Missouri has a medical marijuana program, but recreational use is illegal. Possession of 35 g or less is a misdemeanor; possession of more than 35 g is a felony punishable by incarceration of up to 7 years imprisonment and a fine of up to $10,000. Possession of more than 10 g, but less than 35 g, is punishable by up to 7 years of incarceration and a fine of $2,000. Possession of 10 g or less is punishable by a $500 fine for first-time offenders and 1 year of incarceration and a fine of up to $2,000 for subsequent offenses.

Unless one is participating in the state’s medical marijuana program, marijuana cultivation is a felony. The penalty for growing 35 g or less is up to 4 years imprisonment and a maximum fine of $10,000. The penalty for growing more than 35 g of marijuana is a maximum fine of $10,000 and up to 10 years of incarceration.

The following cities in Missouri have decriminalized marijuana possession of 35 g or less: Columbia, Maplewood, and St. Louis. Violators face fines of no more than $250 or $1 in Columbia and Maplewood, respectively. The civil penalty for possession of 35 g or less of cannabis was repealed in St. Louis on December 13, 2021. Marijuana possession in Kansas City had been decriminalized, but Ordinance #200455, which was passed by the City Council July 9, 2020, repealed the provision in the city code concerning penalties for marijuana possession, including fines.

Patients participating in Missouri’s medical marijuana program can buy up to 4 oz of flower at one time or its equivalent in a 30-day period. They may also choose to grow up to 6 of their own plants. There is an additional $100 fee for this privilege and patients must abide by security regulations outlined in 19 CSR 30-95.030(4). 

Patients with the following conditions may be eligible for Missouri’s medicinal marijuana program:
•    ALS (amyotrophic lateral sclerosis)
•    Alzheimer's disease
•    Autism spectrum disorder
•    Cachexia
•    Cancer
•    Crohn’s disease
•    Chronic pain or neuropathy
•    Epilepsy
•    Glaucoma
•    Hepatitis C
•    Huntington’s disease
•    IBD (inflammatory bowel disease)
•    Intractable migraines
•    Multiple sclerosis
•    Opioid substitution
•    Parkinson’s disease
•    PTSD (post-traumatic stress disorder) or other debilitating psychiatric disorders
•    Tourette syndrome
•    Sickle cell anemia
•    Seizures

Additionally, qualifying physicians may recommend marijuana should they feel it will ameliorate symptoms or conditions associated with any terminal illness or with any chronic, debilitating medical condition. At this time, only MDs and DOs licensed to practice and in good standing in the state of Missouri may choose to recommend marijuana to patients.

Missouri does not have a reciprocity program to accommodate medical marijuana patients from out of state. 

For more information, see the Missouri Department of Health & Senior Service’s page on Medical Marijuana Regulation here: https://health.mo.gov/safety/medical-marijuana/index.php.