What Clinicians Need to Know About: Traveling with Cannabis

As medical and recreational cannabis use becomes increasingly legal across various jurisdictions, clinicians are increasingly confronted with questions from patients about traveling with cannabis. The legal complexities, medical risks, and potential consequences of transporting cannabis across borders—both domestic and international—are significant. It is essential for clinicians to understand these issues in order to offer accurate, up-to-date guidance to patients who rely on cannabis for therapeutic purposes.

The most critical concern is the legal status of cannabis at the point of departure, destination, and during transit. While over 35 U.S. states have legalized medical cannabis, and more than 20 allow non-medical (aka recreational) use, cannabis remains illegal at the federal level (U.S. Drug Enforcement Administration [DEA], 2023). This means that transporting cannabis across state lines—between two states where it is legal, and even two adjacent legal states—is technically a federal offense.

Furthermore, cannabis possession is strictly prohibited in airports and on airplanes governed by federal law, including Transportation Security Administration (TSA) regulations. While TSA officers do not actively search for cannabis, they are required to report illegal substances to law enforcement when discovered during security screening (Transportation Security Administration, 2023).

International travel with cannabis poses even greater risks. Many countries enforce strict drug policies, and possession of cannabis—even with a valid U.S. medical prescription—can result in detention, fines, or imprisonment. For example, countries such as Japan, the United Arab Emirates, and Indonesia have harsh penalties for cannabis possession, regardless of intent or medical need (U.S. Department of State, 2024).

Clinicians must emphasize to patients that a valid medical cannabis card does not provide legal immunity abroad.

From a clinical perspective, discontinuing cannabis during travel may result in withdrawal symptoms, particularly in patients who use it regularly for chronic pain, anxiety, or nausea. Symptoms such as irritability, insomnia, decreased appetite, and mood changes can impair the patient's functioning while away (Bahji et al., 2021).

Clinicians should develop alternative treatment plans in anticipation of travel-related interruptions, including temporary substitution with legal medications. Dronabinol (Marinol) can be used to stave off such withdrawal, but also may not be legal in all countries.

In conclusion, clinicians must counsel patients that traveling with cannabis carries legal and health risks. A comprehensive discussion should include applicable laws, potential penalties, alternative medications, and strategies for managing withdrawal. Ultimately, informed planning can help patients avoid legal jeopardy and maintain therapeutic stability while traveling.

References:

Bahji, A., Stephenson, C., Tyo, R., Hawken, E. R., & Seitz, D. (2021). Prevalence of cannabis withdrawal symptoms among people with regular or dependent use of cannabinoids: A systematic review and meta-analysis. *JAMA Network Open, 3*(4), e2023709. [https://doi.org/10.1001/jamanetworkopen.2020.23709](https://doi.org/10.1001/jamanetworkopen.2020.23709)
Transportation Security Administration. (2023). *What can I bring?*. [https://www.tsa.gov/travel/security-screening/whatcanibring](https://www.tsa.gov/travel/security-screening/whatcanibring)
S. Department of State. (2024). *Traveling abroad with prescription medications*. [https://travel.state.gov/content/travel/en/international-travel/before-you-go/travelers-with-special-considerations.html](https://travel.state.gov/content/travel/en/international-travel/before-you-go/travelers-with-special-considerations.html)
S. Drug Enforcement Administration. (2023). *Drug scheduling*. [https://www.dea.gov/drug-information/drug-scheduling](https://www.dea.gov/drug-information/drug-scheduling)