South Dakota Medical Cannabis Patient Rights: Quick Guide

A plain-language guide to what South Dakota’s medical cannabis law, SDCL chapter 34-20G, and the Department of Health’s rules, ARSD article 44:90, say about cardholders’ rights and limits. Every answer is footnoted to the statute, rule or state agency page it comes from. Updated for rule changes taking effect Nov. 5, 2026. Last reviewed Oct. 27, 2026.

Updated Oct. 27, 2026: revised the Traveling and Guns answers for 2026 federal developments and corrected the low-income fee threshold.

⚠ Not legal advice

This guide is general information, not legal advice. Laws change; check the cited statute or talk to a lawyer about your situation.

Jump to a section

What changes as of Nov. 5, 2026
Getting or renewing a card
How much you can possess
Home cultivation
Where you can’t use
Driving
Employment and the ADA
Housing, school, custody and medical care
Traveling
Guns

What changes as of Nov. 5, 2026

As of Nov. 5, 2026, the Department of Health’s revised rules take effect. Based on the department’s latest posted text, these are the changes that reach cardholders and caregivers directly:¹

Home growers get one registry card authorizing cultivation and must carry it while growing. The two-part card, with one half posted on the grow-room door, is eliminated. A proposed ban on home growing for patients under 21 was dropped.
Caregivers destroy cards instead of returning them. When a patient removes a caregiver or a grow designation, when a caregiver steps down, or when a patient dies, the caregiver must immediately destroy the card. The old 15-day return window is gone.
Card fees keep the same dollar amounts: $75 standard, $20 low-income, $20 for a caregiver card and $20 extra for a card authorizing cultivation. The schedule now applies to “a resident or a nonresident,” and the old exception for a caregiver named on the patient’s initial or renewal application is struck.
Edibles other than tinctures, oils and capsules may be manufactured with up to 100 milligrams of THC per serving, up from 50. The 500-milligram package limit does not change.
Unchanged: the 3-ounce possession limit and its product-equivalency table, and the rule limiting nonresidents to two designated dispensaries.

Getting or renewing a card

Who qualifies for a card?

You qualify if a practitioner (a physician, physician assistant or advanced practice registered nurse) diagnoses you with a “debilitating medical condition” listed in state law and issues a written certification. The list includes AIDS or HIV, ALS, multiple sclerosis, Crohn’s disease, epilepsy and seizures, post-traumatic stress disorder, cancer associated with severe or chronic pain, nausea or severe vomiting, or cachexia or severe wasting, and any chronic or debilitating disease or condition (or its treatment) that produces cachexia or wasting syndrome, severe debilitating pain, severe nausea (except nausea associated with pregnancy), seizures, or severe and persistent muscle spasms. The practitioner must have a “bona fide practitioner-patient relationship” with you, including an in-person physical examination at the initial visit.²

How do I apply?

Your practitioner starts the process by certifying you in the state’s online registry; you then complete the application online. The written certification must be issued within 90 days before you apply. The application requires a photocopy of an unexpired ID acceptable for voter identification, a 2-by-2-inch color photo, and the fee.³

What does a card cost?

The standard patient card fee is $75, or $20 for a low-income patient; the Department of Health defines low-income as gross monthly household income at or below 130 percent of the federal poverty level. Adding home cultivation costs an additional $20. Fees are nonrefundable, and the fee is due again at each renewal.⁴

How long does a card last, and how do I renew?

A card expires on the date your practitioner notes on your written certification, and no later than one year after it is issued. To renew, you need a new certification from your practitioner and the renewal fee. The department says it emails a reminder 45 days before a card expires and tells cardholders to shred the old card once the new one arrives.⁵

Can a patient under 18 get a card?

Yes, but only if the patient’s practitioner explains the risks and benefits to the custodial parent or legal guardian who makes health care decisions for the patient. That parent or guardian must consent in writing to the patient’s medical use, serve as the patient’s designated caregiver, and control the acquisition, dosage and frequency of use.⁶

Who can be a caregiver?

A designated caregiver must be at least 21, must have agreed to help the patient, and must not have been convicted of a “disqualifying felony offense,” defined as a violent crime classified as a felony where the person was convicted. A caregiver may assist no more than five patients, unless the patients live in or are admitted to certain facilities where the caregiver works. A patient may reimburse a caregiver for direct costs of helping with the patient’s medical use.⁷

What do I have to report to the department?

