No, South Carolina does not have a medical marijuana program. The only legal medical use of a cannabis product in the state is a narrow 2014 exception for certain severe epilepsy patients using low-THC CBD oil through a clinical trial. A broader medical cannabis bill, the Compassionate Care Act, has been reintroduced for the 2025–2026 legislative session, but as of early 2026 it has not passed.
The One Existing Exception: Julian’s Law
Julian’s Law, passed in 2014, allows patients diagnosed with Lennox-Gastaut syndrome, Dravet syndrome, or another severe form of epilepsy that hasn’t responded to standard treatment to use cannabidiol (CBD) oil. The oil must contain no more than 0.9% THC and at least 15% CBD.1South Carolina Legislature. 2013-2014 Bill 1035 – Medical Cannabis Therapeutic Treatment Research Act
In practice, the law is far more restrictive than it reads. Patients don’t buy the oil from a dispensary or pharmacy. The oil moves through FDA-approved expanded access clinical trials, managed by board-certified physicians at academic medical centers in the state. Those physicians obtain the cannabidiol from approved sources and administer it as part of the trial. A patient without access to a participating physician or academic medical center has no realistic way to use the law.1South Carolina Legislature. 2013-2014 Bill 1035 – Medical Cannabis Therapeutic Treatment Research Act
What Possession Still Costs
Outside of Julian’s Law, marijuana remains an illegal controlled substance in South Carolina regardless of any medical reason you may have for using it. The state has not decriminalized small amounts.
- One ounce or less, first offense: a misdemeanor carrying up to 30 days in jail and a fine of $100 to $200.
- More than one ounce: a felony punishable by up to five years in prison and a fine of up to $5,000.
Even a first-time offense for a small quantity creates a criminal record that can follow you through employment, housing, and licensing decisions.2South Carolina Legislature. South Carolina Code 44-53-370 – Prohibited Acts A
The Compassionate Care Act: What a Medical Program Would Look Like
The Compassionate Care Act has been introduced in the South Carolina legislature multiple times. The current version, Senate Bill 53, was referred to the Senate Committee on Medical Affairs in January 2025 and builds on the previous session’s S.423.3South Carolina Legislature. 2025-2026 Bill 53 – Compassionate Care Act If it passes in a form similar to the prior draft, here is what would and would not be allowed.
Who Would Qualify
Patients would need a diagnosis of at least one qualifying condition. The list includes cancer, multiple sclerosis, epilepsy and other neurological disorders, PTSD, Crohn’s disease, ulcerative colitis, sickle cell anemia, autism, cachexia, severe muscle spasms from a chronic condition, and severe nausea tied to end-of-life care in non-pregnant patients. A terminal illness with a life expectancy under one year would also qualify, as would any chronic condition for which a doctor could prescribe an opioid under accepted standards of care.4South Carolina Legislature. 2023-2024 Bill 423 – Compassionate Care Act
How Access Would Work
A physician with a genuine ongoing relationship with the patient would need to issue a written certification. Certifying physicians would be required to complete a cannabis-specific continuing education course and conduct a thorough in-person evaluation covering medical, illness, and substance use history. Patients would register with the state health department and receive an identification card. Designated caregivers would have to pass fingerprint-based criminal background checks.4South Carolina Legislature. 2023-2024 Bill 423 – Compassionate Care Act
Products would be sold through licensed therapeutic cannabis pharmacies overseen by the Board of Pharmacy, with a pharmacist on-site during business hours. Physicians could set custom purchase limits for each patient; otherwise, default 14-day limits would apply across edibles, vaporization oils, and topicals.4South Carolina Legislature. 2023-2024 Bill 423 – Compassionate Care Act
What the Bill Would Not Allow
The Compassionate Care Act would not allow smoking cannabis or possessing raw flower or leaf. Growing your own plants at home would remain illegal. The bill also would not shield patients from workplace drug testing. Private employers could still fire employees who test positive, and employers could continue to prohibit cannabis use at work or working while impaired.4South Carolina Legislature. 2023-2024 Bill 423 – Compassionate Care Act
About half of the states with medical cannabis programs offer some form of employment protection for registered patients. South Carolina’s proposed bill does not. A medical cannabis card, if the program is enacted as drafted, would not protect your job.
Hemp, CBD, and Delta-8: The Legal Alternatives
South Carolina draws a clear line between marijuana and hemp. Hemp is legal to grow and sell under Title 46, Chapter 55 of the state code, which defines industrial hemp as cannabis with a delta-9 THC concentration of no more than 0.3% on a dry weight basis.5South Carolina Legislature. South Carolina Code of Laws – Title 46, Chapter 55 CBD products derived from hemp and meeting that threshold are sold widely across the state.
The FDA has not approved CBD as a food additive or dietary supplement, which restricts how CBD products can be labeled and marketed. South Carolina transferred its food safety regulatory authority to the Department of Agriculture in 2024, and the state follows federal guidance on these restrictions.6South Carolina Department of Public Health. Hemp in Beverages
Delta-8 THC
Delta-8 THC products are currently sold in South Carolina. No state law explicitly bans them, and they’ve existed in a gray area since the 2018 federal Farm Bill legalized hemp without addressing hemp-derived cannabinoids like delta-8. That is changing on two fronts.
At the state level, Senate Bill 137 in the 2025–2026 session would require retailers and manufacturers to obtain licenses from the Department of Agriculture, ban sales to anyone under 18, prohibit retail locations within 1,000 feet of schools, and restrict marketing that appeals to minors.7South Carolina Legislature. 2025-2026 Bill 137 – Hemp-Derived Cannabinoids
Federally, new farm bill provisions scheduled to take effect on November 12, 2026, redefine legal hemp to account for total THC, including delta-8 and other isomers, and cap legal hemp products at just 0.4 milligrams of total THC per container. Many delta-8 gummies now on shelves contain 25 milligrams or more per piece. If the federal provisions take effect as written, nearly all intoxicating hemp-derived THC products currently sold in South Carolina would become illegal.
A Federal Issue to Know About: Firearms
Federal law prohibits anyone who is an “unlawful user of or addicted to any controlled substance” from possessing firearms or ammunition.8Office of the Law Revision Counsel. 18 USC 922 – Unlawful Acts Because marijuana remains a federally controlled substance, this applies to cannabis users regardless of state law. An ATF rule effective January 2026 clarified that “unlawful user” means someone who uses a controlled substance regularly and recently, not someone with a single past incident.9Federal Register. Revising Definition of Unlawful User of or Addicted to Controlled Substance Regular medical cannabis use would still qualify. If South Carolina enacts a medical program, registered patients who own firearms should understand that federal law creates a direct conflict with state law.