Legalization advocates everywhere rejoiced with the recent passage of medical marijuana laws in New Hampshire and Illinois. As of today, there are twenty US states with medical cannabis laws, as well as legal medical cannabis in Washington DC.

Less noted, however, is the disturbing trend we’ve seen in medical cannabis laws since 2010 -- the elimination of a patient’s right to grow their own cannabis for medical usage. The nine most recent medical cannabis laws -- Arizona, DC, New Jersey, Delaware, Connecticut, Massachusetts, Maryland, New Hampshire and Illinois -- have maintained criminal penalties for sick and disabled people who plant a pot garden.

Much of this trend is based on the need to pass these laws through legislatures. Most of the states in the eastern U.S. do not have the power of citizen ballot initiatives. Therefore, in these states, activists and lobbyists have to fight for the votes of lawmakers who are very much in the sway of the law enforcement and private prison lobbies. Anti-marijuana forces there shock the legislators with tales of “monster grows” in California, Oregon and Colorado, huge pot farms protected by lax medical cannabis laws, where growers are surreptitiously shipping their excess marijuana into the black markets of eastern states. The legislators then craft restrictive medical cannabis laws that require patients to get their tiny allotments of cannabis from dispensaries (or one specific dispensary in some cases); all while being video recorded and having every gram of cannabis tracked from seed to sale.

Without these restrictions, medical cannabis laws don’t pass in these states, whether it is an unspoken assumption or, as in the case of New Hampshire, the governor specifically refuses to sign a law until the home growing provisions are removed.

Even in states with the ballot initiative process, some pro-marijuana reformers believe they cannot get a law passed by the voters if it includes home growing. In Arizona, framers of the medical cannabis law allowed for an exception for home growing if a patient lived 25 miles or farther from a dispensary. This meant some patients in the city bought equipment for growing and harvested a few crops, only to have to tear down their grow the minute a dispensary opened up a few miles away. Arizona’s law barely passed with 50.13% of the vote -- no one can say whether the 25-mile limit added or subtracted votes.

In Massachusetts, another initiative state, the law passed with 63% of the vote. Framers there created an exception only for patients with “hardship”; if they can show they live too far from a dispensary or shopping at one would be too onerous, they may grow their own garden. It’s hard to imagine that allowing home grow for all patients would have cost Massachusetts 13% of its support for medical cannabis.

As the fight for medical cannabis continues across the nation, activists need to find a way to demonstrate the importance of patients’ being able to grow their own medicine. Without it, those patients may someday find all their dispensary’s cannabis has been replaced with sprays, pills and inhalers from GW Pharmaceuticals.