OLR Research Report

June 15, 2004




By: John Kasprak, Senior Attorney

You asked for information on recently adopted Vermont legislation addressing the use of marijuana for medical purposes.


Vermont lawmakers gave final approval on May 19, 2004 to a bill (S. 76) legalizing the use and possession of marijuana by certain individuals suffering from debilitating medical conditions such as AIDS, cancer, multiple sclerosis, and others resulting in severe, persistent, and intractable symptoms. This legislation, “An Act Relating to Marijuana Use by Persons with Severe Illness,” requires those seeking to use marijuana for medical purposes to apply to the state's Department of Public Safety for status as a “registered patient.”

The act establishes procedures and standards for approval of a patient. It establishes a review board, comprised of three physicians, which can review an appeal when a patient is denied “registered patient” status. A registered patient can also have a “registered caregiver,” upon department approval, who is responsible for managing the patient's well-being with respect to marijuana use for symptom relief.

The act also establishes limitations on the amount of marijuana that can be possessed, allows a registered patient or caregiver to grow marijuana under certain conditions, sets the parameters for use of information by the department and law enforcement officers, and requires reporting on the act's operation.

The act can be accessed at:



Under the Vermont legislation, registered patients can possess and use marijuana for medical purposes. To become a “registered patient,” a physician in the course of a bona fide physician-patient relationship must diagnose the individual with a debilitating medical condition. The act defines a “debilitating medical condition” as (1) end of life care for cancer or AIDS or (2) cancer, AIDS, positive status for HIV, multiple sclerosis, or the treatment of these diseases or medical condition if: (a) the disease or condition or its treatment results in severe, persistent, and intractable symptoms and (b) in the context of the specific disease or condition, reasonable medical efforts have been made over a reasonable amount of time without success in relieving the symptoms (see Sec. 4472(2) of S. 76).

The act defines “bona fide physician-patient relationship” as a treating or consulting relationship of not less than six months, in the course of which a physician has completed a full assessment of the registered patient's medical history and current medical condition, including a personal physical examination (Sec. 4472(1)).

Standards and Procedures for Becoming a Registered Patient

The act directs the Vermont Department of Public Safety (DPS) to review applications of those seeking to become registered patients under the law using the following procedures and standards.

1. The patient must submit, under oath, a signed application for registration to DPS. (If the patient is under 18, both the patient and a parent or guardian must sign it.) The application requires identification and contact information for the patient and his registered caregiver applying for authorization to manage the patient's well being with respect to marijuana use. The patient applicant must attach a copy of relevant portions of his medical record sufficient to establish his debilitating medical condition.

2. DPS must contact the physician to verify the existence of a bona fide physician-patient relationship and the accuracy of the medical record. DPS can approve an application, even if the six-month duration requirement for the relationship is not met, if it is satisfied that the debilitating medical condition is of recent or sudden onset and the patient does not have a previous physician able to verify the nature of the disease and its symptoms.

3. DPS must approve or deny the registration application in writing within 30 days after receiving a complete application. If approved, DPS must issue the applicant a registration card, which includes his name and photo, and a unique identifier for law enforcement verification purposes (Sec. 4473(b)).

The act establishes a $100 fee for this application and the “registered caregiver” application (see below) with the fees deposited into a registration fee fund to offset application processing costs. Registration cards expire one year after the date of issue, with a renewal option, if the patient submits a new application and is approved by DPS. The renewal fee is $100 (Sec.4474a).

Review Board

The act establishes a review board that must meet periodically to review studies, data, and other information relevant to the use of marijuana for symptom relief. The board can make recommendations to the General Assembly for adjustments to the law. The Vermont Medical Practice Board must appoint three Vermont-licensed physicians to make up the review board. The act allows a patient whose application is denied to appeal to the review board within seven days of the denial. The review is limited to information submitted by the patient as required above and consultation with the patient's treating physician. All records concerning the appeal must be kept confidential.

Board members serve three-year terms (Sec. 4473(b)(4)).


