Arkansas Medical Cannabis Practitioner Certification

Last verified: May 2026

Who Can Certify

Amendment 98 § 2(12) defines the universe of authorized certifiers: only Arkansas-licensed Doctors of Medicine (M.D.s) or Doctors of Osteopathic Medicine (D.O.s) with active federal DEA registrations may sign an Arkansas medical-marijuana certification. This is a notably narrower pool than most state medical-cannabis programs, where physician assistants (PAs), nurse practitioners (NPs), advanced practice registered nurses (APRNs), and sometimes optometrists or dentists may also certify within their scope of practice.

Arkansas allows none of those alternatives. PAs, NPs, APRNs, dentists, optometrists, podiatrists, chiropractors, and naturopaths cannot sign Amendment 98 certifications. The Issue 3 ballot measure of 2024 attempted to expand the certifying-provider pool to include PAs and NPs, but the Arkansas Supreme Court enjoined Issue 3 before votes were counted.

The DEA Registration Requirement

The federal DEA registration requirement is structurally interesting. Cannabis remains a Schedule I controlled substance under federal law. A DEA registration authorizes a practitioner to prescribe controlled substances under the Controlled Substances Act — not cannabis specifically, but the broader Schedule II–V universe. The Amendment 98 architecture leverages the DEA-registered M.D./D.O. universe as a quality filter for certifying providers.

In practice, the DEA-registration requirement does not meaningfully constrain access. Most Arkansas-licensed M.D.s and D.O.s hold DEA registrations as a routine condition of clinical practice; the requirement primarily filters out a small number of lifestyle-medicine, integrative-medicine, and academic-only practitioners who may not maintain active DEA registrations.

Bona Fide Patient-Physician Relationship

The certifying physician must have a bona fide patient-physician relationship. ADH Rules require:

• An in-person or telehealth assessment consistent with Arkansas State Medical Board rules.
• A review of relevant medical history, including treating-provider records, prior diagnostic imaging or lab work, prior treatment history, and any specialist consultations.
• A determination that the patient has one of the 18 qualifying conditions under Amendment 98 § 2(13).
• A determination that medical cannabis is appropriate in the practitioner’s clinical judgment.
• The signed written certification form, valid for 30 days.

Telehealth Certification Is Standard Practice

Most Amendment 98 certifications now happen via telehealth. Arkansas State Medical Board telehealth rules permit licensed M.D.s and D.O.s to certify Amendment 98 patients via video consultation, provided the physician has a bona fide patient-physician relationship. Typical structure:

• 15–30 minute video visit.
• Review of patient’s uploaded medical records.
• Discussion of cannabis treatment plan, dosing, and contraindications (drug interactions, pregnancy, history of psychosis, cardiac conditions).
• Signed certification delivered electronically to the patient for ADH submission.
• Typical patient cost: $150–$250.

Several Arkansas-based and multi-state telehealth networks (e.g., NuggMD, Heally, Veriheal, plus regional Arkansas-licensed practices) operate at scale.

What the Practitioner Cannot Do

• Cannot prescribe. Amendment 98 uses certification, not prescription. Cannabis remains Schedule I federally; no DEA registration authorizes a prescription for cannabis. The Amendment 98 framework substitutes a state-law certification for the federal-law prescription.
• Cannot dispense. Practitioners cannot sell or distribute cannabis. All cannabis flows through the eight licensed cultivators → the 36+ active dispensaries.
• Cannot certify outside the 18 qualifying-conditions list. Conditions like generalized anxiety, ADHD, depression, and migraines do not qualify under Amendment 98 § 2(13).
• Cannot authorize home cultivation. Amendment 98 § 6(b) bans home cultivation regardless of physician opinion.

The 30-Day Certification Window

The signed certification is valid for 30 days from the date of signing. If the patient does not file a complete ADH application within that window, the certification expires and a new visit is required. ADH does not issue temporary cards while applications are pending.

Annual renewal requires a new certification — typically a brief follow-up telehealth visit verifying continued qualifying-condition status — together with the $50 ADH renewal fee.

Ethical and Practical Considerations

• Drug interactions. Cannabinoids interact with antidepressants, blood thinners (warfarin), some seizure medications, and certain HIV antiretrovirals. Patients should review medication lists with the certifying physician.
• History of psychosis or schizophrenia. Cannabis use is contraindicated in patients with personal or first-degree-family history of psychosis. Practitioners typically decline to certify in such cases.
• Pregnancy. Cannabis use during pregnancy and lactation is contraindicated. Practitioners typically decline to certify pregnant patients.
• Pediatric patients. Certifying minor patients requires parental consent and a parental-caregiver registration.

Related on this site: Arkansas Medical Marijuana Amendment..., Arkansas Caregiver Card, Arkansas Medical Card.