Cannabis had spent decades under prohibition, dragging the weight of stigma into the late 20th century. Arrests piled up. Prejudice ran deep. And federal law still branded it a Schedule I drug.
But cracks in the wall were starting to show. Scientific studies, patient advocacy, and a shifting cultural conversation began to challenge the narrative that cannabis had no therapeutic value. And in the 1990s, the modern medical cannabis movement officially took root.
If you haven’t already, read Cannabis and the War on Drugs to understand how strict laws and stigma shaped this uphill battle.
Seeds of Change in the 1970s and 80s
Long before voters had a say, there were signs that cannabis could be more than a political scapegoat. In 1978, New Mexico passed the Controlled Substances Therapeutic Research Act, allowing limited medical cannabis research for cancer and glaucoma patients—a historic moment, albeit a modest one.[1]
Around the same time, a small group of patients, including Robert Randall, the first American to legally receive medical cannabis from the federal government, fought in court to use cannabis for serious medical conditions. Their legal wins forced the creation of the Compassionate Investigational New Drug (IND) Program, which quietly provided federally grown cannabis to a handful of patients starting in 1978.[2]
While groundbreaking, the programs remained small and largely hidden from public view. Federal resistance was unyielding, and for most patients, the door to medical cannabis stayed firmly shut.
The AIDS Crisis and the Push for Compassion
The 1980s brought a public health emergency the government could no longer ignore: the HIV/AIDS epidemic. Patients discovered that cannabis helped relieve symptoms like nausea, pain, and wasting syndrome—often more effectively than the limited pharmaceuticals available at the time.[3]
Mary “Brownie Mary” Rathbun became a legendary volunteer at San Francisco General Hospital’s AIDS ward, where she handed out marijuana-infused brownies to patients suffering from wasting and nausea. As she explained:
“I know from smoking pot for over thirty years that this is a medicine that works. It works for the wasting syndrome—the kids have no appetite, but when they eat a brownie, they get out of bed and make themselves some food. And for chemotherapy—they eat half a brownie before a session, and when they get out they eat the other half. It eases the pain. That’s what I’m here to do.”
Meanwhile, Dennis Peron helped establish the first buyers’ clubs, offering a safer and more reliable means of access for those in need. Their activism brought relief to countless patients and laid the foundation for modern medical cannabis advocacy.
California’s Proposition 215: A Turning Point
In 1996, California voters passed Proposition 215, also known as the Compassionate Use Act—the first state law to legalize cannabis for medical purposes.
Prop 215 allowed patients with a doctor’s recommendation to use and cultivate cannabis for conditions like cancer, AIDS, chronic pain, and more. While federal law still banned cannabis, the vote sent shockwaves through the political landscape.
It was no longer just activists calling for change. Now, the people had spoken.
State-by-State Momentum
Following California’s lead, states across the country began passing their own medical cannabis laws. By the early 2000s, Alaska, Oregon, Washington, Maine, Colorado, Nevada, and Hawaii had joined the list.
These laws varied in scope, but all defied federal prohibition. The DEA continued to raid dispensaries, even in states where medical use was legal, sparking a states’ rights battle that would last for decades.
Science and Shifting Perception
As more states legalized medical cannabis, research on its therapeutic potential began reaching the public eye. Evidence pointed to benefits for chronic pain, muscle spasticity in multiple sclerosis, and chemotherapy-related nausea.[5] Each new finding chipped away at the claim that cannabis had “no medical use,” and for many, confirmed what patients had long testified.
Sentiment began to shift. Stories of patients finding relief circulated more widely, the medical community took cautious interest, and cannabis was no longer dismissed as just a counterculture cause. By the mid-2000s, the idea of cannabis as medicine had moved from the margins into mainstream conversation, laying the foundation for broader reform.
The Foundation for Today’s Market
The medical cannabis movement did more than help patients—it set the stage for the industry we know today. It established state-regulated cultivation and dispensary systems, created public awareness around cannabis’s benefits, and weakened the political taboo around reform.
It also forced the federal government to confront an uncomfortable truth: millions of Americans were using cannabis as medicine, and the sky wasn’t falling.
Footnotes:
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New Mexico State Cannabis Information Portal. Controlled Substances Therapeutic Research Act (1978) permitted medical cannabis research. NewMexicoStateCannabis.org.
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NORML. Medical Marijuana Pioneer Passes Away at 53: Glaucoma patient received government pot for 25 years. NORML news release, June 7, 2001.
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National Academies of Sciences, Engineering, and Medicine. Marijuana and Medicine. NCBI Bookshelf, NBK230713.
- National Academies of Sciences, Engineering, and Medicine. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. NCBI Bookshelf, NBK425767 (2017).
