Drug Policy Watch · State Brief 2026

South Dakota

Snapshot (structured)

Adult-use cannabis: Illegal. Voters rejected legalization three times (2020 Amendment A passed but was struck down by the courts; 2022 Measure 27 and 2024 Initiated Measure 29 both failed at the ballot box).
Medical cannabis: Legal. Voter-approved via Initiated Measure 26 (2020, roughly 70 percent yes); operational program administered by the Department of Health.
Home grow: Allowed for registered medical patients, up to four plants (a physician may authorize more in limited circumstances). No adult-use home grow because there is no adult-use program.
Intoxicating hemp / hemp THC: Banned. HB 1125 (2024, effective July 1, 2024) excludes chemically derived/converted cannabinoids (delta-8, delta-10, THC-O, HHC, and similar) from the legal hemp definition; manufacture or sale is a misdemeanor.
Psychedelics: Trigger-law only. HB 1099 (2026) sets the state to legalize crystalline polymorph (synthesized) psilocybin for therapeutic use automatically if and when the FDA approves it and the DEA reschedules. No current legal access.
Broad decriminalization: No. Possession of small amounts of marijuana remains a criminal misdemeanor for non-patients.
Harm reduction: Partial. Fentanyl test strips were exempted from the drug-paraphernalia definition (HB 1041, 2023). Naloxone access and syringe services status are addressed below; statewide syringe-services authorization is unconfirmed.
Governor (party): Larry Rhoden (Republican). Note: a 2026 gubernatorial election is underway, with a contested GOP primary on June 2, 2026, and a possible July 28, 2026, runoff, so the office may change after this cycle.
Legislature control: Republican veto-proof supermajority in both chambers (Senate roughly 32-3, House roughly 64-6); Republican trifecta.
Citizen ballot initiatives allowed: Yes. South Dakota has both initiated measures (statutes) and initiated constitutional amendments, plus the referendum. It was the first US state to adopt the initiative and referendum.
Enclosure pressure score: 3/5

Cannabis

Adult-use cannabis is illegal in South Dakota in 2026. The state has a voter-created medical-only program.

Medical cannabis was established by Initiated Measure 26, approved by voters on November 3, 2020, with roughly 70 percent support. The program is run by the South Dakota Department of Health, which licenses cultivation facilities, manufacturing facilities, dispensaries, and testing laboratories (DOH program page; medcannabis.sd.gov). Registered patients (18 and older with a qualifying debilitating condition such as PTSD, cancer-related symptoms, MS, Crohn's, epilepsy, ALS, glaucoma, AIDS, and severe pain) may possess up to three ounces (NORML, South Dakota medical law).

Home grow: registered medical patients may cultivate up to four plants, and a physician may authorize a larger amount in certain circumstances (NORML).

Market structure: a state-licensed, vertically permitted medical market with cultivation, manufacturing, dispensary, and lab license types under the Department of Health. As of spring 2026 the program reported roughly 18,800 to 19,000 active patient cards, around 577 caregivers, and about 206 providers (How to get a card, SouthDakotaStateCannabis.org; program data summarized at SouthDakotaStateCannabis.org laws page).

Key 2026 actions: the 2026 legislative session saw repeated attempts to weaken or end the medical program, all defeated. Senate Bill 181 (Sen. John Carley, R) would have repealed the medical cannabis chapter (SDCL 34-20G) ninety days after federal rescheduling of marijuana; the Senate Health and Human Services Committee killed it 7-0. Senate Bill 194 (also Carley) would have capped patient THC potency at 5 percent for oils and 60 percent for liquid concentrates; it was rejected 6-1. The Department of Health testified against the repeal bill (Marijuana Moment, Feb 11, 2026; KOTA TV, Feb 10, 2026; NORML blog, Feb 11, 2026). HB 1160, which sought to repeal the medical marijuana oversight committee, failed in the Senate (LegiScan HB1160 2026). A separate House bill to let terminally ill patients use medical cannabis in hospitals and hospices was rejected in committee (Marijuana Moment). This was the second straight session featuring a repeal attempt; in 2025 Rep. Travis Ismay (R) tried to repeal the program and was defeated in committee (Marijuana Moment).

