Shifting Tides in North Carolina: Momentum Builds for Medical Marijuana Legalization

North Carolina may be on the cusp of a significant shift in its approach to medical marijuana. Despite years of failed bipartisan attempts to legalize it, a confluence of factors – including changing federal regulations and a growing number of legislative candidates supporting reform – could alter the landscape in 2026.

Past Roadblocks and Current Momentum

Numerous attempts to legalize medical marijuana in North Carolina have stalled in the past. Legislation led by Senate Rules Chair Bill Rabon, a Southport Republican, passed the Senate in 2023 but ultimately failed in the House . Similar bills met the same fate, with previous House Speaker Tim Moore citing insufficient support within the Republican caucus. However, the political dynamics are evolving.

Candidate Support and the Upcoming Election

The upcoming March primary elections could prove pivotal. Several legislative candidates, including a notable number of Republicans, have publicly expressed support for medical marijuana legalization. If elected, these candidates could reshape the vote split and potentially move a bill forward. A survey by The News & Observer and the Charlotte Observer revealed that over 66% of candidates responding to their questionnaire support legalization, with restrictions such as licensure requirements and age limits.

Specifically, 91% of Democratic candidates indicated support, while 42% of Republicans backed legalization. However, a significant portion of Republican candidates (39%) did not provide a clear stance on the issue. John Powell, a Monroe Republican running for House District 55, emphasized the need for “strict regulation, clear medical necessity, and strong safeguards against misuse,” expressing concerns about diversion, dependency, and adolescent access .

Federal Changes and the Hemp Market

Changes at the federal level are also contributing to the shifting landscape. In late December 2025, President Donald Trump signed an executive order reclassifying marijuana from a Schedule I to a Schedule III controlled substance . While this does not legalize marijuana, it acknowledges its potential medical uses.

Simultaneously, a federal government funding law narrowed the definition of legal hemp, potentially impacting the market for hemp-derived products. This change requires action from state or federal lawmakers to avoid these products becoming illegal in November. The distinction between hemp and marijuana hinges on THC levels, with hemp containing 0.3% or less delta-9 THC by dry weight.

North Carolina’s Advisory Council on Cannabis

Recognizing the need for a comprehensive approach, Governor Roy Cooper established the North Carolina Advisory Council on Cannabis in June 2025 . The Council is tasked with recommending a framework to regulate cannabis sales and create a safe, legal market for adults, prioritizing the safety and well-being of North Carolinians, particularly youth .

Looking Ahead

North Carolina’s legislative session is scheduled to begin in April. With evolving public opinion, federal changes, and a growing number of candidates supporting reform, the debate over medical marijuana legalization is poised to intensify. The outcome of the upcoming elections and the recommendations of the Advisory Council on Cannabis will likely play a crucial role in determining the future of medical marijuana in the state.