Is medical marijuana tax deductible?

What Pub 502 says

Publication 502 has a list of what you can include and a separate list of what you cannot. Marijuana sits on the second list under the heading Controlled Substances. The sentence is direct: you cannot include in medical expenses amounts you pay for controlled substances, such as marijuana, that are not legal under federal law, even if such substances are legalized by state law.

Two other entries on the same list point the same way. The Illegal Operations and Treatments entry says you cannot include amounts you pay for illegal operations, treatments or controlled substances, whether rendered or prescribed by licensed or unlicensed practitioners. So the prescriber’s licence is not the test either. The test is whether the substance is legal under federal law.

Why a state card or a doctor’s note does not help

The deduction is a federal one, claimed on Schedule A (Form 1040) as part of your itemized deductions, and Pub 502 defines medical expenses by federal law. A dispensary receipt, a state registry card, or a physician’s written recommendation can show that the purchase was medical in purpose. It cannot make the item qualify, because the exclusion applies “even if” state law has legalized the substance.

The same logic is why Pub 502 treats imported prescription drugs narrowly. In general you cannot include a prescribed drug brought in, or ordered and shipped, from another country unless it was imported legally, for example a drug the Food and Drug Administration announces can be legally imported by individuals. Legality, not medical need alone, is what the publication looks at.

What you can still deduct alongside it

The exclusion removes one cost. It does not disqualify the rest of the year’s expenses. Pub 502 lets you include prescription drugs and insulin, doctor and dental visits, hospital care, and insurance premiums you paid with after-tax dollars, among many other items. A person who also buys a federally legal prescription still adds that prescription to the total.

The Medicines section lays out the line between prescribed and non-prescribed drugs: apart from insulin, you cannot include a drug that is not prescribed, and the publication’s example is aspirin recommended by a doctor. Nutritional supplements, vitamins and herbal or “natural” medicines are excluded unless a medical practitioner recommends them as treatment for a specific condition diagnosed by a physician. Check those entries separately; they are not the same rule as the controlled-substance exclusion.

Illustration: the exclusion changes nothing

This is an illustration of how the floor works, not an example from the publication. Suppose your AGI is $60,000, so 7.5% is $4,500. Your qualifying medical costs for the year are $6,500 and you also spent $900 on marijuana. The $900 is ignored. Your deductible amount is $6,500 minus $4,500, or $2,000. If you had mistakenly added the $900, you would have claimed $2,900 and overstated the deduction by $900. Use the calculator above to try your own numbers.

How the floor, timing and itemizing apply here

For medical marijuana, the same three rules from Publication 502 decide the final number. First, the deduction is only the part of your total medical and dental expenses that is more than 7.5% of your adjusted gross income, so a $1,000 cost does nothing until the year’s total passes the floor. Second, you include only what you paid during the tax year and were not reimbursed for, and you may include costs for yourself, your spouse and your dependents. Third, the deduction is claimed on Schedule A (Form 1040), so it helps only if your itemized deductions add up to more than your standard deduction. Amounts paid with a tax-free health savings account distribution cannot be counted again, and pre-tax flexible spending arrangement reimbursements are excluded.

Related medical expense topics

More from the same IRS publication: Are hearing aids tax deductible?, Is acupuncture tax deductible?, Are funeral expenses tax deductible?. For a full calculation across all your expenses, use the medical expense deduction calculator.

Sources

• IRS Publication 502, Medical and Dental Expenses (2025): the “Controlled Substances” entries, the 7.5% of AGI rule, the reimbursement rules and the transportation rules. Read November 2, 2026.

Edition read: Publication 502 (2025), for use in preparing 2025 returns. Dollar limits and rates in this publication are for 2025; the publication notes that later legislation (P.L. 119-21) may affect federal deductions, so check the current publication and the Schedule A instructions for your tax year. This page summarizes the publication and does not replace it. Marked for human review.