Lawmakers in South Dakota on Thursday took a step toward making significant changes to the state’s medical cannabis program.

The Republican-controlled state Senate approved a bill that would broaden the list of qualifying conditions for a medical marijuana prescription, while also transferring the power to set those conditions from the South Dakota Department of Health to the state legislature.

The bill passed by a vote of 20-15, according to local news station KELO, and the legislation now moves to the state House of Representatives, where Republicans also maintain a sizable majority. 

Under South Dakota’s medical cannabis law, a patient with one of the following “debilitating conditions” may use medical cannabis once he or she obtains approval from the Department of Health: 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. 

The legislation that was approved by the state Senate on Thursday would broaden the list of debilitating conditions to also include the following: Acquired immune deficiency syndrome or positive status for human immunodeficiency virus; Amyotrophic lateral sclerosis; Multiple sclerosis; Cancer or its treatment, if associated with Crohn’s disease; Epilepsy and seizures; Glaucoma; or Post-traumatic stress disorder. 

The bill also removes language in the law that gives the Department of Health the authority to determine which debilitating conditions will be covered. 

The measure was endorsed by a special legislative committee charged with providing oversight to the state’s medical cannabis law, which was approved by voters in 2020. 

The chair of that committee, Republican state Sen. Erin Tobin, “said taking away the department’s authority to set conditions and putting it with lawmakers instead gave her more confidence to prescribe medical marijuana for a patient,” KELO reported. 

KELO reported that Tobin noted that “the department doesn’t have a medical professional on its staff to decide on conditions.”

“This is something the Department of Health needs,” Tobin said, as quoted by KELO.

Legislators who objected to the proposal argued that the measure that was approved by South Dakota voters in 2020 explicitly gave the authority to the Department of Health.

South Dakota’s medical cannabis law officially took effect in the summer of 2021, but the state’s first licensed dispensary did not open until last year. 

Some Republican lawmakers in the state have been wary of the new medical cannabis law, contending that it could be a gateway to recreational pot use. 

Voters in the state rejected an initiated measure in November that would have legalized recreational marijuana in South Dakota, a disappointing outcome for advocates who believed they had triumphed two years prior. 

In 2020, voters there approved both the medical cannabis measure and an amendment that would have legalized recreational marijuana. 

The amendment drew an immediate legal challenge from South Dakota Gov. Kristi Noem, and the state Supreme Court ultimately struck it down in November of 2021. 

Noem celebrated the ruling.

“South Dakota is a place where the rule of law and our Constitution matter, and that’s what today’s decision is about,” Noem said at the time. “We do things right—and how we do things matters just as much as what we are doing. We are still governed by the rule of law. This decision does not affect my Administration’s implementation of the medical cannabis program voters approved in 2020. That program was launched earlier this month, and the first cards have already gone out to eligible South Dakotans.”

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A new study published this month has found that New York City’s historic safe consumption centers have helped reduce overdoses.

The study, conducted by researchers affiliated with the NYC Department of Health (which oversees the sites), covered the two months of the program across two different consumption sites.

Last November, then-New York Mayor Bill de Blasio announced “that the first publicly recognized Overdose Prevention Center (OPC) services in the nation have commenced in New York City.”

OPCs, the city explained in the announcement, “are safe places where people who use drugs can receive medical care and be connected to treatment and social services.”

NYC officials touted their effectiveness, saying in the press release at the time that such services are “proven to prevent overdose deaths, and are in use in jurisdictions around the world,” and that there “has never been an overdose death in any OPC.”

A study from the city’s Department of Health found that “OPCs in New York City would save up to 130 lives a year.”

“New York City has led the nation’s battle against COVID-19, and the fight to keep our community safe doesn’t stop there. After exhaustive study, we know the right path forward to protect the most vulnerable people in our city. And we will not hesitate to take it,” de Blasio said in the announcement. “Overdose Prevention Centers are a safe and effective way to address the opioid crisis. I’m proud to show cities in this country that after decades of failure, a smarter approach is possible.”

The study published this month may be seen as vindication for the advocates of the program.

“During the first 2 months of OPC operation, trained staff responded 125 times to mitigate overdose risk. In response to opioid-involved symptoms of overdose, naloxone was administered 19 times and oxygen 35 times, while respiration or blood oxygen levels were monitored 26 times,” the authors wrote. “In response to stimulant-involved symptoms of overdose (also known as overamping), staff intervened 45 times to provide hydration, cooling, and de-escalation as needed. Emergency medical services responded 5 times, and participants were transported to emergency departments 3 times. No fatal overdoses occurred in OPCs or among individuals transported to hospitals.”

“This quality improvement study found that during the first 2 months of operations, services at 2 OPCs in NYC were heavily used, with early data suggesting that supervised consumption in these settings was associated with decreased overdose risk,” they added. “Data also suggested that OPCs were associated with decreased prevalence of public drug use.”

