Alabama Governor Kay Ivey signed Senate Bill 46 last week, making her state the 37th to permit distribution, sale, and use of medical marijuana. The bill goes into effect immediately, but lawmakers estimate it will be 15 months before the entire process is legally instituted and medical marijuana will be available to Alabama residents.

Individuals who have at least one of the 16 qualifying medical conditions will need to receive a recommendation from a doctor to obtain medical marijuana in the form of gummies, pills, skin patches, and creams. Smoking, vaping, and other food products that contain marijuana are still prohibited in the state under this new legislation.

Some of the covered medical conditions include autism, cancer, terminal illness, depression, HIV/AIDS-related nausea or weight loss, Crohn’s disease, Parkinson’s disease, and Tourette’s syndrome.

The bill was sponsored by Republican state Senator, Tim Melson, an anesthesiologist who urged others to “open your heart, open your mind and listen to the other side,” in his plea to fellow lawmakers to vote for the bill. Republican state Representative, Mike Ball, pushed the bill in the House after it quickly passed in the Senate. Ball previously opposed any legislation to allow medical marijuana but stated he changed his mind after researching the medical benefits for those with chronic or terminal illnesses.

The bill ultimately passed in the House after countless representatives relayed stories of individuals who could or could have benefited from the use of the drug. The press secretary for Governor Kay Ivey acknowledged that “this is certainly an emotional issue” after the extensive debates in the state legislature.

The bill will be named after Wesley ‘Ato’ Hall, the son of Democrat Representative Laura Hall, who introduced medical marijuana legislation in 2005 after her son died of AIDS. The current bill comes after more than ten years of activism and proposed bills in the state legislature.

Not all in the state could overcome their opposition to the bill with the emotional plea by lawmakers used to pass the legislation. Twenty-three district attorneys signed a letter to the Alabama Legislature calling the bill “a wolf in sheep’s clothing.” Others, like Republican state Representative Rich Wingo, worried over the distribution and packaging permitted by the bill, said he “would rather see it in a form that is least appealing from a child’s view.”

Currently, 36 states and four territories allow for medical marijuana use. However, under federal law, marijuana is still classified as a Schedule I drug under the Controlled Substances Act. The schedules are groupings of drugs based on their potential for dependency and addiction. Schedule 1 has the highest potential for addiction, while Schedule 5 has the least. Other drugs within Schedule 1 include heroin, ecstasy, and peyote.

In 2009, then-President Obama’s young administration sent a memo to federal prosecutors in all states and territories pushing them not to prosecute for the distribution of medical marijuana in compliance with state law. The distribution of marijuana, for recreational or medical use, is still a federal offense in the eyes of the national government, but this memorandum gave prosecutors the leeway to co-exist with state laws.

Four years later in August 2013, the U.S. Department of Justice relaxed its federal marijuana enforcement policy relying more on “strong, state-based enforcement efforts.” The Department of Justice also “defer[ed] the right to challenge their legalization laws” but reserved the right to challenge state legislation when the department felt it becomes necessary.

In January 2018, in a change of policy, former Attorney General (and former Alabama Senator) Jeff Sessions issued a Marijuana Enforcement Memorandum that rescinded previous administrations’ stances on the distribution of medical marijuana. The new memo gave more power to federal prosecutors to decide on how to enforce the federal marijuana laws in relation to state laws.

In 2019, Governor Ivey signed a bill also sponsored by Senator Tim Melson, which created a commission to extensively study medical marijuana. It also extended “Carly’s Law” which allowed CBD oil to treat children with seizures.

Alabama joins the growing list of states that have moved to reduce the criminality of marijuana distribution. In the southeast region of the United States, only South Carolina and Tennessee have yet to decriminalize the use and distribution of the drug or legalized medical marijuana.