North America: Travelling with medical cannabis

Please note that this information does not constitute legal advice and should not be solely relied upon. It is crucial to thoroughly review the current travel advice for each country before making any travel arrangements or embarking on a journey with medical cannabis.

It’s a common dream to jet set away to a faraway land, explore new landscapes and learn about different and diverse cultures. Relaxing in a tropical environment or adventuring through unfamiliar territories are popular bucket list items for millions across the world, and we don’t think medication should stop these dreams from becoming a reality.

That's why we’ve put together this guide, for our Travel Section, to help medical cannabis patients understand the rules and regulations that are in place in five of the hottest destinations in North America. 

Here we will establish the legislations that relate to medical cannabis patients whilst in the US, Canada, Mexico, Barbados, and Puerto Rico so that they can plan the holiday of a lifetime, without having to give up what may be a lifeline. 

Medical cannabis in the United States

Some may assume that because the majority of US States take a relatively liberal stance towards cannabis, that flying into the US with your medical cannabis prescription would be a breeze. However, this is not the case. Although medical cannabis is legal in 39 States and the recreational use of cannabis is permitted in 24 States at the time of writing, cannabis remains illegal at a federal level, and in federal airspace.

Therefore, it is a federal offence to import or export cannabis across US borders and so, medical cannabis patients are advised against travelling with their medication to America. Instead, The Sanskara Platform advises patients take an up-to-date copy of their prescription with them and purchase their medication once in the US, from a legal and reputable dispensary.

However, this may not be possible for every medical cannabis patient. 

Long flight times combined with airport waiting times, possible transfers, the time spent at baggage reclaim, security, or in customs can disrupt dosing schedules. This can in turn have a knock-on effect on the patient's symptoms and general wellbeing, and so going all this time without taking their medication may not be a possibility.

Then there is the extra risk that patients may not be able to secure access to the particular type or cultivar of medical cannabis they have been finding beneficial once reaching the US – which could again negatively impact their health.

When considering any destination, we’d advise contacting the American embassy for individual advice. Although cannabis is federally a schedule 1 drug in the US under the Controlled Substances Act 1970, the US Transport Security Administration website states that medical cannabis is permitted in checked luggage and hand luggage, under special instruction.

However, it is unclear what these ‘special instructions’ are, and they are not stated on their website. The TSA does state that certain medications have to follow ‘special procedures’ when being carried across the US, however it is unclear if these are the rules also applied to medical cannabis.

The TSA does expand slightly and say that CBD products that contain less than 0.3% THC in their dry weight, and cannabinoid based products that have received FDA approval, such as Epidyolex, are approved for travel. They also include a statement in this section that reads:

“TSA’s screening procedures are focused on security and are designed to detect potential threats to aviation and passengers. Accordingly, TSA security officers do not search for marijuana or other illegal drugs, but if any illegal substance is discovered during security screening, TSA will refer the matter to a law enforcement officer.”

Medical cannabis in Puerto Rico 

Puerto Rico is an incredibly beautiful, diverse and vibrant country, and so, it is a dream destination for many. Although Puerto Rico is an island within the Caribbean, it is in fact an unincorporated territory of The United States of America. 

This means that Puerto Rico is not a US State, but it is also not classed as an independent country. It is governed by a mixture of civil and common law systems that are written in Spanish, although most do adhere to the US federal frameworks.

In Puerto Rico, medical cannabis can be legally prescribed to eligible patients to manage the symptoms of over 25 different health conditions. After a qualified doctor has recommended cannabis based treatments to the patient, they can upload a written version of this, along with any other relevant medical information and an image of themselves, to the Cannabis Licensing Website to apply for their medical cannabis ID card. 

According to the Americans for Safe Access (ASA) website, Puerto Rican officials also recognise medical cannabis patient status and ID cards from other states for up to 30 days.

This means that travellers with US medical marijuana ID cards are permitted to possess, consume and purchase medical cannabis in Puerto Rican dispensaries providing their patient status can be verified, and this information was made available to the relevant authorities. 

The ASA’s patient guide for US travel with medical cannabis also states: 

“Non-resident patients may obtain a Puerto Rican medical cannabis card by visiting an authorised healthcare provider, completing the application process and paying $25.”

