Mississippi has finally signed a medical cannabis bill into law after a long and often arduous process.
However, a range of further regulations as well as approvals and zoning restrictions may limit actual patient access to medical cannabis in the state – causing further worries for advocates who fought to get the law passed.
“It’s just been a whole range of emotions, from the highest of highs to the lowest of lows,” said patient advocate Amy Smoot of her fight for medical cannabis in Mississippi. “I’m cautiously optimistic now. I’m walking on ice that at any time could crack, but I feel like we’re gonna get it done.”
A provision will give local governments 90 days from the time of the law’s enactment to opt out of the medical cannabis program. If a local government opts out, citizens may sign a petition to vote on the topic.
Smoot told CBD-Intel she has been talking to municipal government leaders to learn their stance and to speak at meetings if there is a desire to opt out. So far, she said only one or two have stated plans to opt out.
“I want to have conversations with them: ‘What scares you? What are you worried about?’” she said. “Because, let’s be real, it’s already legal in 36 states. If there’s a big monster hiding behind this, I think one of them would have figured it out by now.”
Cannabis companies may also be required to seek local government approval to operate, and zoning and land use restrictions in municipalities may limit their ability to operate. Cannabis companies may only operate in commercial zones of municipalities whose local governments grant a variance.
The law also requires all cannabis used by Mississippians to be grown and processed in the state. The schedule for licensing means the state’s patients may be able to legally obtain medical cannabis by the end of 2022.
The programme will be one of the most conservative in the country and regardless of the hesitation Republican governor Tate Reeves had in signing it into law, which led to some of the further restrictions.
It will allow approved patients to purchase the equivalent of 3.5 grams of cannabis, or one gram of cannabis concentrate per day, with a maximum monthly limit of three ounces.
The law also includes THC limits of 30% for cannabis flower and 60% for concentrates, which Smoot said may not be enough for cancer and chronic pain patients, along with others with certain conditions. She said she believes that amendments will eventually be made to make the law work for all of Mississippi’s medical cannabis patients.
Both smoking and vaping is allowed in Mississippi’s program, but not in public places. Driving under the influence of cannabis remains illegal, and patients and caregivers are not permitted to grow their own cannabis.
The qualifying conditions for patients include cancer, Parkinson’s, Huntington’s and Alzheimer’s disease, muscular dystrophy, glaucoma, spastic quadriplegia, HIV, AIDS, hepatitis, ALS, sickle-cell anemia, Crohn’s, ulcerative colitis, neuropathy, PTSD, autism, spinal cord disease or severe injury. Other qualifying conditions include chronic medical conditions or treatments that produce severe nausea, cachexia or wasting, seizures, severe or persistent muscle spasms and chronic pain.
The Mississippi Department of Health will oversee the program, and a nine-member advisory committee will make recommendations on issues including safety and patient access. The state Department of Health will begin accepting applications and issuing licenses within 120 days, then begin licensing facilities. After 150 days, the Department of Revenue will begin licensing and registering facilities.
A 5% excise tax will be levied on medical cannabis, and purchases will also be subject to the state sales tax.
“Despite tremendous support, Mississippians faced an uphill battle for a medical cannabis program,” said Kevin Caldwell, southeast legislative manager for the Marijuana Policy Project. “With this new law, justice has finally prevailed. Patients in Mississippi who are seriously ill will no longer be subject to arrest and criminal penalties for using medical cannabis and instead will be met with compassion.”
“We applaud the legislature for working to restore the will of the voters in one of the most conservative states in the nation and Governor Reeves for signing it into law,” he added.
Long road to legal status
However opposition from Reeves nearly scuppered the law after its long road back from a Supreme Court decision overturning the voter led initiative on a technicality.
The future of the state’s medical cannabis program was in limbo for months until 2nd February, when Governor Tate Reeves finally signed Senate Bill 3095 into law just hours before the deadline and announced his displeasure over social media.
The delay primarily involved the amount of cannabis patients could obtain per month. Reeves threatened to veto Senate Bill 3095 over the matter. During negotiations, lawmakers reduced the amount of cannabis patients could obtain per month from 4 ounces to 3.5 to 3.
The bill had overwhelming support in both the state House and Senate, which could have overridden a veto by the governor.
