North Carolina’s approach to medical cannabis remains highly restricted. While medical marijuana was legalized in 2015 through the North Carolina Epilepsy Alternative Treatment Act (House Bill 766), it only permits the use of low-THC cannabis, specifically for patients with intractable epilepsy. Cannabis products under this program must contain less than 0.9% THC, and the state’s medical marijuana program is managed by the North Carolina Department of Health and Human Services (NCDHHS).
However, North Carolina residents have broader access to medical marijuana through the Eastern Band of Cherokee Indians (EBCI), who run a more comprehensive program on their tribal land. This program, available to North Carolina residents aged 21 and older, allows for the issuance of medical marijuana cards. Purchases made through this program can only be consumed on EBCI tribal land, where all cannabis cultivation and manufacturing are controlled by the tribe.
Due to North Carolina’s restrictive cannabis laws, cannabis cultivation, manufacturing, and dispensing are limited. Only members of the Eastern Band of Cherokee Indians (EBCI) are legally permitted to engage in these plant-touching activities. The tribe's Cherokee-owned company, Qualla Enterprises LLC, oversees all cultivation and processing of cannabis products for their medical program.
Qualla Enterprises also operates Great Smoky Cannabis Co., which serves as the sole dispensary on EBCI tribal land, providing medical cannabis products to qualified patients. All cultivation, processing, and sales are conducted exclusively within EBCI territory, making it the only area in North Carolina where such plant-touching businesses can legally operate.
North Carolina permits the purchase of CBD oil as long as the THC content is less than 0.3%. The state also allows the sale of hemp extracts with less than 0.9% THC and at least 5% CBD by weight to registered patients with intractable epilepsy and their caregivers. Doctors in North Carolina cannot prescribe CBD oil, but they can recommend hemp-derived CBD oil.
There are no restrictions on the amount of CBD products individuals can possess. However, individuals must be 18 years or older to buy CBD in North Carolina.
Hemp cultivation is legal in North Carolina. The state's journey towards hemp legalization began with the 2014 Farm Bill, which allowed hemp cultivation for research purposes. North Carolina responded with its own legislation, SB 313, legalizing industrial hemp production for research.
Initially, North Carolina issued licenses for hemp cultivation under its pilot program. However, after the 2018 Farm Bill, which federally legalized hemp, licensing shifted to the United States Department of Agriculture. Those interested in a cannabis business can apply for licenses through the USDA. Individuals with felony convictions for drug-related offenses within the past ten years are not eligible. Cannabis business for sale listings may be available for existing operations.
Various hemp products, including fiber, food, seed, and verified propagules for cultivation, are legal in North Carolina, as long as their THC content does not exceed 0.3%. North Carolina residents can also buy hemp-derived tinctures, edibles, and topicals that comply with the THC limit.
The North Carolina Department of Agriculture and Consumer Services (NCDA&CS) plays a role in the state's hemp program. The Industrial Hemp Commission develops regulations and oversees licensing.
While municipalities in North Carolina cannot restrict hemp cultivation, zoning regulations may apply. It is advisable to consult with local government authorities about any zoning ordinances that might affect hemp cultivation.