Ballot history (cannabis): see the Ballot initiatives section below.

Hemp

South Dakota bans intoxicating hemp-derived cannabinoids. HB 1125, signed March 18, 2024, and effective July 1, 2024, amended the state hemp definition to exclude chemically derived or converted cannabinoids, prohibiting the manufacture or sale of delta-8 THC, delta-10 THC, THC-O acetate, HHC, THCP, and intoxicating THCA products produced through chemical conversion. Violations are charged as a misdemeanor (up to one year in jail and/or a $2,000 fine) (Dakota News Now, May 23, 2024; Cannabis Business Times). Enforcement intensified in mid-2025 with statewide compliance pushes and seizures of noncompliant products from retail shelves (Cannabis Regulations AI, HB1125 compliance).

Recent state action: in the 2026 session, the Senate declined even to debate a further bill to ban intoxicating hemp cannabinoid products and kratom, indicating the existing statutory ban is treated as sufficient for now (Marijuana Moment, referenced in Feb 11 2026 article). A legislative panel previously recommended tighter regulation of both medical marijuana and hemp products (Marijuana Moment, legislative panel).

Exposure to the federal hemp changes and the November 12, 2026 deadline: on November 12, 2026, Section 781 of the Continuing Appropriations and Extensions Act, 2026 (P.L. 119-37) takes effect, shifting the federal hemp definition from a delta-9-only 0.3 percent standard to a total-THC standard that includes THCA, and capping finished consumable hemp products at 0.4 mg total THC per container (Vicente LLP; The Haze Connect, state-by-state). Because South Dakota already bans the major intoxicating hemp cannabinoids, the federal change is expected to reinforce rather than reverse state policy; South Dakota is among the more restrictive states going into the deadline. As of early-to-mid 2026 the 2026 Farm Bill was not the vehicle to delay implementation: the House Agriculture Committee advanced it 34-17 on March 5, 2026, with the intoxicating-hemp ban left intact, and a proposed amendment to push the date to November 12, 2027, was filed but its fate is unconfirmed (Cannabis Business Times, Farm Bill).

Psychedelics

No current legal therapeutic or decriminalized access exists in South Dakota. The state enacted a trigger law in 2026: HB 1099, signed by Governor Larry Rhoden in March 2026, sets South Dakota to legalize crystalline polymorph psilocybin (a synthesized form) for medical use automatically if the FDA approves it and the DEA reschedules it from a drug of abuse to one with recognized medical value. Recreational possession would remain illegal. Supporters framed it as faster patient access for treatment-resistant depression and PTSD. The Senate Health and Human Services Committee advanced it 6-0, and it cleared the legislature before signature (South Dakota Searchlight, Mar 10, 2026; SDPB, Mar 2, 2026; KOTA TV, Feb 26, 2026). No broad psilocybin decriminalization or natural-mushroom access has been enacted.

Broader drug policy

Decriminalization: South Dakota has not decriminalized cannabis or other drugs. Possession of small amounts of marijuana by non-patients remains a criminal misdemeanor, and the state is unusual in also criminalizing ingestion (internal possession) of controlled substances. Enforcement data shows thousands of low-level charges, though harsh sentences are infrequently imposed (South Dakota Searchlight, Oct 18, 2024; SouthDakotaStateCannabis.org possession).

Harm reduction: South Dakota enacted HB 1041 in 2023, which exempts fentanyl test strips from the statutory drug-paraphernalia definition, legalizing that form of drug checking (CSG Midwest, fentanyl response). Naloxone is available and distributed through state and community programs, and the federally reauthorized SUPPORT Act (December 2025) funds test-strip access via State Opioid Response grants (networkforphl harm-reduction survey 2024). Statewide statutory authorization of syringe-services programs in South Dakota is unconfirmed; the state has historically lacked an explicit syringe-exchange authorization, and current 2026 status should be verified with the Department of Health (ASTHO harm-reduction legal mapping).

Sentencing and expungement: South Dakota lacks an automatic or broad petition-based expungement mechanism for cannabis offenses. Expungement of a marijuana charge generally requires a judge to grant it, often at the time of plea, leaving lasting collateral consequences for many people charged (South Dakota Searchlight, Oct 18, 2024; Collateral Consequences Resource Center, SD profile).

