Nebraska Medical Cannabis Laws: Your Comprehensive Guide for Patients and Providers (July 2025)
Nebraska’s medical cannabis program is finally live, but it comes with restrictions and ongoing legal questions. As of July 1, 2025, emergency regulations are in effect, opening the door for qualified Nebraska medical cannabis patients to access certain cannabis products and allowing healthcare providers to apply for licenses. This blog breaks down who qualifies, what forms of medical cannabis are allowed, and what patients and medical professionals should expect moving forward regarding Nebraska medical marijuana laws.
How Did Nebraska Legalize Medical Cannabis?
In November 2024, Nebraska voters passed two statewide ballot initiatives:
Initiative 437: The Nebraska Medical Cannabis Patient Protection Act, legalized the possession and use of medical cannabis for qualified patients. This law is "self-executing," meaning patient protections are already in place.
Initiative 438: The Nebraska Medical Cannabis Regulation Act, established a state-regulated medical cannabis industry, overseen by the newly created Nebraska Medical Cannabis Commission (NMCC).
Emergency rules signed by Governor Pillen took effect July 1, 2025. License applications for medical cannabis businesses, including dispensaries, cultivators, manufacturers, and transporters, are now open.
Who Qualifies for Medical Cannabis in Nebraska?
To become a qualified medical cannabis patient in Nebraska, individuals must obtain a written recommendation from a licensed healthcare provider: a physician, nurse practitioner, or physician assistant.
Crucially, Nebraska's medical cannabis law does not specify a restrictive list of qualifying conditions. Instead, a licensed practitioner can issue a recommendation if, in their professional judgment, "the potential benefits of cannabis outweigh the potential harms for the alleviation of a patient's medical condition, its symptoms, or side effects of the condition's treatment."
Qualified patients or their designated caregivers may possess up to five ounces of medical cannabis. For minor patients (under 18), written permission from a parent or legal guardian is also required. Caregivers for adult patients must be at least 21 years of age and designated by the patient in a signed affidavit.
What Forms of Medical Cannabis Are Allowed in Nebraska?
Under current Nebraska medical cannabis regulations, only non-smokable, non-edible forms of medical cannabis are permitted, focusing on precise dosing and controlled administration:
Tablets, capsules, and tinctures
Gelatin-based lozenges (in specific shapes only)
Creams, gels, oils, and other topicals
Transdermal patches
Suppositories
Liquids or oils for nebulizers and inhalers
Not Allowed (Important Restrictions):
Raw cannabis flower (e.g., pre-rolls or loose leaf)
Any smoked or vaped cannabis product
Edibles, including cannabis-infused food or drinks
Flavored or colored cannabis products
Cannabis-infused sugar coatings or candy
Hemp-derived intoxicants like delta-8 or delta-10 THC
How Are Medical Cannabis Dispensaries and Providers Regulated in Nebraska?
Licensing for medical cannabis businesses in Nebraska is now open, but with several significant restrictions overseen by the Nebraska Medical Cannabis Commission:
Limited Access: Only one licensed dispensary is allowed per judicial district, which may limit patient access, especially in rural areas.
Location Restrictions: Dispensaries cannot be located within 1,000 feet of schools, daycares, churches, or hospitals.
Residency Requirement: Licensees must be at least 51% Nebraska-owned and have resided in the state for at least four years. (Note: Similar residency requirements in other states have faced legal challenges, so this aspect may evolve.)
Non-Transferable Licenses: Licenses are non-transferable and valid for two years.
Single License Type: Applicants can only hold one type of license (e.g., a cultivator cannot also be a dispensary).
What Responsibilities Do Healthcare Providers Have in Nebraska's Medical Cannabis Program?
Healthcare providers recommending medical cannabis must adhere to strict guidelines:
Include detailed dosage, potency, and directions for use in their patient recommendations.
Keep comprehensive records and educate patients about potential risks and safe use.
Possibly coordinate with a licensed pharmacist for patient counseling, which can occur in person or via telemedicine.
What Are the Recordkeeping Requirements for Nebraska Cannabis Businesses?
Dispensaries: Must retain sales records for at least 7 days.
Manufacturers, Transporters, and Cultivators: Must maintain thorough inventory records for regulatory inspection by the Nebraska Medical Cannabis Commission.
Key Challenges for Nebraska Medical Cannabis Patients
Limited Access: With only one dispensary per judicial district and a ban on common forms like raw flower or edibles, rural residents and patients needing fast-acting inhaled forms face significant barriers to access.
Form Restrictions: Patients accustomed to or medically requiring options like smoking or vaping must adjust to the currently permitted formats (tinctures, topicals, etc.).
Pending Litigation: Legal challenges are expected from both patient advocacy groups and local governments concerning access, regulatory powers, and specific provisions of the Nebraska medical cannabis program.
Key Challenges for Nebraska Medical Cannabis Providers and Businesses
Strict Compliance: Businesses must meet stringent ownership, location, security, and documentation requirements to obtain and maintain a Nebraska cannabis license.
Specific Recommendations: Healthcare providers must be highly detailed in their cannabis recommendations, which is a new responsibility for many.
Ongoing Changes: The initial emergency regulations are temporary and may shift before the permanent rules are finalized, creating an evolving compliance landscape.
What Happens Next for Nebraska Medical Cannabis?
The Nebraska medical cannabis program is still in its early stages of implementation:
Emergency regulations expire in late September but may be extended another 90 days.
Permanent regulations are expected to be finalized by October 1, 2025.
The first Nebraska medical cannabis dispensaries may open in late 2025 or early 2026, depending on the pace of licensing approvals and the outcomes of any legal challenges.
Frequently Asked Questions (FAQ) about Nebraska Medical Cannabis
Is medical marijuana legal in Nebraska?
Yes. As of July 1, 2025, Nebraska’s medical cannabis program is active under emergency regulations. Patients with a provider’s recommendation may legally possess certain non-smokable forms.
What kinds of medical cannabis are allowed in Nebraska?
Only non-smokable, non-edible forms are currently permitted, such as tinctures, topicals, capsules, suppositories, transdermal patches, and liquids for nebulizers/inhalers. Smoking, vaping, and edibles are currently prohibited.
Who can recommend medical cannabis in Nebraska?
Licensed physicians, nurse practitioners, and physician assistants may issue written recommendations for medical cannabis in Nebraska.
How much medical cannabis can I possess in Nebraska?
Qualified patients or their caregivers may possess up to five ounces of approved medical cannabis products at any time.
Can I open a medical cannabis dispensary in Nebraska?
Possibly. License applications for Nebraska cannabis dispensaries are open, but each judicial district is limited to one dispensary. Applicants must also meet specific Nebraska ownership and location requirements.
If you’re a Nebraska patient, healthcare provider, or business owner trying to understand Nebraska’s medical cannabis laws or seeking Nebraska cannabis legal services, we can help you navigate the process and stay compliant. Contact us to schedule a consultation.