Medical Cannabis in South Dakota
In 2020, the voters of South Dakota passed Initiated Measure 26 and approved medical cannabis. The program is on schedule for implementation. The Departments of Health and Education are creating and will operate a new regulatory program to ensure the safety of patients, students, and the public in this new industry.

Happening Now

South Dakota Department of Health Notice of Public Hearing to Adopt Rules

July 27, 2021

The South Dakota Department of Health announced that a public hearing will be held on August 18, 2021, from 1:30 to 3:30 p.m. CDT, in Conference Room 3 of the Kneip Building, 700 Governor’s Drive in Pierre, SD to consider the adoption and amendment of proposed rules for South Dakota medical cannabis program as required by SDCL 34-20G.

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RFP for Cannabis Seed to Sale Tracking System - RFP ID#2439

July 12, 2021

The South Dakota Department of Health (SD-DOH) and the South Dakota Department of Revenue (SD-DOR) are jointly issuing a request for proposal (RFP) (ID #2439) to acquire a cannabis tracking system to be used to support the final implementation of the South Dakota medical cannabis program.

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Highway Patrol Framework for Implementation of IM-26 & Debilitating Conditions

June 30, 2021

Department of Health Holds
Medical Cannabis Zoom Sessions

June 29, 2021
The Department of Health held four zoom sessions with stakeholders to receive input on the proposed Administrative Rules. Participants included business establishments, law enforcement representatives, local municipalities and health care providers.

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Department of Health Hosts
Medical Cannabis Telephone Town Halls

June 28, 2021
The Department of Health hosted two tele-townhalls to receive public input on the proposed draft rules of medical cannabis in South Dakota.

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Recent Events


  • July 27, 2021: The South Dakota Department of Health announced that a public hearing will be held on August 18, 2021, from 1:30 to 3:30 p.m. CDT, in Conference Room 3 of the Kneip Building, 700 Governor’s Drive in Pierre, SD to consider the adoption and amendment of proposed rules for South Dakota medical cannabis program as required by SDCL 34-20G.
  • July 19, 2021: The legislature’s Interim Rules Review Committee adopted rules to establish the mandatory and permissive district policies for schools to allow students to have access to medical cannabis on school property and at school-sponsored activities.
  • July 12, 2021: The Department of Health and Department of Revenue jointly issued an RFP for a Cannabis Seed to Sale Tracking System.
  • July 9, 2021: The Office of the Attorney General in Agreement with South Dakota Highway Patrol's Framework for Implementation of IM26.
  • July 9, 2021: The South Dakota Board of Education Standards approved amendments to rules initially passed in May establishing the general provisions for schools to allow students to have access to medical cannabis on school property and at school-sponsored activities. Visit the board’s webpage.
  • June 30, 2021: The Department of Health announced a preliminary list of conditions for the medical cannabis program.
  • June 29, 2021: The Department of Health held four zoom sessions with stakeholders to receive input on the proposed Administrative Rules. Participants included business establishments, law enforcement representatives, local municipalities and health care providers.
  • June 28, 2021: The Department of Health hosted two tele-townhalls to receive public input on the proposed draft rules of medical cannabis in South Dakota.
  • June 24, 2021: The Department of Health released its proposed administrative rules to implement the medical cannabis program created by voters in Initiated Measure 26.
  • June 16, 2021: Department of Health held a virtual medical cannabis presentation with the South Dakota Association of Healthcare Organizations and requested input on draft rules.
  • June 10, 2021: Department of Health and Department of Revenue staff went to North Dakota to meet with their counterparts and discuss best-practices, lessons learned and to hear directly what challenges they faced and how they responded in their program implementation.

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SD Secretary of Health
SD Secretary of Health, Kim Malsam-Rysdon, seeks input from the State Medical Association on medical cannabis at their annual conference in Sioux Falls.

frequently asked questions

Patient Information

Any sale or purchase of medical cannabis after July 1, 2021 must comply with the law passed by the voters. The Department of Health will announce the process to obtain medical cards by October 29, 2021 and will also announce rules related to medical cannabis establishments. Any sale or purchase of cannabis outside of the regulated medical cannabis establishments is illegal.

The Department of Health will announce this process as part of its proposed rules implementing the program. Those rules will be available shortly. Keep checking this site for more information.

Under the new law passed by the voters, a condition that allows a patient to use medical cannabis must be a “debilitating medical condition,” which is defined as:

A chronic or debilitating disease or medical condition or its treatment that produces one or more of the following: AIDS; HIV; ALS; Multiple Sclerosis; Cancer associate with severe or chronic pain, nausea or sever vomiting, or cachexia or severe wasting; Chrohn's disease; Epilepsy/seizures; glaucoma; and PTSD.

