Medical Marijuana at 50: A Lived History

Announcing a new, year-long series that celebrates the founding of the medical cannabis movement

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🎧 Audio Reading

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This essay is the opening entry in the Medical Marijuana at 50 series. For readers who prefer to listen — or who want to hear this history in my own voice — an audio reading is available here.

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2026 marks the 50th anniversary of the founding of the medical marijuana movement. To celebrate, I am launching a new series titled "Medical Marijuana at 50."

Why this series exists

Fifty years ago, in 1976, medical marijuana did not yet have a name.

In November of that Bicentennial year, my late husband, Robert C. Randall, became the first person in the United States to receive marijuana legally as a medical necessity—after a federal court recognized that it helped preserve his sight. That ruling helped launch a movement that endures today. It opened a door that many people would pass through, often at great peril.

This series, Medical Marijuana at 50, looks back at the first two decades of that story—not from hindsight or theory, but from lived experience, contemporaneous records, and the voices of patients who were there when nothing about this path was certain.

Alice O’Leary Randall is the co-founder of the medical marijuana movement in 1976. Her late husband, Robert C. Randall, a glaucoma victim, became the first legal medical cannabis patient of the modern era in November 1976. For several years, he was the only legal medical cannabis patient in the U.S.

What this series is

Medical Marijuana at 50 is a year-long, monthly Substack series. Each post will include:

• A written essay

• An audio recording, in my voice

• References to original documents and press coverage, with links to materials online

• Personal memories

The essays will follow a chronological arc beginning in 1976 and moving through the mid-1990s, tracing a remarkable and historically unique patient movement which led—decades later—to an equally unique remedy, as state after state in the 21st century defied federal policy and legalized the medical use of cannabis. It began fifty years ago with a single legal case involving a single patient, but it evolved into a national—and eventually international—movement.

What the series will cover

Over the coming months, Medical Marijuana at 50 will explore:

• The early years of the movement, before “medical marijuana” existed as a recognized category

• The first patients who fought for legal, medical access to cannabis

• How courts, federal agencies, and patients collided in real time

• The “compassionate” access program established by the federal government that was abruptly closed when too many AIDS patients asked for compassion

• How the states attempted to help medical marijuana patients when federal agencies failed

• The role of judges, veterans, doctors, mothers, and activists—many now forgotten

• The AIDS crisis and the moral urgency it brought to the issue

• The transition from courtroom strategy to public protest and ballot initiatives

This is a record of persistence, contradiction, loss, and unintended consequences.

What makes this series different

I do not come to this subject as an observer.

When Robert and I were arrested for cannabis cultivation in 1975—which forced us to prove Robert’s medical need—we were 28 years old. Today I am 78.

This series is not just culled from historical documents. I lived it. I kept the files. The letters. The clippings. The court documents. The notes from long days and longer nights when the future of legal medical access was anything but assured.

Fifty years later, those records matter—not only because of where the country ultimately arrived, but because of how uncertain and fragile the path was along the way. This is a very human story. History tends to smooth rough edges. This series will not.

Looking ahead

Each month throughout 2026, I will publish an essay in the Medical Marijuana at 50 series. Each will include an audio recording for those who prefer to listen. Substack will be the home for this series because, of all existing platforms, it reaches the largest and most diverse audience.

You don’t need to be a medical cannabis patient to appreciate these stories of human courage and perseverance. My hope is to reach people beyond the circle of cannabis activists and reformers who are still working hard to bring about needed reform. Today, people choose to enter the cannabis reform or industry arenas. Fifty years ago, the choice was stark: break the law—or suffer needlessly.

A final note

Recently, I was described as “keeper of the story.” I liked it because it’s true.

Nearly everyone from the very early days of the medical cannabis movement is gone. I have kept their memory close to my heart. But more than that, I have kept their letters, their pictures, video clips of appearances on news shows, and news clippings of their story.

It has been my honor to be the keeper of these items. But history only lives if it is shared. This series is my effort to place the early history of medical marijuana where it belongs: in the public record, told carefully, accurately, and without haste.

Thank you for reading. I hope you’ll stay for the months ahead. ❖

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The story of medical marijuana did not begin as a movement. It began quietly, with one patient, one illness, and one legal case—at a time when the idea of marijuana as medicine had no standing, no language, and no protection. In the next installment of this series, I return to those earliest days, when the risks were personal, the outcomes uncertain, and the future of medical access rested on arguments made one courtroom at a time.