All 50 of the United States of America have just been schooled on their 420-friendliness in a comprehensive ranking by Americans for Safe Access (ASA). The medical marijuana advocacy group has released its fourth annual Medical Marijuana Access in the United States report and the results are a little surprising.

For one thing, states with legalized recreational marijuana did not rank all that high on their list of best places to be for MMJ patients. Of the top ten states for patients, only one was state which had recreational cannabis in 2016. Oregon sat in fourth place. Colorado, Washington and Alaska (the other states with recreational weed) didn’t even make the top ten.

Other states which voted to legalize cannabis in 2016, California, Maine, and Nevada, did make the top ten, but they do not actually implement their recreational laws until this year.

Here are the top ten best and worst states for medical marijuana patients, as ranked by the ASA both on a scale of 0 to 100 and as a letter grade, followed by a map of the continental U.S. color-coded for MMJ scores by the Denver Post

10 Best States for Medical Marijuana Patients

  1. Illinois (89.8, B+)
  2. Michigan (88.75, B+)
  3. California (87, B+)
  4. Oregon (86.2, B)
  5. Maine (86.2, B)
  6. New Mexico (85.8, B)
  7. Nevada (84.6, B)
  8. Montana (83.75, B)
  9. Ohio (83.75, B)
  10. New Hampshire (82.6, B-)

10 Worst States for Medical Marijuana Patients

  1. Wisconsin (21.4, F-)
  2. Tennessee (23.8, F-)
  3. Missouri (24.8, F-)
  4. Utah (25.8, F-)
  5. Wyoming (26.8, F-)
  6. Iowa (26.4, F-)
  7. North Carolina (28, F-)
  8. South Carolina (28.8, F-)
  9. Alabama (30.4, F-)
  10. Mississippi (30.6, F-)

Each state is scored based on five criteria:

  1. Patient rights and protection from discrimination: These include civil rights such as protection from the police, employment discrimination, and parental rights.
  2. Access to medicine: Are there local bans? Medicine regulations like limiting amounts of CBD or THC?
  3. Ease of navigation: This is mostly about qualifying conditions, how comprehensive they are, how flexible laws are to add new ones, and availability to minors.
  4. Functionality: How accessible are dispensaries? How easy is it to grow your own? Are there insurance coverage or financial hardship waivers?
  5. Consumer safety and provider requirements: Regulations for producers and dispensaries to keep medical cannabis healthy for use.

There are additional bonus points of up to 25 added for a state which shows major improvement over the previous year, which may explain how Illinois outranked states with longstanding MMJ programs like California or Michigan.

Photo via Flickr user Mr.Lujan