Because Puerto Rico is an unincorporated territory of the US, it would be sensible to assume that they have similar restrictions surrounding patients travelling into the country with medical cannabis. Although it has been confirmed that documentation and valid patient status will be accepted and recognised when crossing the border, the ASA note that travelling with cannabis across state lines and borders is classed as an illegal, federal crime.

As always, we’d advise contacting the Puerto Rican embassy for more specific and tailored advice before attempting to travel with medical cannabis. It appears that this idyllic island is accepting of cannabis based medicines, and due to their approval of US patient status it may be that the same courtesy could be extended to those from the UK.

Medical cannabis in Canada

Home to Canada’s contribution to the wonder of the worlds, Niagara Falls, and known as the friendly face to the world, Canada is also a cannabis friendly country – which makes it a popular choice amongst patients and advocates alike.

In 2018 The Cannabis Act came into effect in Canada, placing further regulations on the existing and thriving cannabis market that has been evolving since the legalisation of medical cannabis in 2001. In Canada, the production, sale, distribution, and possession of cannabis is now controlled by The Cannabis Act. 

Although, like in the US, medical cannabis is completely legal in Canada, the Canadian Border Services Agency website features a video that tells viewers it is illegal to transport cannabis over the Canadian border even with medical authorisation.

However, conflictingly, their website also states that cannabis can be transported over Canadian borders without it being a criminal offence, but only if its transportation has been approved by Health Canada. The Canadian Border Service Agency website also explains that cannabis must be declared to them upon entry to the country for matters of safety and security.

Health Canada is a governmental department that can grant exemptions to these import and export laws on occasion, but this appears to be on more of a commercial basis than a personal or patient process. The exemption reasons stated include importing starter materials for a licence holder, importing for scientific research reasoning, and exporting to another country where cannabis is legal.

On the other hand, The Canadian Air Transport Security Authority (CATSA) also emphasises the criminality of flying out of Canada whilst carrying cannabis, but state cannabis is permitted in check in and carry on bags on internal flights. They advise Canadian medical cannabis patients to contact the Embassy of their destination country for more guidance on whether they can take their cannabis based medications abroad, but have made these accommodations for patients to fly within the country.

The emphasis on taking cannabis out of Canada is a recurring trend when researching whether medical cannabis patients can travel to Canada whilst carrying their medication, but there is little information available about bringing it into the country. 

Because recreational cannabis is also legal in Canada, and has been since 2017, cannabis can be purchased legally by adults in dispensaries all over the country. These stores are stocked with a wide variety of products, offering a range of administration methods, product forms, flavours, and concentrations to choose from.

If patients have been advised by the airline, or by the Canadian Embassy and Health Canada that travelling to the country with their own medical cannabis may not be possible, buying it abroad may be an option worth considering. Because Canada was one of the first large nations to establish a legal cannabis market, the majority of the products available in the UK can also be found in Canada – and may have actually been produced there.

Medical cannabis in Barbados

In 2019, Mia Mottley, the Prime Minister of Barbados, passed the Medical Cannabis Industry Bill legalising medical cannabis under strict regulations, which came into place the following year. This, combined with the beautiful beaches with white sand and tranquilly clear water, makes Barbados a perfect potential destination for a well deserved vacation.

Delving deeper into legislation, it appears that in Barbados, licensed doctors can prescribe medical cannabis to patients who are struggling to manage a list of qualifying conditions. Once cannabis-based medicines have been prescribed, they must be legally dispensed from a pharmacy according to the Barbados Medicinal Cannabis Licensing Authority (BMCLA).

At a National Council of Substance Abuse panel discussion earlier this year, the BMCLA’s acting Chief Operating Officer Senator Shanika Roberts-Odle spoke about how medical cannabis patients can legally consume their medication when visiting the country.

After explaining that tourists must also be seen by authorised doctors within Barbados to have medical cannabis prescribed to them whilst in the country, Roberts-Odle added:

“We are working on how to bring about medical tourism while working with the rules that are established and to continue that. We are also doing international outreach. We will be going to several international conferences throughout the year to be able to make sure we are ahead of what’s going on internationally. We may be late to the game, but we don’t intend to be staying behind.” 

