2025 Nebraska Medical Marijuana Laws

July 6, 2025

Understanding Nebraska’s 2025 Medical Marijuana Laws: A New Era for Cannabis AccessPosted on [Triple J’s Website] – July 6, 2025In a landmark move for the Cornhusker State, Nebraska voters overwhelmingly approved two ballot initiatives in November 2024 that legalized medical marijuana, marking a significant shift in the state’s approach to cannabis. These measures, Initiatives 437 and 438, have set the stage for a regulated medical cannabis program, with implementation details unfolding throughout 2025. For patients, advocates, and curious Nebraskans, this blog post dives deep into the details of these new laws, their implications, and the ongoing challenges surrounding their rollout. Whether you’re a potential patient or simply interested in the evolving landscape of cannabis policy, here’s everything you need to know about Nebraska’s medical marijuana laws in 2025.The Road to Legalization: A Decade-Long FightThe journey to legalize medical marijuana in Nebraska has been a long and arduous one, driven by passionate advocates like Nebraskans for Medical Marijuana (NMM). After multiple failed attempts, including a 2020 ballot initiative derailed by a single-subject ruling, the 2024 election proved to be a turning point. On November 5, 2024, voters approved Initiative 437 (the Nebraska Medical Cannabis Patient Protection Act) with 71% support and Initiative 438 (the Nebraska Medical Cannabis Regulation Act) with 67% support, passing in all 49 legislative districts.

These initiatives reflect a growing acceptance of medical cannabis, with Nebraska joining 38 other states and Washington, D.C., in legalizing its use for medical purposes. The overwhelming voter support underscores a demand for compassionate access to cannabis for patients suffering from serious medical conditions, a cause championed by advocates like Crista Eggers, whose son has benefited from medical cannabis.

What Do the New Laws Entail?Initiative 437: Patient Protections and AccessInitiative 437, effective as of December 12, 2024, after Governor Jim Pillen issued proclamations following the certification of election results, legalizes the possession, use, and acquisition of up to five ounces of cannabis (excluding the weight of other ingredients) for qualified patients. Unlike many states, Nebraska’s law does not specify a list of qualifying medical conditions, giving healthcare practitioners significant flexibility. To qualify, a patient must have a written recommendation from a licensed healthcare practitioner (MD, DO, physician’s assistant, or nurse practitioner) stating that, in their professional judgment, “the potential benefits of cannabis outweigh the potential harms” for alleviating a medical condition, its symptoms, or side effects of treatment.

For patients under 18, a written recommendation from a healthcare practitioner and written consent from a parent or guardian are required. Caregivers are also protected under the law, allowed to possess and acquire up to five ounces of cannabis on behalf of a qualified patient. Importantly, the law removes state penalties for patients and caregivers who possess, use, or acquire medical cannabis in compliance with these rules. However, the law does not specify that cannabis must be obtained from a particular source, meaning patients can legally possess cannabis even before in-state dispensaries are operational.

Initiative 438: Regulation and ImplementationInitiative 438 establishes the Nebraska Medical Cannabis Commission, tasked with licensing and regulating private businesses involved in the cultivation, manufacturing, distribution, delivery, and dispensing of medical cannabis. The commission, initially composed of the three members of the Nebraska Liquor Control Commission, with the governor able to appoint two additional members (subject to legislative confirmation), is required to draft regulations by July 1, 2025, and begin granting licenses by October 1, 2025. This timeline suggests that regulated medical cannabis businesses, such as dispensaries, will likely not open until 2026.

The commission has already taken steps to meet these deadlines. On June 26, 2025, it approved emergency regulations to begin accepting license applications, with Governor Pillen signing off on these rules by July 1, 2025. These temporary regulations, effective for up to 90 days, limit the number of licenses to 12 per judicial district (one dispensary, one cultivator, one manufacturer, and one transporter per district) and impose location restrictions, such as prohibiting dispensaries and cultivators within 1,000 feet of schools, daycares, churches, or hospitals.

However, the emergency regulations have sparked controversy by banning raw plant material (flower), infused foods or drinks (edibles), and products administered via smoking, combustion, or vaping. Allowable forms include oral tablets, capsules, tinctures, non-sugarcoated gummies, lozenges, suppositories, transdermal patches, and oils for nebulizers or inhalers. These restrictions have drawn criticism from advocates like State Senator John Cavanaugh and Crista Eggers, who argue that they contradict the voter-approved intent to allow all forms of cannabis, including flower, which many patients prefer for its effectiveness and affordability.

Legal and Legislative ChallengesDespite the voter mandate, the implementation of Nebraska’s medical cannabis laws has faced significant hurdles. Legal challenges from former State Senator John Kuehn and Attorney General Mike Hilgers sought to block the initiatives, arguing that they violated the Nebraska Constitution’s single-subject rule and federal law due to marijuana’s status as a Schedule I controlled substance. However, Lancaster County District Judge Susan Strong dismissed these lawsuits in December 2024 and June 2025, ruling that Kuehn lacked standing to sue. The cases are now before the Nebraska Supreme Court, leaving some uncertainty about the laws’ long-term fate.