Patients and caregivers must report a name or address change within 10 days, and must report a lost card within 10 days of learning it is lost. A caregiver must report a patient’s death within 10 days of learning of it. A patient must notify the department before changing caregivers or designated dispensaries.⁸

Can people from other states get a South Dakota card?

Yes. A nonresident (or a resident of fewer than 45 days) who holds a currently valid medical cannabis card or its equivalent from another jurisdiction can register with the Department of Health. The registration expires on the earliest of one year from issuance, the expiration of the home-state practitioner certification, or one year from that certification’s issue date, and it is valid at no more than two dispensaries chosen at registration. Nonresident cardholders may not grow cannabis.⁹

How much you can possess

What is the possession limit?

A cardholder may possess up to three ounces of cannabis. Cannabis products count toward that same three-ounce total using the Department of Health’s equivalency table below. FDA-approved drugs do not count toward the limit.¹⁰

Product type	Amount that counts as one ounce of cannabis
Concentrated cannabis in smokable form	8 grams (net weight)
Vaporizer product	8 grams (net weight)
Cannabis oil or tincture in oral dosage syringe or capsule form	8,000 milligrams (net weight THC)
Edibles, excluding oils	2,000 milligrams THC
Topical ointment, cream, or lotion	12 fluid ounces
Topical dried plant material or powder	16 ounces
Transdermal patch	800 milligrams THC

Source: ARSD 44:90:02:16. Not amended in the rules taking effect Nov. 5, 2026.

Do home growers get more?

Yes. A cardholder whose card allows cultivation may also have “two flowering cannabis plants and two cannabis plants that are not flowering,” plus the cannabis and cannabis products produced from those plants, if they are kept at the same property where the plants were grown.¹¹

How much can I buy at a dispensary?

The Department of Health says it uses a rolling limit of three ounces of flower over 14 days. Each purchase is subtracted from the three-ounce total and added back 14 days after that purchase.¹²

What if I have more than the limit?

The state’s protections from arrest and prosecution apply only if you do not possess more than the allowable amount, and cannabis over the allowed amount may be seized. Selling or transferring cannabis for anything of value to someone who is not a cardholder or a licensed establishment is a Class 6 felony.¹³

Home cultivation

Can I grow at home?

Only if your registry card designates you, or your caregiver, to cultivate. The application requires a diagram and photographs of the enclosed, locked facility where the plants will grow, plus the $20 cultivation fee. Nonresidents may not grow; “age-restricted” cardholders (those under 18 or certain students) may not grow but may designate a caregiver to grow for them unless they are nonresidents.¹⁴

Where do the plants have to be?

Plants must be in an “enclosed, locked facility,” meaning a closet, room, greenhouse, building or other enclosed area with locks or other security devices that allow access only by a cardholder or a person allowed to grow the plants. Two or more cardholders who live in the same home may share one facility. The state’s protections cover plants that are in that facility or are being transported.¹⁵

Can I make concentrates at home?

Not by solvent extraction. State law excludes “the extraction of resin from cannabis by solvent extraction” from protected medical use unless a licensed cannabis product manufacturing facility does it.¹⁶

Can I grow in a rental?

Only if your landlord allows it. State law does not require a landlord to allow cultivation on rental property.¹⁷

What changes for growers on Nov. 5, 2026?

As of Nov. 5, 2026, the department issues one registry card authorizing cultivation, and the patient or caregiver must carry it while cultivating. The old two-part card, with one part posted on the grow-room door, is eliminated. The department dropped a proposal that would have barred patients under 21 from growing.¹⁸

Where you can’t use

Where is smoking or vaping off-limits?

State law does not authorize smoking or vaping cannabis on any form of public transportation, in any public place or place open to the public, or by anyone under 21. It also does not authorize possessing or using cannabis in any correctional facility.¹⁹

What about private property and government buildings?

A person or business in lawful possession of property does not have to let guests, clients, customers or visitors smoke or vape there. State and local governments do not have to allow medical cannabis activity in buildings they own, lease or occupy, and no one may consume cannabis on the property of a medical cannabis establishment such as a dispensary.²⁰

What about hospitals, nursing homes and treatment centers?

