Since Ohio voters approved Issue 2 in 2023, any adult 21 or older can walk into a licensed dispensary and buy cannabis. So why do thousands of Ohioans still carry a medical marijuana card? Because the two programs are not the same. Medical patients pay less tax, can buy more, and can qualify at a younger age.
The quick answer: In Ohio, adult use cannabis is open to anyone 21+ with a valid ID. Medical cannabis requires a physician’s recommendation for a qualifying condition, but patients skip the 10% adult use excise tax, can buy a larger 90 day supply, and can register at 18 (or younger with a caregiver). The state no longer charges a registration fee, so the main cost of a card is the doctor’s visit.
Here’s a full breakdown of the differences between medical and nonmedical cannabis in Ohio, updated for the Senate Bill 56 changes that took effect in March 2026.
Medical vs. Adult Use in Ohio at a Glance
Why Precision Dosing Is the Point
| Medical | Adult Use | |
|---|---|---|
| Who Can Buy | Registered patients 18+; minors through a registered caregiver | Adults 21+ with a valid ID |
| What You Need | Physician recommendation for a qualifying condition and an active registration | Valid government ID |
| Taxes | State and local sales tax only | 10% excise tax plus state and local sales tax |
| Purchase and possession | Up to a 90 day supply (9 oz of flower for most patients) | 2.5 oz of flower and 15 g of extract |
| THC Limits | 35% flower, 70% extracts | 35% flower, 70% extracts |
| Homegrow | Adults 21+ only: 6 plants per person, 12 per household | Adults 21+ only: 6 plants per person, 12 per household |
| Delivery | Allowed for Medical Patients | Not allowed |
| Cost to Access | No State fee; physician visit required and renewed yearly | None |
1. Access and Legal Requirements
Adult use: Any adult 21 or older can buy cannabis at a licensed Ohio dispensary with a valid government-issued ID. No card, no doctor, no paperwork.
Medical: You need a recommendation from an Ohio physician certified by the state for one of more than two dozen qualifying conditions, such as chronic pain, PTSD, cancer, epilepsy, Crohn’s disease, and fibromyalgia. After the recommendation, you register with the Ohio Division of Cannabis Control (DCC) and receive your patient card.
The biggest access difference is age. Adults 18 to 20 can only buy cannabis legally in Ohio as registered medical patients. Patients under 18 can qualify with a parent or guardian registered as their caregiver.
How to Get a Medical Marijuana Card in Ohio
- Book a visit with an Ohio physician certified to recommend medical marijuana. Many offer telehealth for renewals.
- Get your recommendation for a qualifying condition. Your physician enters it into the state registry.
- Complete your registration through the DCC patient registry using the email your physician provides.
- Shop medical at any licensed Ohio dispensary, including Ascend, by showing your patient card and ID.
- Renew every year with a follow-up physician visit to keep your registration active.
2. Taxes: Where Medical Patients Save the Most
| Medical patient | Adult use customer | |
|---|---|---|
| Product price | $100 | $100 |
| 10% excise tax | $0 | $10 |
| Taxes | Applies | Applies |
Spend $100 a month, and that’s about $120 a year in excise tax savings alone, before any medical discounts.
3. Product Selection and Potency
This is where the gap has closed. Senate Bill 56 set the same THC limits for both programs: a maximum of 35% THC for flower and 70% THC for extracts like vapes and concentrates. In most Ohio dispensaries, medical and adult-use customers now shop from the same menu of flower, pre-rolls, vapes, edibles, tinctures, topicals, and concentrates.
Medical patients still get more, but in quantity. Patients can buy up to a 90-day supply, which for most patients includes up to 9 ounces of flower (10 ounces for patients with a terminal illness), along with limits for other product types. Adult-use customers are held to the adult-use possession limit of 2.5 ounces of flower and 15 grams of extract.
