The global debate about the regulation of cannabis has intensified in recent years, and jurisdictions have increasingly amended their legislation to allow for the medicinal or therapeutic use of the plant. Various countries in the Americas have enacted policies that enable patients to access certain types of preparations to alleviate symptoms, reduce pain or improve their quality of life. However, although all these experiences can be considered as progress, not all regulatory regimes are equal, and not all reforms will have the same impact. This paper aims to enhance our understanding of the state of reforms and their potential, as well as offer some general recommendations in an effort to improve public policies where legislation has already changed and inform decision-making processes where the reform is still pending.