Overdose and treatment policy: South Dakota participates in State Opioid Response funding and naloxone distribution; specific 2026 treatment-policy bills are not prominent in the cannabis/psychedelics tracking and would need separate confirmation. Treat any treatment-funding specifics as unconfirmed here.

Political landscape

Governor: Larry Rhoden (Republican), who became governor on January 25, 2025, after Kristi Noem resigned to join the federal cabinet (Ballotpedia, Larry Rhoden). A 2026 gubernatorial election is underway, with a crowded Republican primary on June 2, 2026 (candidates including Rhoden, Toby Doeden, Jon Hansen, and US Rep. Dusty Johnson) and a possible July 28, 2026, runoff if no one clears 35 percent (Ballotpedia, 2026 gubernatorial primary; Fox News). The next governor could shift the executive posture on cannabis.

Party control: Republicans hold a veto-proof supermajority in both chambers (Senate roughly 32-3, House roughly 64-6), a Republican trifecta; South Dakota was one of 19 states with GOP supermajorities in both chambers at the start of 2026 (Ballotpedia, 2026 SD legislative session).

Key committees: the Senate Health and Human Services Committee and the House Health and Human Services Committee are the gatekeepers for cannabis, hemp, and psychedelics bills; both repeatedly defeated restriction bills in 2026 (Marijuana Moment).

Named opponents: Sen. John Carley (R) is the leading 2026 antagonist of the medical program, sponsoring both the repeal-on-rescheduling bill (SB 181) and the potency-cap bill (SB 194). Rep. Travis Ismay (R) pushed a repeal attempt in 2025 (Marijuana Moment).

Named reform champions: the legislature's bipartisan committee majorities, plus the South Dakota Department of Health (which testified against repeal), functioned as the defenders of the voter-approved program in 2026. A specific individual legislative champion is unconfirmed; the most consistent outside advocate has been the Marijuana Policy Project, which ran action alerts against SB 181 and SB 194. The original adult-use ballot sponsor was South Dakotans for Better Marijuana Laws.

Ballot initiatives

South Dakota allows citizen-initiated ballot measures (initiated statutes and initiated constitutional amendments) and was the first US state to adopt the initiative and referendum.

Adult-use ballot history: - 2020 Constitutional Amendment A: passed by voters (about 54 percent yes) to legalize adult-use cannabis, then struck down in 2021 by a circuit court for violating the single-subject rule and amounting to a constitutional revision, a ruling the South Dakota Supreme Court upheld (Wikipedia, 2020 Amendment A; MPP, Amendment A and Measure 26). - 2022 Initiated Measure 27: adult-use legalization, failed at the ballot. - 2024 Initiated Measure 29: adult-use legalization as a statute for those 21 and older, failed roughly 44 percent yes to 55 percent no (Ballotpedia, IM 29 2024; MJBizDaily).

Pending 2026 measures: as of mid-2026 there is no confirmed adult-use cannabis measure certified for the November 2026 ballot. Advocates have discussed a possible fourth attempt, but a certified 2026 cannabis initiative is unconfirmed; verify with the Secretary of State and Ballotpedia closer to the petition deadline (Cannabis Business Times, third shot coverage).

Equity and expungement

South Dakota's medical program does not include meaningful social-equity licensing provisions (no equity-specific license tiers, fee waivers, or ownership set-asides have been identified). Licensing is fee-driven and open to applicants who can meet capital and regulatory requirements, which tends to favor better-capitalized operators.

On expungement, the state has no automatic or broad petition-based sealing for cannabis convictions; relief generally depends on a judge granting expungement, often at plea (South Dakota Searchlight; CCRC SD profile). People with prior low-level marijuana charges are largely excluded from any systematic relief, carrying lasting collateral consequences.

Market and barriers

Hard numbers (medical program): - Dispensary license application fee: $5,000 non-refundable (SouthDakotaStateCannabis.org business). - Patients: roughly 18,800 to 19,000 active cards as of spring 2026; about 577 caregivers and about 206 registered providers (SouthDakotaStateCannabis.org mmj-card). - Patient possession cap: three ounces; patient home grow up to four plants. - License types: cultivation, manufacturing, dispensary, testing laboratory (Department of Health).

