Arkansas Qualifying Conditions — The 18 Pathways

Last verified: May 2026

The Statutory List

What ACHI/UAMS Found

A joint Arkansas Center for Health Improvement (ACHI) / UAMS study published in Health Affairs (March 2025, Vol. 44(3):351–360) examined the Amendment 98 patient population through 2024. The study found:

• PTSD — 41.9% of patients cited PTSD as their qualifying condition. PTSD is the program’s single most-cited pathway, reflecting both genuine prevalence in the Arkansas population (military veterans, first responders, trauma survivors) and the comparative ease of certification relative to some other conditions.
• Intractable pain — 39.8%, requiring documented absence of response to ordinary treatment for at least 6 months. The clinical bar is meaningful: chronic-pain patients must show a treatment record.
• Severe arthritis — 14.7%, the third-most-cited pathway. Many patients in this category use cannabis as an opioid alternative.
• Smaller fractions cite cancer, severe muscle spasms, seizures, Crohn’s disease, fibromyalgia, and the remaining named conditions.

What Is — And Isn’t — on the List

The Amendment 98 list is narrower than several other state medical-cannabis programs:

• NOT on the Arkansas list: Anxiety disorders (general, social, panic), opioid use disorder, autism spectrum disorder, ADHD, depression (in itself), insomnia, migraines, IBD non-Crohn’s/UC.
• ON the Arkansas list as a symptom pathway, not a named disease: Severe nausea, intractable pain, severe muscle spasms, seizures, peripheral neuropathy, cachexia/wasting. These pathways require documented underlying chronic or debilitating disease that produces the symptom.
• The 1-month telehealth certification. The certification is valid for 30 days from the date of signing, which means most Arkansas patients schedule a quick follow-up visit each year to renew.

The Petition Process — And Why ADH Hasn’t Added Conditions

Section XIX of the ADH Rules permits any Arkansas resident to petition to add a new qualifying condition. Each petition is limited to a single condition, must include peer-reviewed medical evidence, and triggers a public hearing. Despite multiple petitions over the program’s history, ADH has not added any new condition since 2016.

This contrasts with the additional conditions added by other state programs through similar petition or rule-making channels (e.g., Pennsylvania, Maryland, Connecticut all have substantially broader lists). The 2024 Issue 3 ballot measure attempted to remove the 18-condition list entirely — allowing certifying providers to recommend cannabis for any condition they reasonably believed cannabis could treat — but the Arkansas Supreme Court enjoined Issue 3 before votes were counted.

How Patients Document a Qualifying Condition

• Named diseases (e.g., cancer, MS, Crohn’s, ALS, PTSD). Documentation = standard treating-physician records of diagnosis. The certifying physician verifies the diagnosis, not establishes it.
• Symptom pathways (e.g., intractable pain, severe nausea, seizures, severe muscle spasms). Documentation = treatment record showing the underlying chronic disease and the failure of standard treatment for at least 6 months (for intractable pain). The 6-month requirement is the most-litigated piece of the symptom-pathway architecture.
• PTSD. Trauma history + current symptoms + impairment of daily function. Treating-physician records, mental-health-clinician records, or VA-validated PTSD diagnosis are all sufficient.

Practical Guidance for Prospective Patients

• Match your documented diagnosis to one of the 18 specific pathways before the practitioner visit.
• Bring treating-provider records, prior diagnostic imaging or lab work, prior treatment history, and any specialist consultations.
• If your condition isn’t on the list (e.g., anxiety, ADHD, depression), the practitioner cannot certify. Consider whether one of the pathway diagnoses (e.g., PTSD if there’s a documented trauma history; severe arthritis if there’s a documented joint disease) applies to your situation.
• For minor patients, parental consent + parental-caregiver application is required.

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