Julian’s Law vs. SB 53: Why SC’s Current Low-THC Program is Failing Patients

South Carolina’s approach to medical cannabis has evolved slowly over the past decade, shaped by caution, regulatory concerns, and a desire to avoid the broader legalization trends seen in other states. At the centre of this evolution are two key legislative efforts—Julian’s Law and SB 53. Both were introduced with the promise of helping patients access cannabis-based treatments safely and legally. However, despite these intentions, many patients across the state continue to struggle to find effective relief. Strict limitations, restricted product options, and ongoing regulatory barriers have created a system that often fails to meet real medical needs. A closer comparison of Julian’s Law and SB 53 reveals that while progress has been made on paper, South Carolina’s current low-THC program still falls short in delivering meaningful outcomes for patients.

Understanding Julian’s Law

In 2014, South Carolina took its first step into the medical cannabis policy with Julian Law. The law was named after a child with severe epilepsy, and its aim was incredibly narrow: to expand access to low-THC cannabidiol (CBD) oil to patients with specific types of seizure disorders.

Scope and Key Restrictions

• Patients who had severe forms of epilepsy could only qualify.

• The cannabis products were limited to low-THC CBD oil.

• THC levels had to remain extremely low

• The use of smoking or whole-plant cannabis was banned.

These limitations had a severe effect on the law. Other serious conditions, including chronic pain, cancer, or PTSD patients, were not included at all. Also, there was no clear in-state production or distribution system defined by law, and even qualified persons had difficulty accessing it. To know more about how cannabis therapies have evolved, read this article: How Cannabis‑based Therapies Are Evolving: From CBD to Full‑Spectrum.

What SB 53 Proposes

The South Carolina Compassionate Care Act, SB 53, was proposed to increase access and provide a more organised medical cannabis program. It is a more recent method compared to the Julian Law.

Expanded Framework

• A broader list of eligible medical conditions.

• Access to various product types, such as oils, edibles, and topicals.

• A controlled cultivation, processing, and dispensing system.

• Physician oversight and patient registration requirements

This framework tries to fill some of the gaps left by Julian Law. Yet, despite such progress, SB 53 still has rigid regulatory checks and balances that limit its overall potency. To know more about South Carolina’s proposed medical cannabis framework, read this article: The 2026 South Carolina Compassionate Care Act: What’s Different This Session?

Julian’s Law vs SB 53: A Limited Evolution

SB 53 is an expansion of Julian Law, though it shares the same philosophy of caution and restriction. This leads to partial improvement and not a total solution.

The Major Differences and Similarities

Improvements under SB 53:

• Eligibility is extended beyond epilepsy.

• Introduces a regulated supply chain

• Allows more product types

Ongoing limitations in both laws:

• Close monitoring of the amount of THC.

• No tolerance of smokable cannabis.

• Excessive dependence on physician approval.

• Low adaptability to individual patient care.

Though SB 53 seems more inclusive, it still leaves the program restrictive. Rather, it continues the same framework, leaving numerous fundamental questions unanswered.

Why the Low-THC Program is Failing Patients

The low-THC medical cannabis program in South Carolina remains inadequate as it focuses less on patient treatment and more on strict control. Its purpose is to keep it safe; the outcome is a system that restricts access and performance. The existing framework discourages the use of a balanced form of THC and CBD, which a significant number of patients need to address their symptoms, including chronic pain, severe anxiety, or other conditions that are not responsive to treatment. 

Meanwhile, administrative obstacles, low physician involvement, and implementation delays complicate the process of patients even accessing the system. Consequently, the program fails to provide a viable and effective means of treatment for most people who need it most. To know more about how whole-plant medicine works, read this article: Entourage Effect 2.0: Why Full Plant Matters More. 

Real-World Impact on Patients

The failure of the existing system has practical implications for the patients who use medical cannabis for relief.

• Travelling to other states where bigger programs are in place.

• Seeking ways to get good products on the black market.

• Uncertainty over product quality and dosing.

• Late or missed treatment due to access challenges.

Moreover, patient choice is also constrained because of the unavailability of smokable cannabis and the insufficient strength of its products. These restrictions can have a great impact on the lives of those who have chronic conditions or those who are debilitated. To know more about why doctors remain hesitant, read this article: Why Carolina Doctors are Hesitant to Recommend Schedule III Substances.

The Need for Meaningful Reform

The medical cannabis program implemented in South Carolina needs to leave its restrictive model to actually serve patients. This is not just enough, as incremental changes are required; a more patient-centred approach is required.

• Flexible THC levels for medical needs.

• Increasing the involvement and education of physicians.

• Making the patient approval process easier.

• Seeking a secure and available supply chain within the state.

By emphasizing these changes, the state will be able to develop a system that is focused on patient outcomes rather than overly burdensome state regulations. To know more about personalized cannabis treatment approaches, read this article: The Future of Personalized Plant Medicine.

Conclusion

The Law by Julian and SB 53 mirror South Carolina's reserved attitude toward medical cannabis, but they also show its restrictions. Although SB 53 is an improvement, it is not a complete resolution of the problems created by Julian Law's limited focus. Rather, it still maintains many of the restrictions in a broader context. This means that even the low-THC program currently in place does not adequately, accessibly, and effectively treat a large number of patients. South Carolina will still be left behind in the provision of the full benefits of medical cannabis unless there is significant reform that focuses on the actual needs of the patients. For more insights and updates on medical cannabis policies and research, visit CBHD News.