South Dakota

Overview

South Dakota legalized medical cannabis via Initiated Measure 26 of November 3, 2020 (69.9% approval), codified at South Dakota Codified Laws Chapter 34-20G. Voter-approved adult-use legalization on the same ballot (Constitutional Amendment A) was invalidated by the South Dakota Supreme Court in November 2021 in Thom v. Barnett, which held that Amendment A violated the state constitution's single-subject rule. A subsequent adult-use ballot measure, Initiated Measure 27 of 2022 and Initiated Measure 29 of 2024, both failed at the ballot. As of 2026, adult-use cannabis remains illegal.

The South Dakota Department of Health (SDDOH) administers the medical-cannabis program. Licensed medical sales began in 2022.

Adult-use status

Adult-use cannabis is illegal. Possession of 2 ounces or less is a misdemeanor under SDCL §22-42-6 (Class 1 misdemeanor, up to 1 year jail and $2,000 fine). Possession of larger amounts scales to felony.

Medical program (Measure 26, 2020)

Qualifying conditions

South Dakota's medical-cannabis program enumerates qualifying conditions including:

• Cancer
• Glaucoma
• HIV/AIDS
• ALS
• Multiple sclerosis
• Crohn's disease
• Parkinson's disease
• Severe and chronic pain
• Severe nausea
• Cachexia / wasting
• Seizure disorders, epilepsy
• Post-traumatic stress disorder
• Terminal illness with under-twelve-months prognosis
• Other debilitating medical conditions as added by SDDOH rule

Patient access

• Possession: up to 3 ounces of cannabis under medical registration.
• Home cultivation: permitted for registered patients certified for home cultivation, up to 3 plants per patient.
• Reciprocity: South Dakota honors out-of-state medical cards at licensed dispensaries for visiting patients.
• Approved forms: flower, edibles, oils, tinctures, capsules, vapes, topicals.

Patients and caregivers

• Patient minimum age: 18. Minor patients require parent/legal guardian as designated caregiver plus physician certification.
• Caregiver minimum age: 21.
• Caregivers per patient: up to 1 designated caregiver per patient.
• Caregiver registration: via SDDOH; criminal background check.

Patient registration steps

1. Obtain a written certification from a South Dakota-licensed practitioner who is registered with the SDDOH Medical Cannabis Program. The practitioner must confirm a qualifying condition and a bona fide patient-provider relationship.
2. Apply through the SDDOH Medical Cannabis Program portal. Submit identity documents, a current photo, and the practitioner certification.
3. Pay the application fee. Reduced fees apply for veterans, Medicaid recipients, and SNAP recipients.
4. Once approved, the patient receives a state-issued medical-cannabis ID card valid for one year and renewable. The card authorizes purchases at any licensed South Dakota dispensary.

Minor patients require a parent or legal guardian as designated caregiver and a written statement from a second physician confirming the certification. Caregivers complete a separate application and background check.

Reciprocity and visiting patients

South Dakota is a reciprocity state for medical-cannabis purposes. Visiting patients holding a valid medical-cannabis card from another state may purchase from South Dakota dispensaries with their home-state card and a government photo ID. The visiting-patient framework is dispensary-by-dispensary in practice; calling ahead to confirm acceptance and product availability is recommended.

The reciprocity protection extends to possession on South Dakota soil within the program possession cap. It does not protect against tribal-jurisdiction or federal-jurisdiction enforcement, which include substantial portions of South Dakota land area.

Employment and workplace

South Dakota provides limited workplace protection for registered medical patients. Employers may not discriminate against a patient solely on the basis of registry status, but the protection has carve-outs:

• Safety-sensitive positions: employers may continue to enforce drug-free workplace policies for safety-sensitive roles as defined by the employer.
• Federal contractor and DOT-regulated positions: federal drug-free workplace and DOT testing rules supersede state-level patient protection.
• Post-accident testing: workers' compensation benefits may be denied where post-incident testing returns positive for THC without contemporaneous documentation of medical use within the patient's certified parameters.

Public-employee positions, healthcare licensing, and CDL holders face additional licensing-board exposure beyond employer discipline.

Failed adult-use ballot history

South Dakota voters have considered adult-use legalization three times since 2020:

• 2020 (Amendment A): passed with 54% but invalidated by the South Dakota Supreme Court in November 2021 in Thom v. Barnett for violating the single-subject rule for constitutional amendments.
• 2022 (Initiated Measure 27): statutory adult-use legalization, failed at the ballot with roughly 47% support.
• 2024 (Initiated Measure 29): statutory adult-use legalization, failed with roughly 44% support.

The 2024 result has been read as evidence of weakening adult-use support in the state. The medical-cannabis program continues to operate with bipartisan voter approval and modest legislative engagement.

Hemp and CBD legality

South Dakota aligns with the 2018 Federal Farm Bill on industrial hemp (cannabis with 0.3% delta-9 THC by dry weight). The state's hemp program operates under SDCL Chapter 38-35, administered by the South Dakota Department of Agriculture and Natural Resources (DANR).

South Dakota is one of the most restrictive states for intoxicating hemp-derived cannabinoids. HB 1125 of 2023 (signed by Governor Kristi Noem) classified delta-8 THC, delta-10 THC, THC-O, HHC, and similar synthetic or chemically-converted cannabinoids as controlled substances effective July 2023. South Dakota Attorney General Marty Jackley aggressively pursued enforcement against retailers who continued selling these products after the effective date, including civil and criminal actions in 2023-24.

Industrial-hemp CBD remains lawful at general retail subject to labeling requirements. Smokable hemp flower is restricted under the same total-THC framework as intoxicating cannabinoids. The South Dakota Highway Patrol and DANR coordinate on roadside and retail enforcement.

Adult-use legalization ballot initiative IM 29 (November 2024) failed at the polls with approximately 44% support; intoxicating-hemp prohibition under HB 1125 framework continues unchanged. Out-of-state visitors carrying intoxicating-hemp products purchased lawfully elsewhere face the same controlled-substance exposure as visitors carrying marijuana. Informational only — not legal advice.

Tribal jurisdiction

South Dakota includes nine federally recognized tribal nations, several of which have asserted independent cannabis-policy authority. The Flandreau Santee Sioux Tribe pursued cannabis cultivation and dispensary licensure as early as 2015 (subsequently halted under federal pressure) and remains active in tribal cannabis governance discussions. Tribal jurisdiction is distinct from state jurisdiction, and product transported off the reservation onto state or federal land is subject to the applicable non-tribal law.

Federal context

Federal jurisdiction layers additional exposure on federal land, federal courthouses, military installations (Ellsworth Air Force Base), and interstate highways. I-29 and I-90 corridors see active state-patrol and federal drug-interdiction activity, particularly at the North Dakota, Minnesota, Iowa, and Wyoming borders.