MONTGOMERY, Ala. — Alabama’s medical cannabis rollout is bringing a new set of restrictions that include a pregnancy-test requirement for some patients, underscoring how tightly the state is regulating a program that only now is starting to reach consumers. Under state administrative rules, a registered certifying physician must obtain a negative pregnancy test “immediately prior” to certifying or recertifying any patient capable of conception, and the result must be kept in the medical record.
The requirement applies as Alabama’s first medical cannabis dispensary opened June 4 in Montgomery, with the Alabama Medical Cannabis Commission saying more dispensaries are expected to follow during the summer. The commission says only registered patients and caregivers with a valid card may enter a dispensary.
The state’s medical cannabis system is built around narrow conditions, limited product forms and multiple layers of physician oversight. Alabama allows only certain products, including tablets, capsules, tinctures, gels, oils, creams, suppositories, patches, nebulizers and inhalable liquids or oils, while raw plant material and products that can be smoked or vaped are prohibited. The commission also says patients must be Alabama residents, at least 19 years old or have a parent or guardian as caregiver, have a qualifying medical condition, receive a recommendation from a certified physician and register with the commission.
The program’s rules also go beyond the pregnancy-test requirement. Before certifying a patient, a physician must conduct an in-person physical examination, review the patient’s medical history, obtain a drug screen and confirm prescriptions through the state prescription monitoring program. For patients capable of conception, the length of a certification cannot exceed 30 days, while other patients may receive certifications for up to 90 days.
The restrictions reflect Alabama’s broader pattern of tightly controlling cannabis access after years of legislative and regulatory delay. The state legalized medical cannabis in 2021, but the program has taken years to become operational, and the first dispensary only opened this month. The Alabama Medical Cannabis Commission says the current system is limited to a closed list of qualifying conditions and prohibited product forms, making it one of the more restrictive medical cannabis programs in the country.
For critics of government overreach, the pregnancy-test rule is likely to stand out as especially intrusive because it reaches into routine medical decision-making before a patient can obtain a certification. Supporters of the policy say the state is acting within a medical framework designed to regulate a controlled substance and protect patients.
The tension comes as Alabama Republicans often frame their politics around individual freedom, even while the state maintains strict rules on marijuana and alcohol. Alabama continues to regulate alcohol sales and distribution through a patchwork of state and local rules, reinforcing a long-standing conservative approach to vice regulation.