SC Compassionate Care Act — Proposed Qualifying Conditions (S.53)

The Bottom Line First

If you are a South Carolina resident with a serious medical condition and you want lawful access to cannabis-based products:

• SC has no medical-cannabis card as of May 2026. There is nothing to apply for at the state level.
• Many SC residents currently rely on hemp-derived products (CBD, Delta-8, Delta-9 from hemp) sold under SC’s 2017 Hemp Farming Act and the federal 2018 Farm Bill. The federal hemp cliff arrives November 12, 2026; see federal hemp cliff.
• SC’s narrow Julian’s Law (2014) provides an affirmative defense for possession of CBD oil with ≤0.9% THC for severe epilepsy patients enrolled at MUSC. It does not authorize purchase or production.
• Some patients travel to EBCI Great Smoky Cannabis Co. (NC tribal sovereignty, adult-use) or other legal states — understanding that re-entering SC with any THC product is a state-law violation.

What S.53 Would Include If Enacted

Sen. Tom Davis has methodically reworked the Compassionate Care Act across sessions to address law-enforcement objections. S.53 (2025-26) describes itself as “the most conservative medical cannabis program in the country.” The bill’s qualifying conditions list is narrowly drawn. Based on S.53 as introduced January 14, 2025:

Likely Qualifying Conditions Under S.53

The bill lists specific debilitating conditions (rather than a general “chronic pain” or “anxiety” bucket of the kind found in NJ or NM). Exact list as introduced:

• Cancer
• Multiple sclerosis
• Neurological disease or disorder, including epilepsy
• Sickle cell anemia
• Glaucoma
• PTSD
• Autism (severe / persistent)
• Crohn’s disease
• Ulcerative colitis
• Cachexia (wasting)
• A terminal illness with life expectancy < 1 year
• A chronic medical condition that causes severe and persistent muscle spasms (e.g., MS, ALS, spinal cord injury)
• A chronic medical condition for which an opioid analgesic could otherwise be prescribed

Note: Sen. Davis has explicitly framed the bill to exclude routine anxiety and routine chronic pain as standalone qualifiers, in order to differentiate the SC program from broader programs in NJ, OK, FL, and AZ that law-enforcement opponents have criticized as “rec-by-another-name.”

The exact list could change in committee or on the floor. As of May 5, 2026 — three days before sine die — S.53 has not received a 2026 hearing in either chamber. See what S.53 would do.

What S.53 Would Exclude

• No smokable flower. All medical-cannabis programs Davis has authored prohibit smokable flower — oils, tinctures, capsules, lozenges, topicals, and patches only.
• No home cultivation. No patient or caregiver may grow cannabis.
• Pharmacist-consultation requirement at “therapeutic cannabis pharmacies.” A pharmacist (not a budtender) must counsel each dispensation.
• No general “chronic pain” or “anxiety” qualifier. The bill is designed to be narrower than typical state programs.
• ~65-75 dispensaries statewide capped at 3 per county. Vertical-integration limits.

The South Carolina Compassionate Care Act (S.53) is the formal name for medical-cannabis legislation introduced in every legislative session since 2014 by Sen. Tom Davis (R-Beaufort). The bill has never become law.

South Carolina Legislature &mdash; S.53

If S.53 Passes — What Patients Should Expect

If the General Assembly enacts the Compassionate Care Act and Gov. McMaster (or his successor; McMaster is term-limited Jan 2027) signs it, the program would not be operational for an extended period. Based on neighboring-state launch timelines (AL: 5 years from law to first sale; OK: 90 days; MS: 6 months; AR: 913 days), an SC launch could realistically be 18 months to 5 years after enactment.

When operational, eligibility would require a written certification by a physician documenting that a patient has one of the listed qualifying conditions and that cannabis is medically appropriate, plus state registration with the program agency (currently proposed to be administered by SCDHEC / DHHS).

What SC Residents Currently Do

Hemp-Derived Products (CBD, Delta-8, Delta-9 from Hemp)

Operate legally in SC under the 2018 Farm Bill and SC’s 2017 Hemp Farming Act — for now. The federal hemp cliff arrives November 12, 2026 (PL 119-37 § 781), which is expected to bring intoxicating-hemp products in their current form to an end. See federal hemp cliff and Delta-8/Delta-9 retail wave.

Julian’s Law (2014)

An affirmative-defense statute (not a positive authorization) for possession of CBD oil ≤0.9% THC by patients enrolled in the MUSC severe-epilepsy program. Has resulted in <50 enrolled patients over a decade. See Julian’s Law.

Cross-Border Options

• EBCI Great Smoky Cannabis Co. (Cherokee, NC, tribal sovereignty, adult-use since 2024). See EBCI cross-border.
• Maryland adult-use (since July 1, 2023) — the closest licensed adult-use sales but a 7+ hour drive from Charleston.
• Florida medical (~900K patients) — closest medical state for SC residents with documented serious conditions, but requires FL residency for program enrollment.
• West Virginia medical (since 2021) — further drive but operational.

Important: Cannabis remains federally illegal, and re-entering South Carolina with any THC product is a state-law violation that can trigger possession (1 oz or less misdemeanor) or PWID felony exposure (over 1 oz prima facie PWID). See interstate interdiction.

For Research-Backed Condition Information

For evidence-based summaries on how cannabis may affect specific conditions, see TryCannabis.org’s conditions guide. Always consult your treating physician.

Next Steps

• Read what S.53 would do for the full program design.
• Read the political reality: Senate-House asymmetry, 2024 House 3M death.
• If you live in SC and want a card now: see cross-border options & reciprocity.