a wider range of conditions. However, as of now, the state does not have a fully operational medical marijuana program, leaving patients with limited options. This guide explores South Carolina’s current cannabis laws, the process for accessing medical cannabis under existing regulations, qualifying conditions, and what the future might hold for medical marijuana in the Palmetto State.

South Carolina’s Cannabis Laws: A Strict Landscape

South Carolina maintains some of the nation’s most stringent cannabis laws. Marijuana, whether for recreational or medical purposes, is classified as a Schedule I controlled substance under state law, indicating a high potential for abuse and no accepted medical use. Possession of any amount of marijuana is illegal, with penalties that can significantly impact one’s life. For example:

• Possession of 1 ounce or less (first offense): Misdemeanor, up to 30 days in jail, and a fine of up to $200.
• Possession of 1 ounce or less (subsequent offenses): Misdemeanor, up to 1 year in jail, and a fine of up to $2,000.
• Possession of more than 1 ounce: Felony, up to 5 years in prison, and a fine of up to $5,000.

These penalties reflect South Carolina’s tough stance on cannabis. Even small amounts can lead to arrest, and convictions often include a six-month driver’s license suspension under the state’s “Smoke a Joint, Lose Your License” policy. This rule has sparked debate for its disproportionate impact on individuals who rely on driving for work or daily necessities.

The only exception to this strict policy is Julian’s Law (S. 1035), passed in 2014, which allows patients with severe forms of epilepsy, such as Lennox-Gastaut Syndrome or Dravet Syndrome, to use CBD oil with no more than 0.9% THC and at least 15% CBD. This law provides a narrow pathway for medical cannabis use but is highly restrictive, covering only a small group of patients and requiring a physician’s certification.

The Compassionate Care Act: A Glimmer of Hope

South Carolina has been on the cusp of broader medical cannabis legalization for years, with the Compassionate Care Act leading the charge. Sponsored by Senator Tom Davis, the bill (S. 53 in 2025) aims to create a regulated medical cannabis program for patients with debilitating conditions. The Senate passed a similar version in February 2024 by a 24-19 vote, but the House failed to act before the legislative session ended, effectively stalling progress [Post and Courier].

If passed, the Compassionate Care Act would allow patients with specific conditions to access medical cannabis in forms like oils, tinctures, edibles, vaporizers, and patches. Smoking cannabis flower would remain prohibited, reflecting the bill’s conservative approach. The program would be overseen by the South Carolina Department of Health and Environmental Control (DHEC) and the Board of Pharmacy, with strict regulations on cultivation, processing, and dispensing. Key features include:

• A limited number of licensed cultivators, processors, and therapeutic cannabis pharmacies.
• A registry for patients and caregivers, requiring medical cannabis cards.
• Prohibitions on home cultivation and public use.
• THC limits, such as 10 milligrams per serving for edibles and 8,200 milligrams for vaporization oils over a 14-day period.

The bill also includes a sunset clause, expiring five years after the first legal sale, allowing()]

• Any other condition added by the Department of Health and Environmental Control after petition by a patient or physician, subject to review.

Despite public support—72% of South Carolinians favor medical cannabis, according to a 2021 Starboard Communications poll—the bill faces resistance in the House, where concerns about recreational use and law enforcement opposition have slowed progress. Sheriff Hobart Lewis and others argue that medical cannabis could lead to increased recreational use, a claim supporters like Senator Davis refute, citing the bill’s tight regulations [SC Daily Gazette].

How to Access Medical Cannabis in South Carolina Today

As of now, South Carolina does not issue medical marijuana cards for a broad medical cannabis program. The only legal pathway for medical cannabis is through Julian’s Law, which allows low-THC CBD oil for severe epilepsy. Here’s how to access it:

1. Consult a Licensed Physician: Schedule an appointment with a South Carolina-licensed physician who can diagnose severe epilepsy (e.g., Lennox-Gastaut or Dravet Syndrome). The physician must certify that conventional treatments have failed and that low-THC CBD oil is appropriate.
2. Obtain a Certification: The physician provides a written certification specifying the use of CBD oil with no more than 0.9% THC and at least 15% CBD. This certification serves as legal protection against possession charges.
3. Source Compliant CBD Oil: Finding CBD oil that meets South Carolina’s requirements can be challenging, as federally legal hemp-derived CBD contains only 0.3% THC. Patients often rely on specialized providers or out-of-state sources, though bringing products into South Carolina carries risks.

This process is limited and does not involve a medical marijuana card or access to dispensaries, as South Carolina has none. Patients must navigate a complex market to find compliant products, and there’s no state-regulated supply chain for CBD oil under Julian’s Law.

Preparing for a Future Medical Marijuana Card

If the Compassionate Care Act passes, South Carolina would establish a medical marijuana card system. Based on the bill’s framework, the process would likely resemble other states’ programs but with stricter oversight. Here’s what patients can expect:

1. Establish a Physician-Patient Relationship: Patients must visit a DHEC-registered physician who has completed a medical cannabis education course. The physician must conduct an in-person exam, review medical history, and certify a qualifying condition.
2. Apply for a Card: Submit an application to DHEC, including the physician’s certification, proof of South Carolina residency (e.g., driver’s license or state ID), and a fee (estimated at $75). Caregivers for minors or incapacitated patients would also need to apply, with background checks required.
3. Receive Approval: Approved patients would receive a registry identification card, valid for one year, allowing purchases at licensed therapeutic cannabis pharmacies overseen by pharmacists.
4. Purchase Cannabis: Cardholders could buy approved products, such as edibles or vaporizers, from a limited number of dispensaries. The state would track purchases to enforce THC limits.

