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

Patient Application Portal Now Available for Physician Certifications

November 8, 2021

Physicians can now access the medical cannabis patient portal and begin certifying medical cannabis patients. Once certified by a physician, patients will then be able to access the online application process and complete their applications. Approved applicants will have a medical cannabis patient card mailed to them.

View Application Portal>

Information pertaining to establishment applications that must be submitted to the department by November 1, 2021 pursuant to ARSD 44:90:03:12

October 28, 2021

The Department of Health has released information pertaining to establishment applications that must be submitted to the department by November 1, 2021 pursuant to ARSD 44:90:03:12. Applicants will be allowed to submit establishment applications without a sales tax ID, so long as the application is supplemented with a sales tax ID within 14 days of submission. Applicants will also be allowed to submit applications without a completed Form E, so long as the application is supplemented with an executed Form E within 90 days of submission. Please see the updated FAQs for more information.

View FAQs>

Establishment Application Now Available

October 25, 2021

Click below to apply for a medical cannabis establishment registration certificate with the Department of Health.

View Application>

Establishment Application Checklist Available

October 21, 2021

In preparing to apply for a medical cannabis establishment registration certificate with the Department of Health, applicants may utilize this checklist to ensure they are prepared to answer all questions and gather all required documents. Applications will be available soon!

View Checklist>

Updated Reverted Rules

October 15, 2021

The South Dakota Department of Health released updated reverted rules related to implementation of the state’s Medical Cannabis Program.

View Reverted Rules>

Medical Cannabis Program Rules Pass Interim Rules Review Committee

September 13, 2021

The Legislature’s Interim Rules Review Committee approved the Department of Health’s proposed administrative rules to establish a medical cannabis program in South Dakota. The legislature approved 143 of 149 proposed rules.

View News Release>

Department of Health Presented Proposed Administrative Rules to the Legislature Interim Rules Review Committee

September 13, 2021

The Department of Health presented to the Legislature Interim Rules Review Committee its proposed administrative rules.

View Presentation>

Department of Health released latest draft of its proposed administrative rules

September 3, 2021

The Department of Health released the latest draft of its proposed administrative rules for the South Dakota Medical Cannabis program.

View Revised Proposed Rules>

Department of Health Holds Medical Cannabis Public Hearing

August 18, 2021

The Department of Health held an in-person/virtual public hearing in Pierre to consider the adoption and amendment of proposed rules for South Dakota medical cannabis program as required by SDCL 34-20G.

**Please note due to technical difficulties, some portions of the hearing may not have audio.

View Public Hearing >

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.

View Info >

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.

View Info >

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.

View Info >

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.

View Info >

Recent Events


  • November 18, 2021: Today, in accordance with SDCL 34-20G and the unwavering commitment of Governor Noem and the South Dakota Department of Health to deliver a safe and responsible medical cannabis program, the first medical cannabis patient cards were printed and issued. See news release here.
  • November 8, 2021: Physicians can now access the medical cannabis patient portal and begin certifying medical cannabis patients. Once certified by a physician, patients will then be able to access the online application process and complete their applications. Approved applicants will have a medical cannabis patient card mailed to them. See Patient Process Overview for more information.
  • October 26, 2021: The Rules Review Committee approved the Department of Health Revised Rules with a 6-0 vote.
  • October 25, 2021: The South Dakota Department of Health released medical cannabis establishment application form.
  • October 15, 2021: The South Dakota Department of Health released updated reverted rules related to implementation of the state’s Medical Cannabis Program.
  • October 8, 2021: A document was released to provide direction on the Department of Health's anticipated treatment of medical cannabis establishment applications in relation to any municipality or county with ordinances pertaining to licensure of these establishments.
  • September 13, 2021: The Legislature’s Interim Rules Review Committee approved the Department of Health’s proposed administrative rules to establish a medical cannabis program in South Dakota. The legislature approved 143 of 149 proposed rules.
  • September 13, 2021: The Department of Health presented to the Legislature Interim Rules Review Committee its proposed administrative rules. View a section-by-section summary.
  • September 3, 2021: The Department of Health released the latest draft of its proposed rules for the states Medical Cannabis program.
  • August 18, 2021: The Department of Health held an in-person/virtual public hearing in Pierre to consider the adoption and amendment of proposed rules for South Dakota medical cannabis program as required by SDCL 34-20G. To view the public hearing, CLICK HERE. To view meeting minutes, CLICK HERE.
  • August 12, 2021: Representatives from the Department of Health presented at the Sioux Falls Chamber of Commerce Issues Management Council on South Dakotas' medical cannabis program.
  • August 5, 2021: Representatives from the Department of Health, Department of Education, and the South Dakota High School Activities Association presented at the joint Associated School Boards of South Dakota and School Administrators of South Dakota conference in Sioux Falls, SD. The conversation revolved around medical cannabis in schools and proposed administrative rules.
  • August 4, 2021: The South Dakota Department of Health presented an overview of the proposed medical cannabis administrative rules to the legislative summer study committee.
  • 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.

more events >
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

Download and Print FAQs

Patient Information

Any sale or purchase of medical cannabis must comply with SDCL 34-20G and ARSD 44:90. Any sale or purchase of cannabis outside of the regulated medical cannabis establishments is illegal.