The authors did, however, caution that the findings are “limited by the short study period and lack of a comparison group with individuals not participating in OPC services,” and that additional “evaluation may explore whether OPC services are associated with improved overall health outcomes for participants, as well as neighborhood-level outcomes, including public drug use, improperly discarded syringes, and drug-related crime.”

But the study provides hope to those who are desperate to mitigate an overdose crisis that has become a national epidemic in the United States.

In the announcement of the OPC services last November, NYC officials said that “over 2,000 individuals died of a drug overdose in New York City [in 2020], the highest number since reporting began in 2000,” and that the “Centers for Disease Control projects that across the United States, more than 90,000 individuals died of a drug overdose during 2020, the worst year on record.”

Citing self-reported data, the authors of the new study said that “the drug most commonly used across 2 sites was heroin or fentanyl (73.7%) and the most frequent route of drug administration at the OPC was injection (65.0%).”

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Efforts to implement the legalization of adult-use cannabis in New Mexico made new progress this month as regulators issued the first license to cultivate recreational marijuana in the state. Tony Martinez, the CEO of Mother’s Meds, announced in a statement last week that the New Mexico Regulation and Licensing Department had issued a license to the company to operate as a cannabis cultivator on November 1.

The company will join 34 other cannabis producers previously licensed by the Department of Health to cultivate medical marijuana, many of which will also grow adult-use cannabis. On Wednesday, a spokesperson for the state’s Cannabis Control Division (CCD), which is overseen by the department, confirmed that the license had been awarded pending a background check of the applicants.

“Mother’s Meds has been issued a cannabis producer’s license and that license will go into effect as soon as all background check requirements are met,” division spokesperson Heather Brewer said in a statement quoted by the New Mexico Political Report. “The Cannabis Control Division is excited to start issuing licenses and looks forward to public announcements and celebrations of new businesses as the Division works to stand up a thriving adult-use cannabis industry in New Mexico.”

Martinez credited the “hard work, due diligence and adaptability” of the company’s staff and San Juan County’s “business friendly attitude” for the first cultivation license being issued to Mother’s Meds, which is doing business as Lava Leaf Organics. He added that the company “will continue to comply with all CCD rules and regulations” as it gets cannabis production up and running.

Rather than hiring a substantial number of employees, Martinez said the company will operate by contracting with cannabis industry professionals. 

“My least favorite part of business is placing a value on another person’s efforts and talents; this model allows people more control over their destiny and to work with us, not for us,” Martinez wrote in a statement. “I believe this will allow our community to attract and retain more talented professionals than our competitors.”

More Than 1,500 More Cultivation License Applications Still Pending in New Mexico

Since the CCD begin accepting applications for adult-use cannabis producers in August, more than 1,500 potential applicants have initiated the detailed and time-consuming process. More than 1,000 applications were started for licenses to operate microbusinesses, which are limited to growing no more than 200 cannabis plants at a time.

“We’re off to a great start,” John Blair, the deputy superintendent for the New Mexico Regulation and Licensing Department, told local media earlier this month. “I don’t know that we could have anticipated what the demand was going to be other than knowing there really seems to be a great excitement across the state.”

State regulators continue to accept applications, and Blair noted that regulators have not established a cap on the number of licenses issued, a practice common in many jurisdictions with legal marijuana production.

“We don’t have any limit on the number of people that we’ll license for any of the cannabis businesses,” he said. “If a million New Mexicans want to get a license, we would license a million people.”

Completing the application, however, is not a simple process. Johnathan LeDuc, an applicant hoping to produce medical and recreational marijuana in Los Alamos, said that the CCD required him to submit a social and economic equality plan, a government identification card, a current business license, a fire inspection report, zoning approval, proof of business premises ownership, a diagram of the location, a water and energy use plan and a demonstration of water rights.

“It’s quite a daunting process. The application is very, very thorough, and there’s a lot of steps and requirements,” he said. “I have basically only been able to submit my application provisionally.”

No Guarantee of Success

While there is no limit to the number of licenses that can be issued to cultivate adult-use cannabis in New Mexico, receiving one does not guarantee a successful business. A.J. Sullins, a New Mexico resident who owns cannabis companies in several other jurisdictions and is now applying to produce marijuana in his home state, said that market forces and production costs are likely to lead to many business failures.

“There’s going to be quite a few people who have received licensure and their costs are outweighing their revenue because they didn’t plan for a low-cost production,” he said. “And they’re going to start to get consolidated or washed out within a three-year period. I saw the same thing happen in Arizona.”

Sullins added that even businesses with millions of dollars in investment can have difficulty competing with large multistate cannabis operators.

“There’s about one or two large players out there who are absolutely dominating the market,” he said. “I hate to use the word, but almost ‘monopolizing’ the market. So competition is definitely steep at the top.”

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