License caps, exact dispensary counts, additional license-type fees, residency requirements, and capital requirements: not fully confirmed from the sources reviewed. The Department of Health licensing pages (medcannabis.sd.gov; DOH program) are the authoritative source and should be checked for current caps and fee schedules. Treat specific caps and counts as unconfirmed pending that check.

Enclosure read

Who is fenced out: adult-use consumers and would-be adult-use entrepreneurs (three failed legalization attempts and a court-voided win), the intoxicating-hemp retail sector (banned outright since 2024 and now reinforced by the federal November 2026 deadline), and people with prior marijuana charges (no systematic expungement). High medical license fees and the absence of equity provisions favor capitalized operators over small entrants.

Who is consolidating: the existing licensed medical operators, who serve a stable patient base of roughly 19,000 and face no adult-use competition and no intoxicating-hemp competition. The state has effectively channeled all legal THC commerce into the regulated medical lane.

Why 3/5 (moderate fencing): South Dakota fences out adult-use and intoxicating hemp and offers no expungement or equity, which pushes toward the restrictive end. But the medical program is genuinely operational, voter-protected, defended by the Department of Health, and survived two straight years of repeal attempts; the legislature also passed a forward-leaning psilocybin trigger law and declined to add further hemp restrictions. That mix of a working, defended medical market plus hard limits on everything else lands at a middle score rather than a 4 or 5.

What to watch next

November 12, 2026: federal hemp Section 781 total-THC standard takes effect, reinforcing the state ban; watch for any last-minute federal delay amendment (proposed move to November 12, 2027 is unconfirmed).
June 2, 2026 GOP gubernatorial primary and a possible July 28, 2026 runoff; the next governor could change executive posture on cannabis.
November 2026 general election: watch the Secretary of State for any certified cannabis ballot measure (none confirmed as of mid-2026).
HB 1099 psilocybin trigger: legalization activates only upon FDA approval and DEA rescheduling of psilocybin; watch federal action.
2027 legislative session (South Dakota's legislature convenes in January each year, typically the second Tuesday): expect another possible repeal or potency-cap attempt given the two-year pattern.
Department of Health rulemaking and any updated fee schedules or license caps.

Regulators

South Dakota Department of Health, Medical Cannabis Program: licensing and regulation of cultivation, manufacturing, dispensaries, and testing labs, and patient/caregiver registration (doh.sd.gov medical-cannabis; medcannabis.sd.gov).
South Dakota Department of Agriculture and Natural Resources: industrial hemp program oversight (hemp cultivation/licensing under state and USDA rules).
Law enforcement (state and local) and the Attorney General: enforcement of the intoxicating-hemp ban and controlled-substance laws.
South Dakota Secretary of State: ballot measure certification.

Federal exposure (2026)

South Dakota's exposure to the 2026 federal moves runs through every major lever, and on most of them the state is positioned to gain rather than lose, because its policy is already restrictive and medical-only.

Rescheduling and 280E. The DOJ/DEA order signed April 22, 2026 and effective April 28, 2026 (91 FR 22714) moved FDA-approved cannabis drugs and state-licensed medical cannabis to Schedule III, while recreational cannabis stays Schedule I. Because South Dakota is a medical-only state with no adult-use program (adult-use was rejected at the ballot three times, in 2020 by court invalidation and in 2022 and 2024 at the polls), its entire legal THC industry sits in the category that the order covers. The practical effect is 280E relief: South Dakota's licensed cultivators, manufacturers, dispensaries, and testing labs would no longer be barred from deducting ordinary business expenses on their federal returns, improving the margins of the roughly handful of vertically permitted medical operators serving about 19,000 patients. Schedule III does not legalize cannabis, does not authorize interstate commerce, and does not protect the state-licensed businesses from federal law generally; it changes the tax treatment for the medical category and ends 280E for that category. South Dakota captures the upside available to a medical state without absorbing the recreational-stays-Schedule-I downside, because it has no recreational lane to begin with.

