Medical use of cannabis has now been legalized in 39 states and the District of Columbia. After decades of prohibition, it begs the question– How did we get here?

Early Advocates

The earliest advocates for legalization of marijuana were medical patients and caretakers. Those with first-hand knowledge of the plant’s medicinal benefits bravely spoke out for the right for citizens to have legal access to it, often facing jail for doing so. It was these patients that have shaped the reform movement and helped us develop our modern understanding of the cannabis plant as medicine. Here are some notable trailblazers in the cannabis world: 

Robert Randall was a Washington D.C. man who successfully argued that use of marijuana to ease the symptoms of his glaucoma constituted a medical necessity. On November 24, 1976, federal Judge James Washington dismissed criminal charges against Randall. Per his petition, the government began providing Randall with licit, FDA-approved access to government supplies of medical marijuana. Randall was the first American to receive marijuana for the treatment of a medical disorder.

Dennis Peron watched how cannabis eased the nausea and pain of his partner, Jonathan West, as he was succumbing to AIDS in 1990. In 1991, Peron put his grief into action and became an instrumental part of the passage of Proposition P, allowing for medical cannabis use in the city of San Francisco.

Mary Jane Rathbun is known to many as “Brownie Mary”. Rathbun suffered from several painful and chronic illnesses, including pulmonary disease, osteoarthritis and colon cancer. Working as a hospital volunteer at San Francisco General Hospital during the 1980s, she was arrested three times for baking marijuana brownies for residents with HIV and AIDS. Public outcry made it difficult for local authorities to prosecute her for possession.

In 1991, Brownie Mary helped to win approval of San Francisco’s Proposition P, as well as supporting California’s landmark Proposition 215, approved in 1996. Rathbun also helped establish the first medical marijuana dispensary in the United States, the San Francisco Cannabis Buyers Club. 

California became the first state to legalize, and other states weren’t far behind. Alaska, Oregon, and Washington become the 2nd, 3rd, and 4th states to vote in favor of state medical cannabis programs. Throughout the next two decades, a majority of U.S. states would legalize cannabis for medical patients. Here’s a few notable “firsts” of some of the state medical programs: 

Texas, 2018 

In February 2018, an anonymous six-year-old girl suffering with intractable epilepsy became the first legal medical marijuana patient in Texas. In 2015, Texas passed the Compassionate-Use Act, which allowed the first legal use of low-THC cannabis products in the state, but only for patients with intractable epilepsy. The Compassionate-Use Act was expanded in 2019 and again in 2021 to include other conditions including seizure disorders, multiple sclerosis, spasticity, amyotrophic lateral sclerosis, autism, cancer, post-traumatic stress disorder, and incurable neurodegenerative diseases. 

Pennsylvania’s “First Batch”

A single patient did not get the honor in Pennsylvania of being the first to get a medical marijuana card. Rather, the first batch of applicants for Pennsylvania’s medical marijuana program were sent their cards and could begin purchasing cannabis on February 15, 2018. At the time, only 10 dispensaries were approved, and only 17,000 patients had registered for the program. 

Theresa Nightingale, a cannabis activist in Pittsburgh, received her card two days before Christmas 2017. The state Department of Health mailed over 400 cards to doctor-certified patients “all in a batch” in the days preceding the holiday, spokeswoman April Hutcheson told the Philadelphia Inquirer.

“It was the perfect gift,” said Nightingale, a cancer survivor. “It came exactly two weeks after seeing my doctor.”

Another important first for Pennsylvania occurred more recently in March 2022. York County-based Groff North America said it became the first business in the country to bring a cannabis crop to market legally for scientific study. (Researchers had been restricted since 1968 to cannabis grown at a single site at the University of Mississippi.)

Missouri, 2020

A 73-year-old man named Larry Simpson was first in line at the first Missouri medical marijuana dispensary to open on Oct. 16, 2020. Today, he’s one of about 150,000 cannabis card carriers. Voters approved medical marijuana in 2018.

“It’s really added to the quality of my life,” he told Missouri’s KSDK

Ohio, 2019

Ohio’s first medical marijuana customer was Joan Caleodis of Martin’s Ferry, Ohio. 

“I’m ecstatic patients are no longer waiting for relief,” Caleodis told the Cincinnati Enquirer on the 2019 opening day of CY+ Dispensary in Wintersville, Ohio. 

Diagnosed in 2010 with Primary Progressive Multiple Sclerosis (PPMS), Caleodis explained that at the time there were no FDA -approved meds for her type of MS. (PPMS represents only about 15 percent of MS patients.) She was prescribed Tramadol, Gabapentin, Lyrica, Cymbalta, Methotrexate, Xanax and a few other pharmaceutical medicines that she no longer takes.

Caleodis had used cannabis in the past, but after her MS diagnosis, she left work on disability and drove to Colorado to learn about the different forms of cannabis. “I suffer daily with pain and spasticity but with my cannabis oil, I can have a life,” she told us, now three years into having her Ohio medical marijuana card. “They told me I’d probably be in a wheelchair [within] 8-9 years and it’s been 12… a few puffs of oil and I do water aerobics 90-120 minutes a day Monday thru Friday…. I feel like I’m getting a life back.”

Today, Caleodis enjoys a much wider selection at the dispensary than when the program first started. She uses vaping oils, topicals, edibles and flower. But mostly oil. “I also use a really good CBD patch I buy online that works great!!”

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  • Gabrielle Dion

    Medicate OH's Founder and Publisher is a native of Cincinnati, Ohio and holds an undergraduate degree in journalism and a master's degree in public administration, both from Northern Kentucky University. She has more than 20 years of experience writing and editing professionally for the medical and wellness industries, including positions with The Journal of Pediatrics, Livestrong, The Cincinnati Enquirer, and Patient Pop.


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