4. Legal Protections and Rules
Medical patients in Ohio have a few rights that adult use customers do not:
- Higher possession limits. Patients can possess up to their 90 day supply, compared to 2.5 ounces of flower and 15 grams of extract for adult use.
- Access at 18. Only registered patients under 21 can buy legally.
- Caregivers. A registered caregiver can buy and carry cannabis on a patient’s behalf.
- Delivery. Senate Bill 56 allows dispensaries to deliver to medical patients.
A common myth is that only medical patients can grow at home. In Ohio, home grow is available to every adult 21 or older, medical or not: up to 6 plants per person and 12 per household, kept in a secured, enclosed area out of public view. Patients under 21 can’t grow.
Rules That Apply to Everyone
Senate Bill 56 tightened a few rules for all cannabis consumers in Ohio:
- Buy from licensed Ohio dispensaries. Cannabis must come from a licensed Ohio dispensary or be grown at your own home. Cannabis bought out of state isn’t legal to possess in Ohio.
- No smoking or vaping in public. Smoking and vaping are limited to private residential or agricultural property.
- Transport it out of reach. In a vehicle, keep cannabis in the trunk or behind the last row of seats, and don’t open packages while driving.
Laws change, and this article isn’t legal advice. Check the Ohio Division of Cannabis Control for the latest rules.
Consultation and Support
Medical patients get something adult-use customers don’t: a relationship with a physician who knows their health history and can talk through how cannabis fits into their care. That can be especially valuable for patients who are new to cannabis or managing other medications.
At the dispensary, every customer can lean on budtenders for guidance on product types, formats, and where to start. Ascend budtenders are trained to help both medical patients and adult-use customers find products that fit their preferences.
6. Cost: Is a Medical Card Worth It in Ohio?
Getting a medical card in Ohio is cheaper than it used to be. The state dropped its $50 patient registration fee in 2024, so the main cost is the physician visit, which is typically a paid appointment you’ll repeat every year to renew.
A simple way to decide: compare what you pay for the doctor’s visit with what you’d save on the 10% excise tax. If your visit costs $150, you break even at about $1,500 a year in purchases, or roughly $125 a month. Spend more than that, or want access to delivery, higher limits, or access under 21, and a medical card likely pays for itself. If you buy occasionally, adult use may be the simpler choice.
Earn Rewards on Every Purchase With the Ascenders Club
If you are stocking up, every purchase at Ascend adds up to real savings. The Ascenders Club is Ascend’s free loyalty rewards program, where you earn 1 point for every $1 spent (pre-tax) at any participating location.
Points redeem for discounts at checkout, and they go even further on Ascend’s top brands, including Ozone, Simply Herb, Effin’, High Wired, Common Goods, and Royale, where your points are worth double.
Standard redemption:
- 250 points = $5 off
- 500 points = $10 off
- 1,000 points = $20 off
- 1,500 points = $30 off
- 5,000 points = $100 off (Platinum and Legends members only)
Track your balance in the Ascend Dispensary app, available on the Apple App Store and Google Play, or through Ascend’s email communications. Points expire 90 days after your last point-earning transaction.
Join for free at any Ascend location or at letsascend.com/ascenders-club.
Medical or Adult Use: Your Next Visit Starts at Ascend
Now that you know the difference, put it to work. Ascend’s Ohio dispensaries serve both registered medical patients and adults 21+, so you can shop the same menu of flower, vapes, edibles, concentrates, and more, whichever path you choose.
Why Ohioans shop Ascend:
- One stop for medical and adult use. Bring your patient card or your ID and we’ll take care of the rest.
- Budtenders who know Ohio cannabis. Get straight answers on products, purchase limits, and what fits your needs.
- Rewards that add up. Join the Ascenders Club and earn on every purchase.
- Order ahead, skip the wait. Browse the menu online, reserve your order and pick it up when it works for you.
Have a medical card? Have your patient card ready at checkout so you skip the 10% excise tax. Thinking about getting one? Ask our team how it works on your next visit.
Your next favorite product is waiting.
