NH Therapeutic Cannabis Qualifying Conditions

Last verified: April 2026

The Statutory List — RSA 126-X:1, IX

For most of the program’s history, qualifying for the New Hampshire Therapeutic Cannabis Program (TCP) meant matching one of a finite list of conditions enumerated in RSA 126-X:1, IX. The list has expanded steadily since 2013 — chronic pain in 2017, opioid use disorder in 2019, insomnia in 2022, generalized anxiety disorder in 2024, autism spectrum disorder for patients under 21, and so on. The current stand-alone qualifying conditions are:

HB 1278 — The Open-Ended Provider Attestation

The most consequential 2024 expansion was HB 1278, signed by Gov. Chris Sununu on August 2, 2024 and effective October 1, 2024. Under HB 1278, a certifying provider may recommend cannabis for any debilitating or terminal medical condition or symptom in a patient 21 years of age or older, provided the provider clinically attests that the likely therapeutic benefit outweighs the risk. In practice, this turns the stand-alone list above into a non-exhaustive list for adults: providers can now certify off-list conditions if they are willing to put their professional judgment in writing.

HB 1278 was signed into law by Governor Chris Sununu on August 2, 2024 and took effect October 1, 2024. Together with HB 1349 (anxiety) and SB 357 (broader provider list), it represents the most significant expansion of New Hampshire's Therapeutic Cannabis Program since flower was added in 2019.

RSA 126-X — Therapeutic Use of Cannabis

SB 357 — Who Can Certify You

For most of the program’s first decade, only physicians (MD/DO), advanced practice registered nurses (APRN), and physician assistants (PA) could certify TCP patients. SB 357, signed by Sununu in 2024, expanded the list to any New Hampshire-licensed medical provider with prescriptive authority — explicitly adding dentists, podiatrists, optometrists, and naturopathic doctors.

SB 357 also imposed a counseling requirement: certifying providers must counsel patients under age 25 and women of childbearing age about adolescent and prenatal risk before issuing a certification. The counseling requirement is documented in the patient’s medical record but does not become part of the registry application itself.

Pediatric and Under-21 Patients

Patients under 21 face additional structural requirements in the program. For autism spectrum disorder specifically, the statute requires a consultation between the certifying provider and another medical professional before a pediatric certification can issue. For all under-21 certifications, providers must complete enhanced attestation that the benefits of cannabis outweigh known adolescent-development risks. A parent or legal guardian must serve as the registered designated caregiver, which carries its own $50 registration fee and background-check requirements.

The newer SB 357 counseling rule for patients under 25 layers on top of these pediatric protections. New Hampshire’s combined approach is among the more cautious in New England for under-21 patients, while still preserving access for autism, severe epilepsy, and pediatric cancer cases that drove much of the 2017–2019 expansion debate.

The Opioid Use Disorder Carve-Out

Opioid use disorder (OUD) was added to the qualifying-condition list in 2019, but with significant guardrails not applied to other conditions. Under RSA 126-X, OUD certifications may be issued only by providers who are board-certified in addiction medicine or psychiatry, who are actively treating the patient for OUD, and only when the patient experiences cravings or withdrawal symptoms. The practical effect is to channel OUD certifications through specialty addiction-medicine clinics rather than primary care, and to position cannabis as adjunct rather than first-line treatment for OUD — a posture meant to address the concerns of the NH Medical Society and the addiction-medicine community.

What Is Not on the List

Several conditions sometimes covered in other states — intractable migraine as a stand-alone, Tourette syndrome, ADHD, and depression as a stand-alone — are not enumerated in RSA 126-X:1, IX. After HB 1278, however, these and other conditions can still qualify a patient 21 or older if a certifying provider documents that cannabis benefits likely outweigh risks for that individual. A common practical question for off-list conditions is whether a particular provider is willing to write that attestation; some are not.

Explore the TCP

Official Sources

• RSA 126-X — Therapeutic Use of Cannabis
• NHDHHS Therapeutic Cannabis Program