As the deadline approached, Reeves refused to say whether he would sign. Just hours before the deadline, Reeves announced he would sign it with a Facebook post. Reeves did not veil his disappointment in the bill even as he announced it would pass.
His statement said, in part:
“There is no doubt that there are individuals in our state who could do significantly better if they had access to medically prescribed doses of cannabis. There are also those who really want a recreational marijuana program that could lead to more people smoking and less people working, with all of the societal and family ills that that brings.
“My goal from Day 1 (post Supreme Court ruling) has been to allow for the former and do everything in my power to minimize and mitigate – though knowing it is impossible to eliminate – the likelihood of the latter. After all, the overwhelming majority voted for a medical marijuana program in the 2019 election and I committed to supporting the will of the people.
“I have made it clear that the bill on my desk is not the one that I would have written. But it is a fact that the legislators who wrote the final version of the bill (the 45th or 46th draft) made significant improvements to get us towards accomplishing the ultimate goal.”
In the 2020 election, the majority of Mississippi voters cast ballots in support of the state’s proposed medical cannabis bill, Initiative 65. But Madison Mayor Mary Hawkins Butler filed a lawsuit against the state saying the measure could not be on the ballot due to an outdated requirement for ballot initiatives, prompting the Mississippi Supreme Court to weigh in. The state Supreme Court agreed with the lawsuit and ruled in May 2021 that the measure was placed on the ballot illegally.
Smoot said that years earlier, she had made it her mission to get medical cannabis to Mississippi patients.
“Those patients were suffering in silence, and to know that they were fighting that alone killed me. It absolutely killed me, and I knew that I had to do everything I could do help,” she said. “If it meant standing and yelling at senators, if it meant snotting and crying in front of them, I was gonna do whatever I could do to help.”
Smoot’s fight for medical cannabis in Mississippi started long before the bill hit the governor’s desk.
She took on the mantle of cannabis advocacy because of a little girl named Rylee, the daughter of one of her close friends. Rylee suffered from a medical condition that caused her to have hundreds of seizures every day. When she was five, a hospital told her parents there was nothing more they could do for her.
“They sent her home to die. They said they had done all that they could do for her, and the hospital told them to take her home to die,” Smoot said. “Instead of taking her home to die, they packed their bags and moved to Colorado.”
There, Rylee has gone from “near death to thriving”, Smoot said.
Spreading the word
She began her own research into medical cannabis, and started sharing Rylee’s story on community boards, talking to people in grocery stores, and anywhere she could find people who would listen. She worked as an EMT before suffering an injury on the job that ended her career.
“So this was just natural for me to jump in to speak for people who were suffering in silence,” she said.
Other parents began telling Smoot their stories, and she began advocating for them as well.
“I don’t have a lot of fear, so I said, ‘OK, fine. I’ll email the entire Mississippi House and the entire Mississippi Senate,’” she said.
She received only one response. It was from her local state senator, Republican Kevin Blackwell of Southaven. He became the bill’s sponsor, and led negotiations until the bill was signed.
“It only takes one,” Smoot said.
Smoot said she did not think Initiative 65 would pass during the general election. She helped collect signatures to put it on the ballot, but she did not think that Mississipians had enough knowledge about the bill to vote in its favour. When she learned that it passed, she was floored.
“When I woke up the next day, I lost it. I cried. I don’t have any words for the elation that I felt,” she said. “These patients across the state had hope for the first time. I was on cloud nine.”
She knew about the lawsuit filed to block the vote, but legislators told her not to worry. When the state Supreme Court voted to overturn the law, Smoot was shocked.
“It took the breath out of my body. It made me feel like I had gotten punched square in the nose, because these people had hope and then they had it taken away. There were lives hanging in the balance. With these children that were seizing, every seizure that they had could be their last,” she said.
Section 273, which the state Supreme Court used to overturn Initiative 65, was written in the 1990s when Mississippi had five Congressional districts. It required at least a minimal equal number of signatures from all five districts before an initiative could reach the ballot. The state’s population stagnated since then, and one district was eliminated following the 2000 Census. But Section 273 remained in place for more than 20 years, and many measures were passed through ballot initiatives in that time frame. The matter was never brought before the state’s governing bodies until Mississippians voted in favour of medical cannabis.
The state Supreme Court voted 6-3 to say the measure was placed on the ballot illegally.