Debilitating Conditions

Highway Patrol personnel will not, at the scene of a stop or interaction, arrest a South Dakota resident who is unable to present an unexpired medical cannabis card, as long each of the following apply:

  • The individual possesses no more than three ounces of natural and unaltered marijuana, as defined by SDCL 22-42-1;
  • The individual claims at the time of the interaction that the medical cannabis is to treat or alleviate a debilitating medical condition as defined by the Department of Health;
  • The individual produces printed or electronic documentation relative to the debilitating medical condition from a licensed medical doctor.

Highway Patrol personnel will not arrest nonresident cardholders for possession of cannabis, nor will they seize the cannabis or any associated paraphernalia, if the following applies:

  • The cardholder presents an unexpired medical cannabis card issued by another state; and
  • He or she possesses no more than three ounces of natural and unaltered cannabis, as defined by SDCL 22-42-1;

The nonresident card provision applies in this instance, so long as the cardholder is an enrolled tribal member and presents an unexpired medical cannabis card issued by the resident’s tribe.

South Dakota's impaired driving laws still apply. An individual may not operate a motor vehicle under the influence of medical cannabis. Drivers are prohibited from smoking or consuming cannabis or cannabis concentrate. Passengers are also prohibited from smoking cannabis or cannabis concentrate.

Initiated Measure 26 became South Dakota Codified Law (SDCL) 34-20G

Department of Health is required to enact Administrative Rules for medical cannabis by October 29, 2021.

You may submit comments and/or request administrative rule draft documents by emailing DOHcomments@state.sd.us. Please be sure to include your full contact information along with your request/message. You may also participate in the public hearing. Keep checking this site for information on opportunities to participate in the rule making process. You can get administrative rule updates by clicking here.

Per SDCL 34-20G-1, physicians with authority to prescribe drugs must provide a written certification stating that in their professional opinion the patient is likely to receive therapeutic or palliative benefit from the medical use of cannabis to treat or alleviate the patient's debilitating condition or symptom associated with the debilitating condition. The document must affirm that it is made in the course of a bona fide practitioner-patient relationship and must also specify the qualifying patient’s debilitating medical condition.

Yes, so long as the designated caregiver:

  • Is at least twenty-one years of age;
  • Has agreed to assist with a qualifying patient's medical use of cannabis;
  • Has not been convicted of a disqualifying felony offense; and
  • Assists no more than five qualifying patients with the medical use of cannabis, unless the designated caregiver's qualifying patients each reside in or are admitted to a health care facility or residential care facility where the designated caregiver is employed.

To be approved as a patient eligible for cultivation, you must have a certification from your physician that you are eligible to cultivate medical cannabis. In addition, you will need to apply to the Department of Health when that process is available. The Department of Health will establish and implement rules related to this process by October 29, 2021.

On April 26, 2021, the Department of Health issued a request for proposal (RFP) (ID #2357) for a statewide patient registry, verification, and licensing system to be used in the implementation of the medical cannabis program.

This system will ensure that patients and caregivers can be accurately identified and ensure that only verified patients and caregivers have access to medical cannabis. The patient verification system will also ensure that South Dakota law enforcement officials have the necessary tools to accurately identify medical cannabis patients/caregivers they may encounter.

The Department of Health takes privacy and health information security seriously. We aim to develop a secure online registry system for patients, caregivers, physicians and law enforcement that meets or exceed all state and federal standards for confidentiality, accessibility, and information security.

Medical Cannabis Establishments

SDCL 34-20G establishes the following registration types: cultivator, manufacturer, dispensary, and testing. Collectively these are referred to as establishments. The Department of Health will promulgate rules related to medical cannabis establishments and the issuance of business registrations by October 29, 2021.

Initiated Measure 26 became South Dakota Codified Law (SDCL) 34-20G.

The Department of Health will issue business registrations to medical cannabis establishments according to administrative rules that are under development. These rules will be promulgated by October 29, 2021.

Note: Additional registration and operational requirements may be established/required at the local level.

The Department of Health will announce this process as part of its proposed rules implementing the program. Those rules will be available shortly. Keep checking this site for more information.

No, the transportation of cannabis across state lines remains a federal crime and could result in federal criminal prosecution.

Highway Patrol Framework for Implementation of IM-26 Debilitating Conditions Proposed Administrative Rules Submit Comment Request for Proposal Statute & Rules - SDCL 34-20G Helpful Terminology DOH DOE