The November 12, 2026 hemp cliff. The FY2026 agriculture appropriations rider (Sec. 781, Rep. Andy Harris R-MD) narrows the federal hemp definition to a total-THC standard of about 0.4 mg THC per container, recriminalizing an estimated 90 to 95 percent of intoxicating hemp products effective November 12, 2026; the H.R.7010 delay was not enacted, and the 2026 Farm Bill (H.R.7567) keeps the ban. South Dakota is one of the states least disrupted by this cliff, because it already banned chemically derived and converted intoxicating cannabinoids in 2024 via HB 1125 (effective July 1, 2024), criminalizing delta-8, delta-10, THC-O, HHC, and similar products at the state level. The federal change therefore reinforces existing state law rather than overriding it: the practical effect is that the narrow window of intoxicating-hemp product that may have persisted in interstate-supplied or gray-market channels loses its federal cover, hardening the state's existing prohibition and removing any argument that federally lawful hemp products could circulate in South Dakota. There is no in-state intoxicating-hemp retail sector left to protect, so the cliff lands as a confirmation, not a shock.

Banking. SAFER Banking remains stalled in the Republican Congress. South Dakota's medical operators continue to face the cash-heavy, banking-constrained environment common to all state cannabis markets; rescheduling to Schedule III does not by itself solve the banking problem, which is a separate statutory fix that has not advanced. The state has no ability to cure this on its own, so its operators stay exposed to limited depository access and higher operating friction regardless of the favorable 280E change.

Psychedelics. South Dakota's psilocybin posture is the clearest example of direct federal coupling in the brief. HB 1099 (signed March 2026) is a trigger law: it legalizes crystalline polymorph (synthesized) psilocybin for therapeutic use automatically, but only if and when the FDA approves it and the DEA reschedules psilocybin out of Schedule I. The federal context confirms that psilocybin, MDMA, and ibogaine all remain Schedule I, and that the April 18, 2026 executive order, Accelerating Medical Treatments for Serious Mental Illness [https://www.whitehouse.gov/presidential-actions/2026/04/accelerating-medical-treatments-for-serious-mental-illness/] plus FDA priority vouchers fast-track FDA review without any approval yet. The consequence is that South Dakota's psilocybin legalization is presently inert: no in-state access exists, and none will until the two federal conditions, FDA approval and DEA rescheduling, are both met. The state has voluntarily bound its own timeline to the federal pathway, so federal delay equals state delay, and a federal approval would flip South Dakota to legal medical access without any further legislative action.

Harm reduction. The SAMHSA guidance of April 24, 2026 bars federal funds from paying for fentanyl test strips, clean syringes, and sterile water, while naloxone remains federally supported. South Dakota is exposed here in two ways. First, although the state legalized fentanyl test strips by exempting them from the paraphernalia definition (HB 1041, 2023), the SAMHSA cut removes a federal funding stream that had supported test-strip distribution (including via State Opioid Response grants), so test strips remain legal but may lose federal subsidy. Second, the state's already thin syringe-services posture (statewide statutory authorization is unconfirmed) gets no federal financial support for syringes or sterile water under the new guidance. Naloxone distribution, the one pillar South Dakota most relies on, stays federally funded, so the core overdose-reversal program is insulated while the drug-checking and safer-injection supplies lose their federal backing.

Patient access and rights

This section covers what South Dakota law does and does not protect for a medical cannabis patient: use inside a hospital, and the broader rights that follow a patient into work, housing, parenting, an organ transplant list, and school. It is information, not legal advice, and it reflects the law as of July 2026. Each point links to the primary statute.

Hospital access (Ryan's Law): South Dakota has no hospital-access law. No statute requires a hospital, nursing home, or hospice to let a qualifying patient use medical cannabis on site, so whether a facility allows it is left to that facility's own policy, and many refuse. Seven states have now enacted a Ryan's Law protection (California in 2021, and Colorado, Delaware, Louisiana, Oregon, Virginia, and Washington in 2026), and Pennsylvania has a bill pending; South Dakota is not among them. The absence is the finding: a South Dakota patient has no enforceable right to use their medicine in a hospital today.