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 by SDCL 34-20G-1 as "a chronic or debilitating disease or medical condition or its treatment that produces one or more of the following: cachexia or wasting syndrome; severe, debilitating pain; severe nausea; seizures; or severe and persistent muscle spasms, including those characteristic of multiple sclerosis".

ARSD 44:90:02 establishes the requirements for applying for a medical cannabis card including:

  • A photocopy of an unexpired form of identification (e.g., driver’s license, passport, US government-issued ID card, tribal ID card, student ID card);
  • A passport-quality photo; and
  • A $75 fee. Low-income individuals (those with gross monthly household income <130% of the federal poverty level) can request a reduced fee by providing documentation of household income.

Applications for a medical cannabis card cannot be processed until the South Dakota Medical Cannabis Program receives the certification for medical cannabis use by the patient’s physician. Click here for an overview of the patient process.

Per 44:90:04:04, a photograph meeting all the following requirements:
 (a)  A high resolution color photo that is not blurry, grainy, pixelated, or digitally altered;
 (b)  Uses a clear image of the individual’s face without filters;
 (c)  Uses a plain white or off-white background;
 (d)  Is two by two inches in size;
 (e)  Is printed on matte or glossy photo quality paper; and
 (f)  Is not damaged with holes, creases, or smudges;

The South Dakota Medical Cannabis Program began accepting applications from qualifying patients on November 8, 2021. Click here for an overview of the patient process.

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. An in-person assessment is required. Physician participation in the medical cannabis patient certification process is voluntary.

No, the South Dakota Medical Cannabis Program does not maintain a list of physicians who will provide a certification for medical cannabis use.

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.

As part of the application process to obtain a registry identification card for the South Dakota Medical Cannabis Program, applicants may also apply to cultivate three cannabis plants in their home. An application to cultivate more than three plants simultaneously for a single patient’s use must be accompanied by a certification from the individual’s physician authorizing cultivation of an extended plant count.

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 SDCL 34-20-1;
  • 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 or tribal 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.

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 SDCL 34-20G. Administrative rules for the program can be found at ARSD 44:90.

The South Dakota Medical Cannabis Program is in the final stages of implementing a statewide patient registry, verification, and licensing system that will 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 South Dakota Medical Cannabis Program takes privacy and health information security seriously. The secure online registry system for patients, caregivers, physicians, and law enforcement will meet or exceed all state and federal standards for confidentiality, accessibility, and information security.

The South Dakota Medical Cannabis Program cannot provide legal advice to qualifying patients as to the impact of medical cannabis use. Qualifying patients or others with legal questions should consult with their own legal counsel.

No. Our patient-friendly application process is explained here and no fee, other than an application fee, should be paid to apply for your medical cannabis patient/caregiver card. Individuals should use caution if using a business offering to assist with the application process. If you have been targeted or feel you have been victim to a scam, please report it here. Got questions about the medical cannabis program? Call us at 605-773-3048.

Medical Cannabis Establishments

SDCL 34-20G establishes the following registration types: cultivator, manufacturer, dispensary, and testing. Collectively these are referred to as establishments.

Initiated Measure 26 became SDCL 34-20G. Administrative rules for the program can be found at ARSD 44:90.

You may register your medical cannabis establishment with the Department of Health using this link.

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

The South Dakota Medical Cannabis program has developed a checklist to help establishments in preparing to apply for a medical cannabis establishment registration certificate.

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

For Medical Cannabis Establishment Applications that Must be Submitted by November 1, 2021 pursuant to ARSD 44:90:03:12:

Yes, the Department of Health will allow applicants who must submit applications by November 1, 2021 (per ARSD 44:90:03:12) to submit applications that do not have a sales tax ID number. You must supplement your application with the sales tax ID number within 14 days of submission, or as soon as you receive the sales tax ID number from Department of Revenue. Please contact the Department of Health with questions.

Yes, the Department of Health will allow applicants who must submit applications by November 1, 2021 (per ARSD 44:90:03:12) to submit applications without an attached Form E. You must supplement your application with a completed Form E within 90 days of submission. Please contact the Department of Health with questions.

Highway Patrol Framework for Implementation of IM-26 Local Process Guidance Draft RulesProposed Administrative Rules Revised Proposed Administrative Rules Section-by-Section Summary DOH Response to LRC Submit Comment Request for Proposal Statute & Rules - SDCL 34-20G Helpful Terminology Safe Storage Tips DOH DOE