Cannabis in South Dakota

South Dakota has a medical cannabis program and no adult-use market, and it has voted on the second question more than once. In November 2020 voters approved both medical marijuana (Initiated Measure 26) and adult-use Amendment A; the state Supreme Court voided the amendment in 2021 on a single-subject technicality. A 2022 initiative for adult possession and home grow lost, and voters rejected another adult-use proposal in 2024. As of September 2026 the Secretary of State's list of ballot questions showed no cannabis measure for the November election.

The medical program is run by the Department of Health under SDCL chapter 34-20G. On September 2, 2026 it counted 19,821 approved patient cards, 620 caregivers and 211 supporting providers, and more than 70 percent of patients reported severe, debilitating pain. Registered patients may possess up to three ounces, and home cultivation licenses have climbed from 61 in fiscal 2022 to 715. The market has shrunk from its peak: the state licensed 139 establishments, 79 of them dispensaries, in fiscal 2023, and 108 on August 27, 2026, including 62 dispensaries, 31 cultivators and 14 manufacturers. Delivery is not permitted.

The Department filed 38 amendments to its rules (article 44:90) on August 21, 2026, covering patient cards, security, testing, packaging and enforcement. A public hearing was set for September 23, with comments due October 3 and committee review on October 14, so details may shift.

Without a card, marijuana is criminal. Possession of two ounces or less is a Class 1 misdemeanor (up to a year, $2,000), and ingesting any intoxicating substance to get high is also a Class 1 misdemeanor. Chemically converted hemp products such as delta-8 were restricted by House Bill 1125 in 2024, and Senate Bill 39, signed in March 2026, repealed the state hemp licensing program and codified exclusions for delta-8, delta-10, THC-O, HHC and THCP.