“Registered caregivers” are individuals at least 21 years of age and never convicted of a drug-related crime, who agree to be responsible for managing the well-being of a registered patient concerning the marijuana use. (Apparently, having a registered caregiver is not mandatory under the law.) An individual can submit a signed application to DPS to become a registered caregiver. DPS must approve or deny it within 30 days. If it approves, the department must issue the person an authorization card, including his name, photo, and a unique identifier, after verifying (1) the person will serve as the registered caregiver for one registered patient only and (2) the person has never been convicted of a drug-related crime.

Before acting on the application, the act directs DPS to conduct a state and national criminal background check (Sec. 4474).


A person possessing a valid registration card who complies with the law, including the possession limit, is exempt from arrest or prosecution. “Possession limit,” under the act means the amount of marijuana collectively possessed between the registered patient and his registered caregiver which can be no more than one mature marijuana plant, two immature plants, and two ounces of usable marijuana (Sec. 4472(4)).

A physician participating in a patient's application process cannot be arrested, prosecuted, or disciplined or denied any right or privilege under state law except for giving false information. Nor can a person be arrested or prosecuted for constructive possession, conspiracy, or any other offense for “simply being in the presence or vicinity of a registered patient or registered caregiver engaged in use of marijuana for symptom relief.” The act specifies that a law enforcement officer is not required to return marijuana or related paraphernalia seized from a registered patient or caregiver (Sec. 4474b).


Growing and Transporting Marijuana

A registered patient or registered caregiver choosing to grow marijuana for use for symptom relief by the patient can do so only if the marijuana is cultivated in a single, secure indoor facility. The patient or caregiver may not transport marijuana in public unless secured in a locked container (Sec. 4474c(c)(d)).

Disposal of Marijuana After Death of Patient

The patient's registered caregiver must return to DPS for disposal any marijuana or marijuana plants in the patient or caregiver's possession within 72 hours after the patient's death. If the patient did not have a registered caregiver, the patient's next of kin must contact the department within 72 hours after death and ask DPS to take the marijuana for disposal (Sec. 4474c(e)).

Giving of False Information

The act provides that anyone knowingly giving any law enforcement officer false information to avoid arrest or prosecution, or to assist another in such activities, is subject to imprisonment for up to one year, a fine of $1,000, or both. These penalties are in addition to any other penalties that may apply for the possession or use of marijuana (Sec. 4474c(f)).

Prohibited Activities

The act provides that it does not exempt a person from arrest or prosecution for:

1. being under the influence of marijuana while (a) operating a motor vehicle, boat, vessel or other powered vehicle; (b) in a workplace; or (c) operating heavy machinery or handling a dangerous instrumentality;

2. the use or possession of marijuana by a registered patient or caregiver (a) for purposes other than symptom relief as allowed by the act or (b) in a way endangering the health or well-being of another;

3. smoking marijuana in any public place including a school bus, public bus, or other public vehicle; a workplace; or any school grounds, correctional facility, public park, public recreation center, or youth center (Sec. 4474c(a)).

Insurance Coverage

The act specifies that it should not be construed as requiring coverage or reimbursement for the use of marijuana for symptom relief by a health insurer, an employer, or for worker's compensation purposes (Sec. 4474c(b)).


The act requires DPS to maintain a separate, secure electronic database accessible to law enforcement personnel 24 hours a day that uses a unique identifier system to allow law enforcement officials to verify that a person is a registered patient or caregiver (Sec. 4474d).

DPS must maintain and keep confidential the records of all persons registered under this act as patients or caregivers in a secure database accessible by authorized department employees only. Exceptions are made for purposes of prosecution for false swearing and when in response to a person-specific inquiry or property-specific inquiry by a law enforcement officer made in the course of a bona fide investigation or prosecution (Sec. 4474d).


The act requires DPS to report by January 1, 2006 to the legislature's Health and Welfare and Judiciary committees on the use of marijuana for symptom relief. The department must work with the review board and the Health Department on this report.