Alabama Medical Cannabis Dose & Supply Rules — 50 mg / 75 mg / 70-Day Supply

Last verified: May 2026

The Adult Daily THC Cap — 50 mg Default

Adult patients (19+) may receive up to 50 mg of total THC per calendar day for the first 90 days of registration. The cap is total cannabinoid content, not per-dose. A patient who takes a 25-mg tablet at 9:00 AM and a 25-mg tincture at 3:00 PM has reached the daily cap. The cap is enforced at the dispensary level — the state seed-to-sale system tracks daily aggregate dispensing and dispensaries cannot dispense over the cap.

Dispensaries verify the cap at each visit using the patient’s registration in the seed-to-sale system. Patients who attempt to circumvent the cap by visiting multiple dispensaries cannot succeed because all licensed dispensaries report into the same seed-to-sale infrastructure.

The 75 mg Expanded Cap (After 90 Days)

After the first 90 days of registration, the certifying physician may approve a daily cap up to 75 mg total THC per day. Approval requires documentation of one of the following:

• Inadequate symptom control at 50 mg. Physician documentation that the 50-mg cap has not produced adequate clinical response.
• Established tolerance. Physician documentation that the patient has developed tolerance requiring higher dosing.
• Terminal illness. The Compassion Act expressly authorizes higher dosing for end-of-life palliative care.
• Documented medical appropriateness. A general clinical-judgment finding supported by patient-specific factors.

The expanded cap is recorded in the patient’s AMCC registration; dispensaries verify the expanded authorization at each visit.

The Minor Patient Cap — 3% THC Dose-Form Maximum

Patients under 19 are subject to a 3% THC dose-form maximum. The cap is on the composition of the dose form rather than on a daily milligram total — a tincture containing 30 mg THC per mL would exceed the cap if the formulation is more than 3% THC by composition. The cap is intended to limit pediatric psychoactive exposure while permitting high-CBD / low-THC formulations effective for pediatric epilepsy and similar conditions where CBD-dominant formulations are clinically supported.

Minor patients require a designated caregiver (21+, Alabama resident, background-check cleared, $25 fee) who handles purchase and administration on the patient’s behalf. The caregiver receives a separate caregiver card and is the only person authorized to purchase on the minor’s account.

The 70-Day Supply Limit Per Visit

Each dispensing visit is limited to a 70-day supply. The 70-day calculation is the daily THC cap multiplied by 70:

• Adult at 50 mg/day cap × 70 = 3,500 mg total THC max per visit.
• Adult at 75 mg/day expanded cap × 70 = 5,250 mg total THC max per visit.
• Minor patient: not a milligram cap but a dose-form composition cap; supply tracked by total dose-form quantity.

The next dispensing visit must be at least 70 days after the previous visit’s purchase. Patients who consume their supply faster than 70 days cannot legally repurchase from a Compassion-Act dispensary until the 70 days has elapsed.

The 9% Excise Tax & Total Out-the-Door Cost

Compassion Act sales are subject to a 9% excise tax on gross retail sales (§ 20-2A-71). State sales tax (4%) and municipal sales tax (variable, typically 1–5%) apply on top of the excise tax. Total out-the-door tax burden ranges 14–18% depending on jurisdiction.

The 9% excise rate is among the lowest in U.S. state medical-cannabis programs — reflecting the Compassion Act’s patient-access framing. Excise revenue funds AMCC operations, the Alabama Medical Cannabis Patient Registry, and Alabama Department of Public Health compliance work.

Insurance & Cash-Pay

Health insurance does not cover Compassion Act medical cannabis. Federal Schedule I status historically prevents Medicare, Medicaid, Tricare, VA, and private commercial insurers from covering cannabis as a medication — the April 2026 Schedule III order does not yet alter that calculus.

Dispensaries operate on cash or debit-card terms. Credit-card processing has historically been unavailable due to federal banking restrictions; the SAFE Banking Act remains pending in Congress as of May 2026 and would resolve the credit-card issue if passed. Some dispensaries accept ATM withdrawals on-site.

Drug-Drug Interactions & Special-Population Dosing

Medical cannabis dosing requires careful attention to drug-drug interactions, particularly:

• CYP3A4 inducers and inhibitors. Many cannabinoids are CYP3A4 substrates; co-administration with strong inhibitors (clarithromycin, ketoconazole, ritonavir) may dramatically increase cannabinoid plasma concentrations.
• Warfarin and other CYP2C9 substrates. CBD is a known CYP2C9 inhibitor; warfarin INRs may rise unpredictably.
• Sedative-hypnotic medications. Cannabis may potentiate CNS depression with benzodiazepines, opiates, and other sedatives.
• Antihypertensives. Cannabis may produce orthostatic hypotension; combining with antihypertensives may produce additive effects.

Pregnant and lactating patients should avoid cannabis — the Compassion Act does not include pregnancy as a qualifying condition and does not provide formal pregnancy guidance. Patients with mental-health histories (psychosis, severe depression, suicidality) should be screened carefully — cannabis use can exacerbate certain psychiatric conditions.

Practical Notes

• Track your daily dosing. The 50-mg / 75-mg cap is total cannabinoid — a single 50-mg tablet exhausts the daily allotment.
• Plan for the 70-day visit cadence. Build the 70-day cycle into your medication-management routine.
• Do not pool with another patient or caregiver. Each patient’s allotment is individually tracked; pooling violates Compassion Act rules.
• Bring cash or debit. Credit cards are not accepted.