Health care facilities, accredited prevention or treatment facilities, mental health centers, child welfare agencies and certain community service providers may restrict medical cannabis use by cardholders who live there, are being treated there or are visiting. They may refuse to store a patient’s supply and may require use only in a specified place; they are not required to allow consumption on their grounds.²¹

Driving

Can I drive after using medical cannabis?

Not while under the influence, and the law defines that broadly. The medical cannabis law does not authorize “operating, navigating, or being in actual physical control of any motor vehicle, aircraft, train, or motorboat while under the influence of cannabis.” The law defines “under the influence of cannabis” as an abnormal mental or physical condition that tends to deprive a person of clearness of intellect and control, “as the result of consuming any degree of cannabis.” South Dakota’s DUI statute separately prohibits driving under the influence of marijuana.²²

Can police search me because I have a card?

Having or applying for a registry card “does not constitute probable cause or reasonable suspicion,” and it may not be used to support a search of you or your property. A cardholder with a card and no more than the allowable amount is presumed to be engaged in medical use, but that presumption can be rebutted with evidence.²³

What if I’m asked about my cannabis?

Intentionally making a false statement to a law enforcement officer about medical use of cannabis to avoid arrest or prosecution is a Class 2 misdemeanor. A cardholder convicted of it is disqualified from being a cardholder.²⁴

Employment and the ADA

Can my employer punish me for being a patient?

Except as the chapter otherwise provides, state law gives a registered patient the same rights under state and local law as someone prescribed a pharmaceutical medication, in dealings with an employer and in employer drug testing. The exception is a “safety-sensitive job,” one with duties an employer reasonably believes could cause illness, injury or death, or serious property damage. In those jobs, an employer may take adverse action, or refuse to hire, based solely on a positive test for cannabis metabolites.²⁵

What can employers still do?

Employers do not have to allow cannabis in the workplace or let anyone work under the influence, and they may discipline employees for using cannabis at work or working while under the influence. They may adopt and enforce a drug-free workplace policy, including drug testing that complies with state and federal law. The law creates no cause of action for discrimination or wrongful termination arising from an employer’s enforcement of a drug-free workplace policy in compliance with the chapter.²⁶

Do federal rules override these protections?

They can. The rights in §§ 34-20G-19 through 34-20G-25, including the employment, school and housing protections, do not apply to the extent they conflict with an employer’s obligations under federal law or regulation, or would disqualify an employer from a federal monetary or licensing-related benefit.²⁷

Does the federal Americans with Disabilities Act protect me?

That question is unsettled. The ADA does not protect an individual “currently engaging in the illegal use of drugs” when an employer or other covered entity acts on that basis, and it defines illegal use by reference to the federal Controlled Substances Act, excluding drugs taken under supervision by a licensed health care professional or other uses authorized by federal law. The 9th U.S. Circuit Court of Appeals held in 2012 that doctor-recommended marijuana use permitted by state law was not protected by the ADA. How the 2026 federal rescheduling order affects that question has not been settled.²⁸

Housing, school, custody and medical care

Can a landlord refuse to rent to me?

Not solely because you are a cardholder, unless renting to you would violate federal law or regulations or cost the landlord a federal monetary or licensing-related benefit. A landlord may still impose reasonable restrictions on a resident cardholder’s medical use of cannabis at the property and does not have to allow growing there.²⁹

Can a school turn away a student who is a cardholder?

A school may not refuse enrollment or penalize a cardholder solely for cardholder status, with the same federal-law exception that applies to landlords. State law also requires the Department of Education and the Department of Health to have a policy allowing students who are cardholders to have their medicine administered at school in accordance with their physician’s recommendation.³⁰

Can being a cardholder cost me custody of my children?

No one may be denied custody, visitation or parenting time “solely because the person is a cardholder.” There is no presumption of neglect or child endangerment for conduct the law allows, unless the person’s behavior creates an unreasonable danger to the child, and courts still decide custody based on the child’s best interests.³¹

Can I be denied medical care, such as an organ transplant?

For medical care, including organ and tissue transplants, a registered patient’s lawful cannabis use is treated as the equivalent of using any other medication at a practitioner’s discretion. It does not count as use of an illicit substance and may not otherwise disqualify the patient from needed care.³²

Can a licensing board discipline me?

