Election Brings Big Wins for Cannabis Legalization

The 2020 election brought big wins for cannabis, with all of the five state ballot initiatives regarding legalization passing. Both adult-use (or recreational) and medicinal cannabis were legalized in South Dakota; Medicinal cannabis was approved in Mississippi; and adult-use initiatives passed in Arizona, Montana and New Jersey.

Across these states, in different parts of the US, the message was clear: people recognize the benefits of legalization and want access to cannabis in their communities. Implied by the results is another more subtle, but all the more significant message—that the stigma surrounding cannabis is fading as awareness of its effects and medicinal uses grows throughout the country. The following is a breakdown of the ballot initiatives and what their passage means for each state.

Arizona: Adult-use

While medicinal cannabis was already legal in Arizona, voters in the recent election passed Proposition 207: The Smart and Safe Arizona Act to make adult-use cannabis—or recreational use for ages 21 and over—legal statewide.


  • Allows the possession of up to one ounce of cannabis and no more than five grams of concentrate
  • Permits individuals to possess up to six cannabis plants in their homes
  • Public consumption prohibited
  • In addition to local taxes and 16% excise tax, state sales tax of 5.6% applied to cannabis sales 

Mississippi: Medicinal 

Mississippi voters supported the less restrictive of two cannabis questions on the ballot. Initiative 65 (74%) passed over the Alternative 65A (32%)—the latter of which would have restricted medicinal cannabis to terminally ill patients. The passing initiative legalizes cannabis prescriptions for 22 medical conditions.

Qualifying conditions for a cannabis prescription:

  • Cancer
  • Epilepsy or other seizures
  • Parkinson’s disease
  • Huntington’s disease
  • Muscular dystrophy
  • Multiple sclerosis
  • Cachexia
  • Post-traumatic stress disorder (PTSD)
  • Positive status for Human Immunodeficiency Virus (HIV)
  • Acquired Immune Deficiency Syndrome (AIDS) 
  • Chronic or debilitating pain
  • Amyotrophic Lateral Sclerosis (ALS)
  • Glaucoma
  • Agitation of dementias
  • Crohn’s disease
  • Ulcerative colitis
  • Sickle-cell anemia
  • Autism with aggressive or self-injurious behaviors
  • Pain refractory to appropriate opioid management
  • Spinal cord disease or severe injury
  • Intractable nausea
  • Severe muscle spasticity

It also allows for medical marijuana prescriptions for conditions “of the same kind or class” to the above, for which a physician believes the benefits of medical cannabis would outweigh any potential health risks.

Montana: Adult-use

With the passage of Montana I-90, voters legalized the sale and possession of cannabis for recreational purposes for adults 21 and older. Medicinal cannabis was already approved in Montana in 2004.


  • Individuals can possess up to four cannabis plants and four seedlings in their homes
  • 20% state tax applies to retail cannabis and cannabis-infused products
  • Montana Department of Revenue to regulate the cultivation, manufacturing, transport, and sale of marijuana in the state
  • Local authorities responsible for regulating cannabis businesses

New Jersey: Adult-use

New Jersey legalized medicinal cannabis in 2010. Thanks to the passage of New Jersey Public Question 1, the state now permits the sale and possession of recreational cannabis for adults 21 and older.


  • Does not include information relating to possession limits, retail sales or growing plants at home; these regulations will be established by a Cannabis Regulatory Commission
  • 6.625% state sales tax for adult-use sales, and local governments will be allowed to add another 2%

South Dakota: Medicinal and Adult-Use

Voters in South Dakota supported two separate ballot questions concerning cannabis legalization—one for medicinal use, and the other for adult-use by individuals 21 and over. Below are a few details on each of those programs.

Medicinal use:

  • Legalizes cannabis prescriptions for patients with chronic or debilitating diseases, medical conditions or treatments with one or more of the following symptoms: cachexia or wasting syndrome; severe, debilitating pain; severe nausea; seizures; or severe and persistent muscle spasms, including those characteristic of multiple sclerosis.
  • Patients can possess up to three ounces of cannabis or another amount specified by a physician 
  • Patients are allowed to grow up to three cannabis plants at home, if registered to do so


  • Adults over 21 can possess and distribute up to one ounce of cannabis
  • Permits the possession of up to three cannabis plants in a private residence, if located in a jurisdiction with no licensed retailer
  • Tax of 15% applies to cannabis sales
  • Public consumption of cannabis remains prohibited
  • Local governments allowed to ban any cannabis business from operating in their jurisdiction

My state legalized adult-use cannabis. Should I still get a medical card?

Regardless of whether recreational cannabis is legal in your state, there are many benefits of obtaining a medical marijuana card. For many states, these include lower costs and taxes for patients, higher potency limits and permission to grow your own cannabis if necessary. Medicinal cannabis is typically not restricted to adults 21 and older, allowing younger patients seeking treatment to obtain the prescriptions they need. 

Regulations vary, so check your state laws relating to medical marijuana before you apply. 

Schedule a virtual consultation today

When you’re interested in taking the next step, set up a virtual or in-person meeting with one of our medical marijuana physicians. 

We’ll walk you through the application process, go over the details of your state’s medical marijuana program and applicable laws, and provide you with information about medical cannabis, potential risks, and side effects. 

Then a medical cannabis doctor will discuss your medical history with you, treatment options for your qualifying condition, and any questions you have.


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