Broader protections: here South Dakota is comparatively strong. Chapter 34-20G of the South Dakota Codified Laws protects a registered cardholder across all six areas. It bars employment discrimination against a cardholder (Section 34-20G-22), bars a landlord or a school from refusing a person solely for being a cardholder (Section 34-20G-19), protects custody and visitation absent a showing of danger to the child (Section 34-20G-21), and provides that for the purposes of medical care, including organ transplants, authorized use is treated as the equivalent of any other prescribed medication (Section 34-20G-20). A South Dakota patient cannot be denied a transplant listing solely for lawful medical cannabis use.

Out-of-state patients: South Dakota lets a nonresident cardholder register with the state in order to purchase at a South Dakota dispensary.

The federal picture: the April 2026 federal move of state-licensed medical cannabis to Schedule III did not change any of this. Schedule III does not make dispensary cannabis a lawful prescription medicine and does not create any hospital-use right; only state law can force hospital access, and South Dakota has not enacted a Ryan's Law. The broader protections above are a creature of South Dakota law, not federal law.

Sources: South Dakota patient protections, South Dakota Codified Laws Section 34-20G-22 (employment), Section 34-20G-19 (housing and school), Section 34-20G-21 (custody), and Section 34-20G-20 (transplant and medical care).

Analysis: the enclosure read in depth

Who is fenced out in South Dakota. The defining feature of South Dakota is a voter-created medical program that has survived repeated repeal attempts inside a Republican veto-proof trifecta, paired with an adult-use lane that voters and courts have closed three times. The people fenced out are: adult-use consumers and would-be adult-use entrepreneurs, who have no legal path after the 2020 court invalidation of Amendment A and the 2022 and 2024 ballot defeats; people with prior marijuana charges, who have no automatic or broad petition-based expungement and must rely on a judge granting relief, leaving lasting collateral consequences; small and undercapitalized would-be operators and equity applicants, since the medical program has no social-equity license tiers, fee waivers, or ownership set-asides, and a $5,000 non-refundable dispensary application fee plus capital and regulatory requirements favor better-funded entrants; and the intoxicating-hemp retail sector, already banned since 2024 and now reinforced by the federal cliff. What consolidates inside the fence is the existing licensed medical industry: a stable patient base of about 19,000, no adult-use competition, and no intoxicating-hemp competition, with all legal THC commerce channeled into the regulated medical lane and now handed 280E relief by federal rescheduling.

State-plus-federal interaction. South Dakota shows two distinct interaction patterns. On cannabis and hemp, state restriction and federal enclosure point the same direction: the medical-only structure captures the 280E upside of Schedule III without recreational downside, and the state hemp ban is reinforced by the November 12, 2026 federal total-THC standard, so federal action hardens rather than disturbs the existing fence. On psychedelics, the interaction is a deliberate coupling: the HB 1099 trigger law ties state legalization of synthesized psilocybin directly to FDA approval plus DEA rescheduling. This is the sharpest illustration of federal enclosure logic in the state, because South Dakota has chosen to let the federal medicalize-and-control pathway, the same FDA-and-DEA gating that the April 18, 2026 executive order, Accelerating Medical Treatments for Serious Mental Illness [https://www.whitehouse.gov/presidential-actions/2026/04/accelerating-medical-treatments-for-serious-mental-illness/] and priority vouchers are designed to run through, decide when and whether in-state access opens. A medicalized, FDA-gated psilocybin approval would favor pharmaceutical-scale and institutional providers of a crystalline synthesized compound, not natural-mushroom or decriminalization models, which fits the federal read that enclosure favors large incumbents and fences out small actors.

What to watch. Watch the broader DEA cannabis hearing that opened June 29, 2026 (and may slip to 2027), since it bears on how durable the Schedule III medical treatment is and how the state's repeal-on-rescheduling antagonists may reframe their arguments. Watch the November 12, 2026 hemp cliff for any last-minute federal delay (the move to November 12, 2027 is unconfirmed), though South Dakota is largely insulated either way. Watch the FDA and DEA on psilocybin, because that is the sole switch that activates HB 1099. Watch the SAMHSA funding fallout for South Dakota test-strip distribution. And watch the state's own commons channel: the citizen initiative.

