Last verified: April 2026
The Foundational Statute: RSA 126-X
The TCP was created by HB 573, signed by Democratic Gov. Maggie Hassan on July 23, 2013, after two earlier bills (2009 and 2012) had been vetoed by Gov. John Lynch. The statute is codified at RSA 126-X — Therapeutic Use of Cannabis, with administrative rules at He-C 401 and He-C 402 (most recent rule updates effective October 1, 2025). The program is operated by the New Hampshire Department of Health and Human Services (NHDHHS) Therapeutic Cannabis Program at 29 Hazen Drive, Concord.
Although signed in 2013, the program did not begin issuing patient ID cards until late 2015 — and even that required a lawsuit. Attorney Paul Twomey argued in Merrimack County Superior Court on November 12, 2015, that the state had to issue a card to his client Linda Horan, a terminally ill cancer patient. The court ordered the state to comply on November 24, 2015; Horan’s card issued the next day. The first ATCs opened in April 2016 — almost three years after enactment.
New Hampshire became the 19th U.S. state to enact medical cannabis when Gov. Maggie Hassan signed HB 573 on July 23, 2013. The first patient ID cards weren't issued until late 2015 — a 2½-year delay that required litigation to resolve.
RSA 126-X — Therapeutic Use of Cannabis
The Patient Registry — RSA 126-X:4
NHDHHS maintains a confidential registry of qualifying patients, designated caregivers, and certifying medical providers. Card details:
- Card fee: $50/year (caregiver registration also $50, no fee for renewals; replacement cards $25)
- Application: mail or in-person only — telemedicine certification is not permitted
- Processing time: typically 21 days
- Card validity: 1 year (under May 2023 rule changes, providers may now issue certifications valid up to 3 years)
- Active patients (late 2025): ~15,000–17,000 (figures vary by source; MPP placed total at ~17,000 as of November 2025)
- Patient growth: 6–8x growth from 2,089 in 2016
Qualifying Conditions — RSA 126-X:1, IX
Stand-alone qualifying conditions include:
Cancer; chronic pain; PTSD; ALS; Alzheimer’s; Crohn’s; Ehlers-Danlos; epilepsy/seizures; glaucoma; hepatitis C; HIV/AIDS; lupus; MS; opioid use disorder (with restrictions); Parkinson’s; severe muscle spasms; severe nausea; spinal cord injury; traumatic brain injury; ulcerative colitis; terminal illness; generalized anxiety disorder (added by HB 1349, 2024); autism spectrum disorder (under 21, with consultation requirements); insomnia (added 2022).
The most important recent expansion was HB 1278, signed by Gov. Sununu August 2, 2024, effective October 1, 2024. It allows certifying providers to recommend cannabis for any debilitating or terminal medical condition or symptom for adults 21+ if the provider clinically attests benefits likely outweigh risks. The qualifying-condition list is now non-exhaustive for adults. See qualifying conditions.
Healthcare Provider Certification — SB 357 (2024)
For most of the program’s first decade, only physicians, advanced practice registered nurses, and physician assistants could certify patients. SB 357, signed by Sununu in 2024, expanded that to any NH-licensed medical provider with prescriptive authority — explicitly adding dentists, podiatrists, optometrists, and naturopathic doctors. Providers must counsel patients under 25 and women of childbearing age about adolescent and prenatal risk before issuing certifications.
Possession and Supply Limits — RSA 126-X:2
A qualifying patient may possess up to 2 ounces (56.7 g) of usable cannabis at one time, with a 10-day rolling purchase cap of 2 ounces. There is no separate concentrate weight limit — concentrates count toward the 2 oz cap by the cannabis-equivalent weight assigned by the dispensing ATC.
Home cultivation is prohibited for both patients and caregivers. New Hampshire is the only New England state that bars patients from growing their own medicine, and one of only roughly 14 medical-state holdouts on home grow nationally. Multiple home-grow bills have passed the House (HB 53 in 2025; HB 1231 in 2024) only to die in the Senate Judiciary Committee, most recently after a tabling motion by Sen. Daryl Abbas (R) in 2025.
Out-of-State Reciprocity — HB 1278
Until June 28, 2023, New Hampshire offered no meaningful reciprocity. That changed administratively, then more broadly under HB 1278 (effective October 1, 2024), which removed the prior three-purchases-per-year cap. Visiting patients from any U.S. state, U.S. territory, or Canada with valid out-of-state medical cannabis credentials may now purchase from any NH ATC at the same frequency as in-state patients (subject to the 2 oz / 10-day cap).
Visitors must show their out-of-state ID card and a matching photo ID. NH does not require reciprocal patients to share a qualifying NH condition. This makes NH ATCs an unexpected option for travelers in the region — a policy almost no one in NH knows about. See products & rules.
Explore the TCP
Official Sources
For in-depth cannabis education, dosing guides, safety information, and research summaries, visit our partner site TryCannabis.org