A cardholder may not be arrested, prosecuted or penalized, including through discipline by a court or an occupational or professional licensing board, for medical use that follows the chapter and stays within the allowable amount. Property used in connection with lawful medical use may not be seized or forfeited.³³

I’m on probation or parole. Can I use medical cannabis?

Only with an extra step. A person on probation supervised by the Unified Judicial System, or on parole or conditional release from a state prison, needs a practitioner to attest that medical cannabis use is consistent with the medical standard of care and reasonable compared with other treatment options.³⁴

Traveling

Does South Dakota honor out-of-state medical cards?

Not automatically. Visitors must register with the Department of Health as nonresident cardholders, which requires a currently valid card or its equivalent from their home jurisdiction. Once registered, a nonresident may possess up to three ounces of cannabis, with cannabis products counted toward that limit under the department’s equivalency rule, and may buy at no more than two designated dispensaries.³⁵

Will other states honor my South Dakota card?

That depends entirely on the other state’s law. South Dakota’s law makes medical cannabis activity lawful “for the purposes of state law,” so its protections stop at the state line.³⁶

What about national parks, national forests and other federal land?

Federal law applies on federal land in South Dakota as it does everywhere else, and South Dakota’s protections apply only under state law. Federal law makes it unlawful to possess a controlled substance unless it was obtained directly from, or under a valid prescription or order of, a practitioner. Since April 28, 2026, a federal rescheduling order has placed marijuana subject to a state medical marijuana license in Schedule III and allows dispensaries registered with the Drug Enforcement Administration to dispense to people authorized by state law to possess medical marijuana; other marijuana remains in Schedule I. The order does not expressly say whether a patient’s possession is lawful under federal law, so how it applies to a cardholder on federal land is unsettled.³⁷

Can I take my cannabis into another state?

Doing so remains legally risky. Federal law makes possessing a controlled substance a crime unless it was obtained directly from, or under a valid prescription or order of, a practitioner, and the April 2026 federal rescheduling order does not expressly address patients who carry cannabis between states. You would also be subject to the other state’s laws, because South Dakota’s protections apply only in South Dakota.³⁸

Guns

Can a cardholder own a gun?

South Dakota’s medical cannabis law does not override federal firearms law. Federal law, 18 U.S.C. § 922(g)(3), prohibits anyone “who is an unlawful user of or addicted to any controlled substance” from shipping, transporting, receiving or possessing a firearm or ammunition. South Dakota requires every card application and renewal to include a notice that, “[u]ntil marijuana is legalized under federal law, an individual who is a current user of marijuana is, under federal law, an unlawful user of a controlled substance,” and that “[f]ederal law does not exempt the use of marijuana for medicinal purposes.”³⁹

On June 18, 2026, in United States v. Hemani, the U.S. Supreme Court held that the federal government’s prosecution of a man under § 922(g)(3), based solely on his admitted use of marijuana about every other day, was inconsistent with the Second Amendment. The Court said it was not deciding other questions, including bans on people who are addicted or presently intoxicated and prosecutions backed by individualized proof that a person’s drug use makes him a danger to himself or others.⁴⁰

Separately, the Bureau of Alcohol, Tobacco, Firearms and Explosives revised its regulatory definition of an “unlawful user” in an interim final rule effective Jan. 22, 2026. Under the revised definition, an unlawful user is a person who “regularly uses a controlled substance over an extended period of time continuing into the present, without a lawful prescription or in a manner substantially different from that prescribed by a licensed physician”; isolated or sporadic use, or use that has stopped, does not qualify.⁴¹

The April 2026 federal rescheduling order amended Drug Enforcement Administration regulations, not the federal gun law, and moved only some marijuana to Schedule III. ATF’s Form 4473 (revised August 2023), which gun buyers fill out at licensed dealers, asks whether the buyer is “an unlawful user of, or addicted to, marijuana” or any other controlled substance, and warns that marijuana use or possession “remains unlawful under Federal law” regardless of state law. ATF proposed revising the form in May 2026. How these developments apply to a South Dakota cardholder has not been settled; a cardholder who owns or wants to buy a firearm should talk to a lawyer.⁴²

This guide is general information, not legal advice. Laws change; check the cited statute or talk to a lawyer about your situation.

Questions for the state program: Department of Health, Medical Cannabis Program, MCQuestions@state.sd.us, 605-773-3361. Spot an error in this guide? Email weedpressnewstips@gmail.com.