For a smoother experience, services like Kif Doctors offer online platforms to connect patients with certified physicians. I always recommend going for a Medical Marijuana Card Online Instantly to streamline the process and ensure quick access to care once the program launches.

Challenges and Limitations

Even if the Compassionate Care Act passes, South Carolina’s program would be among the most restrictive in the nation. Patients face several challenges:

• Limited Access: The small number of dispensaries and strict licensing could make it hard for rural patients to access products. Local municipalities can also ban dispensaries, further limiting availability.
• Workplace Risks: The bill offers no protections against workplace discrimination. Employers can terminate cardholders for testing positive for THC, even if used legally off-duty.
• Restricted Professions: Patients in public safety, commercial transportation, or heavy machinery roles cannot obtain cards or use medical cannabis, limiting eligibility.
• High Costs: Application fees, physician visits, and product costs may be prohibitive, especially since health insurers are not required to cover medical cannabis.

These restrictions aim to prevent abuse but may deter patients from participating. Advocates argue that the program’s conservative design addresses critics’ concerns while offering relief to those in need.

Hemp and CBD: A Legal Alternative

While medical marijuana remains largely inaccessible, South Carolina permits hemp-derived CBD under the 2018 federal Farm Bill, which legalized hemp with 0.3% or less THC. CBD oils, gummies, and tinctures are widely available without a prescription, sold at retailers, smoke shops, and online. However, smokable hemp and raw hemp flower are illegal in South Carolina, and products must comply with state testing and labeling rules.

Julian’s Law provides additional protections for CBD oil with up to 0.9% THC for epilepsy patients, but consumers should be cautious. The CBD market is loosely regulated, and some products may contain higher THC levels than advertised, risking legal issues. Always purchase from reputable sources and request lab reports to verify THC content.

The Future of Medical Marijuana in South Carolina

South Carolina’s path to medical cannabis legalization is fraught with obstacles, but momentum is building. The Compassionate Care Act’s repeated Senate passage and bipartisan support signal a shift in attitudes, driven by stories of patients who’ve found relief through cannabis in other states. Veterans, in particular, have been vocal advocates, with groups like Hidden Wounds and the Veterans Cannabis Project highlighting cannabis’s benefits for PTSD and chronic pain.

However, the House remains a hurdle. In 2022, a procedural ruling killed the bill, and in 2024, the House Medical Cannabis Ad Hoc Committee adjourned without a vote, citing time constraints. Law enforcement opposition, led by figures like SLED Chief Mark Keel, continues to influence conservative lawmakers, who fear a “slippery slope” to recreational use. Critics like Rep. John McCravy argue that the infrastructure for a medical program could pave the way for broader legalization, a concern echoed by Greenville County Sheriff Hobart Lewis.

Public sentiment, however, leans heavily in favor of reform. Polls show strong support among veterans (80% per Iraq and Afghanistan Veterans of America) and police officers (69% per Pew Survey), alongside widespread backing from medical professionals. The federal government’s decision to reclassify marijuana as a Schedule III drug in 2024 has also sparked renewed debate, with advocates arguing it validates cannabis’s medical value.

Looking ahead, the 2025 legislative session will be critical. Senator Davis remains optimistic, emphasizing the bill’s safeguards and its focus on empowering doctors and patients. If passed, South Carolina could join 38 other states with medical cannabis programs, offering relief to thousands. Until then, patients must rely on limited CBD options or risk legal consequences by sourcing cannabis elsewhere.

FAQs About Medical Marijuana in South Carolina

Is medical marijuana legal in South Carolina?

Medical marijuana is not broadly legal in South Carolina. Julian’s Law allows low-THC CBD oil (0.9% THC, 15% CBD) for severe epilepsy, but no broader program exists. The Compassionate Care Act, if passed, would legalize medical cannabis for specific conditions.

Who qualifies for low-THC CBD oil under Julian’s Law?

Patients with severe epilepsy, such as Lennox-Gastaut or Dravet Syndrome, qualify if certified by a licensed physician. The physician must confirm that conventional treatments have failed.

How can I get a medical marijuana card in South Carolina?

South Carolina does not currently issue medical marijuana cards. If the Compassionate Care Act passes, patients with qualifying conditions could apply through DHEC after physician certification.

Can I use hemp-derived CBD without a prescription?

Yes, hemp-derived CBD with 0.3% or less THC is legal for anyone to purchase in South Carolina, per the 2018 Farm Bill. Smokable hemp is illegal, and products must meet state standards.

Will I lose my job for using medical cannabis?

Possibly. South Carolina offers no workplace protections for medical cannabis users. Employers can enforce drug-free policies and terminate employees for positive THC tests, even if used legally.

Conclusion

South Carolina’s medical marijuana landscape is a mix of promise and frustration. While Julian’s Law provides a narrow exception for epilepsy patients, the lack of a comprehensive program leaves many without legal options. The Compassionate Care Act offers hope, but its fate hinges on the 2025 legislative session and the House’s willingness to act. For now, patients can access hemp-derived CBD or prepare for a potential medical cannabis program by staying informed and consulting physicians. As South Carolina inches toward reform, understanding the laws, processes, and challenges is key to navigating this evolving terrain. Whether you’re a patient, caregiver, or advocate, this guide equips you with the knowledge to make informed decisions in a state where change is on the horizon.