The commons counter-move of the initiative. South Dakota is the original initiative-and-referendum state, and the initiative is the one lever that has repeatedly overridden a hostile legislature. Medical cannabis itself exists only because voters enacted Initiated Measure 26 in 2020 with about 70 percent support, over the preferences of the political branches, and the program has since been defended against legislative repeal in 2025 and 2026. The same direct-democracy channel that created the program is the plausible counter-move against enclosure: a future adult-use initiative, an expungement initiative, or an equity-focused measure could in principle reopen what the legislature and courts have closed. The limits are real, though. Adult-use has now lost three times (once by court ruling, twice at the polls), no certified 2026 cannabis measure is confirmed, and a constitutional-amendment route faces the single-subject and revision constraints that sank Amendment A. So the commons tool is live and proven, but it is not a guaranteed escape from the fence.

Justifying the enclosure score (3 of 5, moderate). South Dakota fences out adult-use, intoxicating hemp, expungement relief, and equity entrants, which all push toward the restrictive end and would, on their own, support a 4. What pulls the score back to a 3 is that the medical program is genuinely operational, voter-created, defended by the Department of Health, and proven durable across two straight years of repeal attempts; the legislature passed a forward-leaning psilocybin trigger law and declined to pile on further hemp restrictions; and the initiative remains a live, historically effective commons counter-move. The federal 2026 picture nudges the same way without changing the score: Schedule III hands the medical lane 280E relief and the hemp cliff merely reinforces an existing state ban, so federal enclosure largely benefits the incumbents already inside South Dakota's fence rather than tightening it further. A working, defended, voter-protected medical market sitting behind hard limits on everything else, with a real but unproven initiative escape valve, lands at the middle of the scale rather than at a 4 or 5.

Active legislation (2026)

This list covers significant 2026 measures surfaced in cannabis, hemp, psychedelics, and drug-policy tracking. It is not exhaustive; for the full long tail see the live trackers linked below.

Beyond the live tracker

These measures are not in the live bill list below: some are not bills (executive orders, rules, referendums, or budgets), and some are proposals or prior-session measures the live tracker does not currently carry.

HB (terminally ill in hospitals) Allow terminally ill patients to use medical cannabis in hospitals/hospices (Dead (rejected in House HHS committee))
Hemp/kratom ban measure Ban intoxicating hemp cannabinoids and kratom (Dead (Senate declined to take up debate))

Bill	Title/Topic	Chamber	Status	Sponsor(s)
SB 181	Repeal medical cannabis program (SDCL 34-20G) upon federal rescheduling	Senate	Dead (rejected in committee 7-0)	Sen. John Carley (R)
SB 194	THC potency caps for medical patients (5% oils / 60% concentrates)	Senate	Dead (rejected in committee 6-1)	Sen. John Carley (R)
HB 1099	Trigger law to legalize crystalline polymorph psilocybin upon FDA/DEA approval	House (originated)	Signed into law (March 2026)	Unconfirmed prime sponsor; advanced 6-0 in Senate HHS
HB 1160	Repeal the medical marijuana oversight committee	House (originated)	Failed in the Senate	Unconfirmed
HB (terminally ill in hospitals)	Allow terminally ill patients to use medical cannabis in hospitals/hospices	House	Dead (rejected in House HHS committee)	Unconfirmed
Hemp/kratom ban measure	Ban intoxicating hemp cannabinoids and kratom	Senate	Dead (Senate declined to take up debate)	Unconfirmed

Live trackers: LegiScan South Dakota, South Dakota Legislature bill search, and Marijuana Moment bill tracker. Where I could not independently confirm a prime sponsor or exact bill number, I have marked it unconfirmed rather than guess.

Support this work

This work is free and reader-funded. No paywalls, no ads. This brief is independent and fully sourced, and reader contributions are what keep the 50-state coverage current and answerable to readers, not advertisers or owners.

If it helped you, please chip in $5 to keep it going. Recurring support helps most; about $25 funds a full refresh of a state brief like this one.

Contribute $5 on Ko-fi Become a member

← Back to all 50 states and federal briefs

A planning snapshot for 2026, not legal advice. Policy moves quickly; confirm any single detail against the cited sources before acting on it. Sponsor names are given where confirmable and marked unconfirmed otherwise.

About the author. Jessica Mantonya is the founder of Drug Policy Watch and Hold in Common. She also advises operators, advocates, and funders on regulatory strategy and anti-enclosure positioning. Work with her →