After the results of a public referendum, in September 2020 the Barbadian government also decided to decriminalise cannabis possession to a certain degree. Although cannabis is still classed as an illegal substance, now adults in Barbados found to possess less than 14 grams of cannabis are subjected to a small fine, and these offences are policed and handled in a similar way as parking offences.

So, it seems in the last five years the Barbadian government has liberalised its stance towards cannabis considerably, despite it still being classed as an illegal substance. Although cannabis based medicines are approved for use in Barbados, it is unclear whether patients can bring their own prescribed cannabis products into the country with them.

On the Customs declaration form that must be submitted when applying for entry to the country, there are two sections that may be applicable to medical cannabis patients from the UK. The first, would apply to anyone taking medication into Barbados and reads ‘ I am (we are) bringing pharmaceuticals’.

The second, that may apply to cannabis based medicines specifically, reads ‘I am (we are) bringing narcotics and other illicit drugs, biological substances, arms, ammunition, explosives, fireworks, toy guns and other weapons.’ 

This second section seems extreme, but also covers children's toys, and so it is best to seek advice from the Bajan Embassy on how to proceed with travelling with and declaring cannabis-based medicines in relation to this form.

Medical cannabis in Mexico

If the bright and vibrant streets of Mexico City or Madera are calling your name, you’re a connoisseur of Mexican cuisine, or desperate to attend a Day of the Dead celebration in person – Mexico could very well be on your bucket list. So, you may be relieved to hear that the medical use of cannabis is legally permitted in Mexico. 

The Mexican Ministry of Health issued Rules of Medical Cannabis in January 2021, which lawfully permits the consumption, prescription, possession, growth, import, export, and processing of cannabis for medical or scientific use in Mexico. This expanded the original legislations in place from 2017, which restricted THC content in cannabis based medicines to less than 1%. 

The Supreme Court of Justice in Mexico now also recognises residents rights to consume cannabis recreationally, and although technically the recreational consumption of cannabis is illegal, its possession is decriminalised. According to The Guardian, there are now around 800 producers of cannabis for medical and recreational consumption in the Mexican state of Oaxaca alone. 

In a Forbes article from 2021 it is explained that doctors who prescribe medical cannabis need to be registered with the Federal Commission for the Protection from Sanitary Risks, and these medicines must be dispensed from licensed pharmacies. The article also states:

“Both Mexican citizens and foreigners are permitted to travel in the country with their products. This opens the door for medical cannabis tourism.”

The Mexican Consular website offers some advice to those wanting to travel to Mexico with medications, however the information provided here is confusing when read in relation to cannabis based products.

When bringing medications into Mexico for personal use, it states, ‘passengers travelling with medicines for personal use are allowed to enter the country (regardless of active component) as long as they bring their prescription or a letter from their GP.’ This would imply that, so long as the relevant approvals are granted and the correct documentation is presented in Spanish, medical cannabis products may be permitted into Mexico.

However, later in the same extract, it states that in accordance with the law of general import and export taxes, marijuana, its seeds, extracts, and cannabis-based medical preparations are prohibited products in Mexico.

This is why it is imperative to seek individual advice from the Mexican Embassy, who will be able to advise patients on the best course of action for visiting the country as a medical cannabis patient. 

Conclusion

In conclusion, although America, Canada, Mexico, Barbados, and Puerto Rico all have given the green light to allow their residents access to medical cannabis, tourists attempting to take their own products on holiday with them face a lot of red tape and potentially prosecution. 

It is imperative to seek specific advice from the destination's Embassy before travel, and to gain approval from the relevant authorities before attempting to take medical cannabis out of the country. It is always best to travel with your medication in its original packaging, with labelling and documentation to prove its concentration, prescription, quantity and intended usage, from a reputable, licensed and legal clinician and pharmacy.

For further guidance on how to travel with medical cannabis, why not check out ‘What the Professionals say about Medical Cannabis on Holiday’ for more information, or our Continental Cannabis Guide or Destination Inspiration feature to find more places to add to your bucket list. 

Accessing medical cannabis can be challenging due to the stigma surrounding it. However, Releaf makes it simple with our tailored monthly packages, specialist consultations for medical cannabis, and a unique medical cannabis card for protection, all based on your cannabis prescription.