South Carolina Senate Approves Medical Marijuana Bill On Initial Vote

South Carolina’s Senate gave initial approval to a medical marijuana legalization bill on Tuesday—setting it up for a final vote to send the measure to the House of Representatives, which is expected soon.

The vote on second reading passage was 26-17 and came days after senators began debate on the legislation from Sen. Tom Davis (R), which if enacted will allow medical cannabis access for patients with certain health conditions.

It’s a renewed push by lawmakers after the body passed an earlier version of the legislation in 2022 that went on to stall in the House over a procedural hiccup.

The Senate earlier this session had failed to advance the measure to floor debate, falling short on a vote that required two-thirds support. But last week, lawmakers voted again and came up 23–13 to give the bill a special order slot and keep it in play for the 2024 session.

Davis said during last week’s initial debate on the bill that his goal has always been to “come up with the most conservative medical cannabis bill in the country that empowered doctors to help patients—but at the same time tied itself to science, to addressing conditions for which there’s empirically based data saying that cannabis can be of medical benefit.”

“I think when this bill passes—and I hope it does pass—it’s going to be the template for any state that truly simply wants to empower doctors and empower patients and doesn’t want to go down the slippery slope” to adult-use legalization, he said. “I think it can actually be used by several states that maybe regret their decision to allow recreational use, or they may be looking to tighten up their medical laws so that it becomes something more stringent.”

Overall, the bill would allow patients to access cannabis from licensed dispensaries if they receive a doctor’s recommendation for the treatment of qualifying conditions, which include several specific ailments as well as terminal illnesses and chronic diseases where opioids are the standard of care.

Before voting on initial approval on the current bill on Tuesday, senators adopted two amendments.

One would make it so no more than three medical cannabis dispensaries could be located in any county. The other would clarify that regulators cannot prevent the “accurate listing of ingredients on a cannabis product that is a beverage,” with the sponsor of the amendment citing a recent letter from health officials that he said has “caused confusion” about the components of hemp-derived beverages.

Last week, members adopted an amendment that clarifies the bill does not require landlords or people who control property to allow vaporization of cannabis products.

As debate on the legislation continued last week, members clashed over whether the current version of the legislation contains major differences from an earlier iteration that the body passed in 2022.

“I think by and large, the changes are consistent with the spirit of what we did two years ago, and in some instances make the language clear,” Davis said on Tuesday, explaining that some provisions had been reformulated to address a lack of clarity in earlier amendments that were drafted in “real time” on the floor during the prior bill’s consideration.

Certain lawmakers have also raised concerns that medical cannabis legalization would lead to broader reform to allow adult-use marijuana, that it could put pharmacists with roles in dispensing cannabis in jeopardy and that federal law could preempt the state’s program, among other worries.

Here are the main provisions of the proposal: 

• “Debilitating medical conditions” for which patients could receive a medical cannabis recommendation include cancer, multiple sclerosis, epilepsy, post-traumatic stress disorder (PTSD), Crohn’s disease, autism, a terminal illness where the patient is expected to live for less than one year and a chronic illness where opioids are the standard of care, among others.
• The state Department of Health and Environmental Control (DHEC) and Board of Pharmacy would be responsible for promulgating rules and licensing cannabis businesses, including dispensaries that would need to have a pharmacist on-site at all times of operation.
• In an effort to prevent excess market consolidation, the bill has been revised to include language requiring regulators to set limits on the number of businesses a person or entity could hold more than five percent interest in, at the state-level and regionally.
• A “Medical Cannabis Advisory Board” would be established, tasked with adding or removing qualifying conditions for the program. The legislation was revised from its earlier form to make it so legislative leaders, in addition to the governor, would be making appointments for the board.
• Importantly, the bill omits language prescribing a tax on medical cannabis sales, unlike the last version. The inclusion of tax provisions resulted in the House rejecting the earlier bill because of procedural rules in the South Carolina legislature that require legislation containing tax-related measures to originate in that body rather than the Senate.
• Smoking marijuana and cultivating the plant for personal use would be prohibited.
• The legislation would sunset eight years after the first legal sale of medical cannabis by a licensed facility in order to allow lawmakers to revisit the efficacy of the regulations.
• Doctors would be able to specify the amount of cannabis that a patient could purchase in a 14-day window, or they could recommend the default standard of 1,600 milligrams of THC for edibles, 8,200 milligrams for oils for vaporization and 4,000 milligrams for topics like lotions.
• Edibles couldn’t contain more than 10 milligrams of THC per serving.
• There would also be packaging and labeling requirements to provide consumers with warnings about possible health risks. Products couldn’t be packaged in a way that might appeal to children.
• Patients could not use medical marijuana or receive a cannabis card if they work in public safety, commercial transportation or commercial machinery positions. That would include law enforcement, pilots and commercial drivers, for example.
• Local governments would be able to ban marijuana businesses from operating in their area, or set rules on policies like the number of cannabis businesses that may be licensed and hours of operation. DHEC would need to take steps to prevent over-concentration of such businesses in a given area of the state.
• Lawmakers and their immediate family members could not work for, or have a financial stake in, the marijuana industry until July 2029, unless they recuse themselves from voting on the reform legislation.
• DHEC would be required to produce annual reports on the medical cannabis program, including information about the number of registered patients, types of conditions that qualified patients and the products they’re purchasing and an analysis of how independent businesses are serving patients compared to vertically integrated companies.

After Davis’s Senate-passed medical cannabis bill was blocked in the House in 2022, he tried another avenue for the reform proposal, but that similarly failed on procedural grounds.

The lawmaker has called the stance of his own party, particularly as it concerns medical marijuana, “an intellectually lazy position that doesn’t even try to present medical facts as they currently exist.”

Meanwhile, a poll released last year found that a strong majority of South Carolina adults support legalizing marijuana for both medical (76 percent) and recreational (56 percent) use—a finding that U.S. Rep. Nancy Mace (R-SC) has promoted.