South Dakota Medical Cannabis Guide

South Dakota's cannabis history is turbulent. Voters approved both medical and adult-use cannabis with Measure A in 2020, but the Supreme Court struck down the adult-use portion. The legislature then passed the medical programme (Amendment A). A second adult-use measure (Amendment A on 2022 ballot) was again rejected.

Medical Legal (2020) — No Adult Use Since: 2020 (Measure A — medical portion) Adult Use: No (adult-use struck down by court)

Quick Facts

Legal StatusMedical SinceAdult UseAccess TypeEst. CostInsurance
Medical Legal (2020) — No Adult Use2020 (Measure A — medical portion)No (adult-use struck down by court)Licensed dispensaries — SDDOH regulated, medical card requiredUSD 45-80/eighthNo

Legal Timeline

YearDevelopment
2020Measure A passes (54%) — medical and adult-use both approved by voters
2021South Dakota Supreme Court strikes down adult-use portion of Measure A
2021Legislature passes SB 1 to implement the medical-only programme
2022First medical dispensaries open; Amendment A (adult-use 2.0) fails at ballot
2024Medical programme stable; adult-use reform advocates continue work

How to Access Cannabis in South Dakota

  1. Consult a South Dakota-licensed physician to certify your qualifying condition
  2. Register with the South Dakota Department of Health (SDDOH) for a patient card
  3. Patient card costs USD 75 per year
  4. Visit a licensed dispensary with your card and state ID
  5. Patients may possess up to 3oz of cannabis

Qualifying Medical Conditions

Licensed Dispensaries & Providers

ProviderWebsiteNotes
South Dakota Dept. of Healthdoh.sd.govOfficial regulator — patient registry and dispensary list
Dank's Wonder Emporiumdankswonder.comSouth Dakota medical dispensary
Prairie Band Health ServicesN/ALicensed SD medical cannabis dispensary

Cost Breakdown

ItemEstimated Cost (USD)Insurance Coverage
Flower — 1/8 oz (3.5g)USD 45-80No insurance coverage
Oil/tincture (30ml)USD 50-90No coverage
Vape cartridge (0.5g)USD 40-75No coverage
Patient card (annual)USD 75Not covered

Frequently Asked Questions

Is medical cannabis legal in South Dakota?+

Yes — South Dakota has a medical cannabis programme following the 2020 voter approval of Measure A. Recreational use is not legal after the adult-use portion was struck down by the courts.

What happened with adult-use cannabis in South Dakota?+

Voters approved adult-use cannabis in 2020 as part of Measure A, but the South Dakota Supreme Court struck down that portion. A second adult-use ballot measure in 2022 also failed. Recreational cannabis remains illegal.

How do I get a medical card in South Dakota?+

A licensed physician certifies your qualifying condition. You register with the SDDOH for a patient card costing USD 75 per year.

What is the possession limit in South Dakota?+

Medical patients may possess up to 3 ounces of usable cannabis. Non-registered possession of any amount is illegal.

Are there many dispensaries in South Dakota?+

The number of licensed dispensaries is growing but limited compared to adult-use states. Use the SDDOH dispensary finder for current locations.

Is South Dakota likely to revisit adult-use legalisation?+

Reform advocates continue to work on this. The challenges to getting adult-use on the ballot and the 2022 defeat have slowed progress. A future ballot measure is possible but requires careful legal navigation.