Maryland Tops ASA's List of Medical-Marijuana States in 2022

Cover image via Americans for Safe Access

Maryland is among just five states to receive B- grades in Americans for Safe Access' 2022 State of the States Report . The Free State ranks No. 1 with an overall score of 75.71%. "In addition to lower prices, patients surveyed in Maryland reported more accessibility," the report notes.

The other B- states are Connecticut, Illinois, Michigan and Rhode Island. No other states rated higher. In last year's report, Maine and Illinois scored B grades.

The states with C+ grades are: California, Delaware, Hawaii, Massachusetts, Maine, Missouri, Nevada, New Mexico, New Jersey, Ohio and Pennsylvania (also: Washington, DC)

The states with C grades are: Arizona, Oklahoma, South Dakota, Virginia and Washington

The states with C- grades are: Montana, New York, Oregon and West Virginia (also: Guam)

The states with D+ grades are: Alaska, Arkansas, Florida, New Hampshire, Utah and Vermont (also: Northern Mariana Islands and Virgin Islands)

The states with D grades are: Alabama, Iowa, Louisiana and North Dakota (also: Puerto Rico)

The states with F grades are: Georgia, Idaho, Indiana, Kansas, Kentucky, Mississippi, Nebraska, North Carolina, South Carolina, Tennessee, Texas, Wisconsin and Wyoming.

Here's a rundown of ASA's conclusions:



• "When looking at state data in the aggregate, it is clear that nationwide medical cannabis programs need to be stronger."

• "Many states with limited and even comprehensive medical cannabis programs have dedicated much, if not all, of their time for cannabis reforms to adult-use access during the 2021-2022 year, while failing to make much-needed improvements to their medical programs."


Prioritization of Recreational Use Over Patient Needs

• "While states continue to slowly adapt their laws to meet the needs of patients, we have noticed a big shift in states prioritizing adult-use."

• "Recreational adult-use programs and medical cannabis programs are NOT the same and should not be treated as such."


Patients Are Forgotten

• "There is no reason why states cannot pass a robust medical cannabis program in conjunction with adult-use. Adult-use cannabis laws do not serve patients, and while ASA supports the need for recreational adult-use laws, we are vehemently opposed to policies that ignore patient and caregiver needs." 


Product Testing and Labeling

• "This is one area in which we saw positive trends for the year, with a number of states adding or amending testing requirements for cannabis products."


Lack of Insight on Federal Policy

• "Federal inaction creates a backlog of patient issues in which state legislators and regulators need federal guidance. Until the federal government acts, important protections like the right to access cannabis on school grounds, safety in federal housing and many more issues face legislative and regulatory hurdles that are hard for patients and states to overcome."



• "Many patients responding to ASA’s 2022 patient survey reported needing to travel long distances to reach the limited amount of such facilities that do exist. A variety of factors can produce this outcome, including state laws that permit local governments to completely prohibit a patient’s legal access to medicine by banning licensed medical retail providers."


Insufficient Legal Protections

• "Granting state-regulated access to medical cannabis does nothing to protect patients who require legal protections pertaining to employment, housing, education, and family legal matters in order to purchase, possess, and use medical cannabis without fear of monetary fines, arrest, prosecution, and imprisonment."


Medical Program Challenges

• "For most states, there remains considerable work to be done to address concerns raised by patients about their experience with state medical cannabis systems."

Download the report here.


Become a Patron!


Steve Bloom

Steve Bloom

Publisher of, former editor of High Times and Freedom Leaf and co-author of Pot Culture and Reefer Movie Madness.