“Whether with intent, by oversight, or for some other reason, the drafters of section 273(3) wrote a ballot-initiative process that cannot work in a world where Mississippi has fewer than five representatives in Congress,” Justice Josiah Coleman wrote for the majority in the ruling. “To work in today’s reality, it will need amending — something that lies beyond the power of the Supreme Court.”
Justice James Maxwell wrote a strongly worded dissent saying Initiative 65 was placed on the ballot correctly. He further said the justices did not have the power to amend the state’s constitution.
“Yet the majority does just that — stepping completely outside of Mississippi law — to employ an interpretation that not only amends but judicially kills Mississippi’s citizen initiative process,” Maxwell wrote.
Law in limbo
With the law in limbo, legislators called on Reeves to hold a special session. In the meantime, Smoot continued contacting her legislators.
Months of negotiations had followed the Supreme Court ruling with a bipartisan effort to write a bill that Reeves would sign.
Republican Lee Yancey told Mississippi Today in October that Reeves was refusing to call a special session over last-minute, “unreasonable demands”. At the time, Reeves called on lawmakers to reduce the dosage unit of marijuana flower by 0.7 grams. One-eighth of an ounce (3.5g) is the industry standard, with machines calibrated to one-eighth of an ounce, making small changes to the standard dosage unit a headache to implement.
“We have worked long hours on this,” Yancey told Mississippi Today. “We have brought forward a bill that many have said would be the best program in the country. We are ready to have a special session. We have the votes to pass this. An overwhelming number in the House and Senate are ready to pass this, and we have a majority of people in Mississippi who voted for us to pass this.
“If there is any further delay, that will be squarely on the shoulders of the governor, rather than the Legislature,” he said.
There was further delay, which left patient advocates and parents frustrated. A video posted on the “We Are the 74” Facebook group in October showed Reeves dodging questions from a mother whose son was in a wheelchair. During a political meet-and-greet at a restaurant, the mother asked Reeves when a special session would be held. She handed him a photo of her son with a black eye he suffered from falling during a seizure.
“We need his medicine and we need it soon,” she told him in the video.
“Yes, ma’am, I’m working really hard on that,” he answered.
“He wouldn’t give me an answer,” the mother said. “We told him we know that both sides have agreed to something, and they’re waiting on him to call a session. He would not answer us as to when the session would be … pretty much, he treated Bryan like he had the plague, barely even looked at him.”
It took another three months before state legislators sent a bill to the governor’s desk.
“I knew if I could get 10 minutes, you can’t argue with real facts, with real patients,” Smoot said. “They never once replied. Staff never set up meeting. So we went all those months waiting for a special session that he never called.”
Legislators promised Smoot and made public statements saying they would address the bill at the very beginning of general session.
“They promised it would be one of the first things they brought up, and they did,” she said.
The delay primarily involved the amount of marijuana patients could obtain per month. Reeves threatened to veto Senate Bill 3095 over the matter. During negotiations, lawmakers reduced the amount of marijuana patients could obtain per month from four ounces to 3.5 to 3 as part of negotiations to alleviate concerns.
House and Senate support
The bill had overwhelming support in both the state House and Senate, which could have overridden a veto by the governor. This may have played a part in Reeves’s decision to eventually sign the bill into law despite his misgivings.
Smoot said she plans to continue fighting until every medical cannabis patient is properly served by the program.
“I love this. I love what I’m doing. It’s the greatest honour,” she said. “I’m gonna keep fighting. I’ve made promises that I’m gonna keep. “We’re not taking ‘no’ for an answer anymore.”
Rylee is just one of many “medical refugees” who left Mississippi for Colorado, Smoot said. For Rylee, the law’s passage means she will be able to visit her grandparents again. She has been unable to even travel to Mississippi since she needs cannabis to prevent her seizures. While her parents plan to remain in Colorado, they also want to visit without risking their daughter’s life.
“With this passage, she’ll be able to come home,” Smoot said.
Many other patients and their families have told Smoot that they plan to move back to Mississippi once they can access medical cannabis in their home state.
“They say, ‘As soon as this is up and running, I’ll be back.’ They want to be in their home states. They just don’t want to get arrested,” Smoot said. “Patients aren’t criminals. They’re patients.”
–Alyssa Choiniere, CBD-Intel US correspondent
Photo: Ed Grawes