South Dakota Cannabis: A 2-for-1 First?

Will the only state where your urine can make you a criminal become the first to pass medical and adult-use at the same time?

South Dakota voters will decide two separate questions on their November ballots—a constitutional amendment allowing adult-use, and a statutory medical cannabis program. 

Currently South Dakota has the unfortunate distinction of being the only state where police can force people to take a urine test, and charge people who test positive for illegal substances with a crime. Were both these measures to pass, it would mark a milestone in cannabis election history by being the first state to create both programs at the same time.

On the Ballot

Amendment A would create adult-use license types for cultivations/manufacturers, wholesalers, dispensaries, testing labs, and whatever additional types the Department of Revenue chooses to add. That department would also choose the total number of licenses allowed, which they will need to geographically distribute. Home grow would be allowed only in places without a dispensary (though municipalities with dispensaries could pass ordinances allowing home grows as well if they wished). 

Initiated Measure 26 would create medical license types for cultivations, manufacturers, dispensaries, and testing labs. Though there is no state cap on the number of medical licenses, municipalities would be able set their own caps, and the state would do the scoring to determine who receives the licenses in that area. Municipalities cannot ban medical dispensaries. Qualifying patients would be allowed to home grow.

Why Adult Use and Medical?

Adult-use cannabis sales in regulated states are now larger than medical sales. Amendment A has a 15% tax on adult-use sales, while Initiated Measure 26 has no taxes on medical cannabis, which would benefit patients by reducing prices. Having a medical program also allows products and staff more catered to the four qualifying conditions, which includes “severe, debilitating pain” and “severe nausea.” Citizens would be able to petition to add more conditions. 

The income from the adult-use sales tax would be first used to pay for the regulation of the program, then split evenly, half into the general fund, and the other half going to public schools. Though there are not yet evaluations of how much tax revenue the adult-use program would generate in South Dakota, for context Colorado’s state tax revenue has cumulatively contributed over $300 million to schools, alone, in that state.

Expectations for the Vote

So what will the voters of South Dakota approve? South Dakota is a traditionally conservative state, though republican Governor Kristi Noem won with just 51% of the vote in 2018. The state has come under national attention in 2020 because of Governor Noem’s decisions to not issue stay-at-home orders, nor cancel the Sturgis Motorcycle Rally, which brought hundreds of thousands from around the country to South Dakota. The number of Americans that support legal adult-use cannabis is also now consistently polling over 60% nationally, with even more in support of medical-only programs. 

In the coming months we will see the organized support and opposition groups make their cases, as well as polling giving us some indication of what South Dakota voters may do come November.  

If you are looking to get involved, learn more at New Approach South Dakota and South Dakotans for Better Marijuana Laws, and make sure you’re registered to vote!


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