On July 14, 2014, Missouri Governor Jay Nixon signed HB 2238 into law, which allows the use of cannabis oil that is at least 5% CBD and less than 0.3% THC for intractable epilepsy. The bill requires a neurologist to determine that the patient did not respond to at least three treatment options to be eligible to use the hemp extract.

There is a Missouri medical marijuana program, but in name only. The law states that only patients suffering from epilepsy are eligible to use cannabidiol (CBD) oil, and that the oil must be derived from hemp, and not marijuana. Hemp lacks many of the medicinal qualities marijuana, and many advocates believe it is nowhere near as effective as a medicine.

The Missouri Hemp Extract Registration Card allows the registrant to purchase cannabidol (CBD) oil from one of the two facilities licensed in this state by the Missouri Department of Agriculture