On the legislative front, efforts to refine the regulatory framework have met resistance. Legislative Bill 677, sponsored by State Senator Ben Hansen, aimed to provide clearer guidelines for the Medical Cannabis Commission, including protections against arrests for compliant patients and caregivers, and to prevent a “Wild West” scenario without state oversight. Despite advancing from committee in May 2025, LB 677 failed to overcome a filibuster, falling short of the 33 votes needed in the Nebraska Legislature, with a final vote of 23-22. Opponents, including Senator Jared Storm, argued that the bill was too permissive and could pave the way for recreational marijuana, a concern Hansen disputed.

Storm also introduced LB 483, which would restrict medical cannabis to pills and tinctures, excluding flower and other forms, but this bill has not gained traction. Meanwhile, LB 705, proposed by Senator Terrell McKinney, sought to incorporate social equity measures, such as prioritizing licenses for communities disproportionately harmed by the war on drugs and offering resentencing for past marijuana convictions. This bill also stalled, reflecting the contentious nature of cannabis policy in Nebraska’s nonpartisan legislature.

Implications for Patients and EmployersFor patients, Initiative 437 provides immediate protections, allowing those with a healthcare practitioner’s recommendation to possess up to five ounces of cannabis without state penalties. However, since in-state dispensaries are not yet operational, patients may need to source cannabis from neighboring states like Colorado or Missouri, where recreational or medical cannabis is legal, though this carries federal risks due to marijuana’s Schedule I status.

For employers, the new laws do not mandate accommodations for medical cannabis use in the workplace. Nebraska employers can maintain zero-tolerance drug policies and are not required to permit use, possession, or impairment at work. The Nebraska Fair Employment Practice Act (NFEPA) does not explicitly protect medical cannabis users, leaving ambiguity about workplace protections. Employers are advised to review their drug testing policies to ensure compliance with state law while maintaining workplace safety standards.

Economic and Social ImpactThe legalization of medical cannabis is poised to have a significant economic impact in Nebraska. While the state’s medical cannabis market is not yet operational, projections from the Tax Foundation suggest that a fully legalized cannabis market (including recreational use, which remains illegal) could generate up to $35 million in excise tax revenue annually. In 2014, Nebraska spent $10.2 million on cannabis prohibition enforcement, highlighting potential savings from redirecting resources.

Socially, the laws reflect a shift in public perception, with 71% of voters supporting medical cannabis access. However, the absence of explicit non-discrimination protections in the initiatives means patients could still face challenges, such as job loss or custody disputes, due to their medical cannabis use. Advocates are pushing for future legislation to address these gaps, drawing on models from other states where courts have upheld protections under disability laws.

Ongoing Debates and Future OutlookThe emergency regulations issued by the Nebraska Medical Cannabis Commission have raised concerns among advocates, particularly the exclusion of cannabis flower and smoking as delivery methods. Critics argue that these restrictions limit patient access to preferred and cost-effective forms of cannabis, potentially undermining the voter-approved intent. The public has until July 15, 2025, to comment on these regulations, with a final set of rules expected later in the summer after a public hearing.

The commission’s composition, including members with reported anti-cannabis stances, has also sparked skepticism about its commitment to implementing the laws as voters intended. Senators like Ben Hansen and John Cavanaugh have called for vigilance to ensure the commission does not “choke” the program through restrictive regulations.

Looking ahead, the Nebraska Supreme Court’s ruling on the pending lawsuits will be critical. If the court upholds the initiatives, the Medical Cannabis Commission will proceed with licensing, potentially opening dispensaries by 2026. However, legislative efforts in 2026 may revisit regulatory frameworks, social equity measures, and protections for patients to align more closely with voter expectations.

How to Stay EngagedFor Nebraskans interested in shaping the future of medical cannabis, there are several ways to get involved:

Submit Comments: Provide feedback on the emergency regulations by emailing the Nebraska Medical Cannabis Commission at lcc.frontdesk@nebraska.gov (mailto:lcc.frontdesk@nebraska.gov) by July 15, 2025.
Stay Informed: Subscribe to updates from Nebraskans for Medical Marijuana (NMM) at nebraskamarijuana.org or the Marijuana Policy Project (MPP) at mpp.org/subscribe.
Contact Legislators: Urge your state senator to support bills like LB 677 and reject restrictive measures like LB 483 to ensure a patient-centered medical cannabis program.
Consult Legal Experts: For legal advice on navigating the new laws, consult a Nebraska-licensed attorney, as the information here is for educational purposes only.

Final ThoughtsNebraska’s medical marijuana laws represent a historic victory for patients and advocates who have fought for over a decade to provide safe, legal access to cannabis for medical purposes. While the passage of Initiatives 437 and 438 is a major step forward, the journey is far from over. Legal challenges, restrictive regulations, and legislative debates will continue to shape the program’s implementation. By staying informed and engaged, Nebraskans can help ensure that the will of the voters—expressed resoundingly in November 2024—is fully realized, providing relief to those who need it most.At Triple J’s, we’re committed to keeping you updated on Nebraska’s evolving cannabis landscape. Stay tuned for more insights, and let us know your thoughts in the comments below!Disclaimer: This blog post is for educational purposes only and does not constitute legal advice. For specific legal guidance, consult a Nebraska-licensed attorney.Sources: