This article has been revised to include information from the South Dakota Department of Health provided after the story was published.

SIOUX FALLS, S.D. (KELO) — In the November 2020 election, 70 percent of South Dakota voters approved the legalization of Medical Marijuana in the state.

The law took effect July 1, the same day Native Nations dispensary opened on the Flandreau Santee Sioux Reservation.

But in this Eye on KELOLAND, potential patients across South Dakota say the state’s medical marijuana program is taking much longer to effectively roll out.

“We have about 10,000 plus patients in our system right now,” Flandreau Santee Sioux Attorney General Seth Pearman said.

The number of interested patients Native Nations Cannabis is seeing on the Flandreau Santee Sioux Tribe is a stark contrast to the number of state medical cannabis cards issued so far.

“We have only 300 state licensed cannabis patients right now,” South Dakota medical cannabis patient and dispensary owner B.J. Olson said.

The state’s most recently released numbers showed that 306 patient cards have been approved in South Dakota, with another 21 pending applications.

B.J. Olson, a medical cannabis patient, dispensary owner and member of the Cannabis Industry Association of South Dakota, says he is certain there are far more South Dakotans interested in utilizing medical marijuana than reflected in the number of current state cardholders.

“I’m having 5-10 people per day reach out to me with additional questions. I don’t want to be the resource for everyone, but somebody has to be,” Olson said.

He believes the low number of state issued cards is due to a lack of public information and available help from the state for patients trying to figure out this new system.

“When you look at the state’s website and it shows the patients the process, the very first step in the process is, see your physician,” Olson said. “As we know, with 2,000 physicians in the state, only 90 of them certified to help a patient with cannabis, but nobody knows who those 90 are…so finding those doctors is like finding a needle in a haystack.”

“Nobody gets a card without a doctor’s recommendation,” Pearman said.

Native Nations Cannabis also requires patients to be evaluated by a doctor in order to receive a medical cannabis card, but Pearman says the tribe’s ordinance is designed to make that process more accessible and affordable for patients.

“We do authorize telemedicine so if someone were to utilize a service here in South Dakota or any other state, as long as the physician has a license to practice medicine,” Pearman said.

Pearman says the tribe also has a longer list of ailments for patients to quality for a medical marijuana card on the reservation than one from the state of South Dakota.

“Right now we have some conditions from other jurisdictions we’ve seen like PTSD, diabetes, insomnia, loss of appetite, things like that that we cover in our system but the state hasn’t allowed yet,” Pearman said.

But both the tribe and the state of South Dakota require those conditions to be confirmed by a physician who will then give a recommendation for medical marijuana. But how they’re required to see that doctor differs.

“The doctor I ended up seeing was actually from Illinois, who was also registered to practice health in South Dakota,” Olson said.

Olson says the state requires in-person visits with a physician, turning a generally less costly telemedicine visit into an often times expensive endeavor for patients.

“No one’s insurance or health care current provider is going to help them get that recommendation,” Olson said. “So they seek options like I did through…where an out-of-state doctor flies in for an in-person visit.”

Olson says the Illinois doctor provided through the website is one of the 90 doctors registered with South Dakota’s medical cannabis program.

“This is another opportunity for an out-of-state company to make money in our state just by shipping their doctors in. Why aren’t our doctors taking advantage of this economic opportunity and more so helping the people of South Dakota, the patients of South Dakota, get the relief that they need?” Olson said.

Olson says his doctor’s visit was a $200 out-of-pocket fee. The application to receive his medical marijuana card from the state was another $75 fee.  He says that $275 just to gain access to a medication is in stark contrast to what he was paying for his former medication through insurance.

“My insurance allows me to get Oxycodone for $2,” Olson said.

Several years ago Olson’s physician wrote him an open prescription for opioids to help him manage pain while trying to hold off on back surgery for as long as possible.

“The opioids work, they take away the pain, but they also take away all emotion, all feeling in general. I couldn’t live that way,” Olson said.

Olson said a friend from Colorado invited him to come and give medical marijuana a try for his pain management instead.

“It was a very, very foreign concept to me,” Olson said. “But for me it was instant. I knew this was something that was going to work for me and not make me a zombie like the opioids had.”

He says he was able to use medical cannabis less frequently than oxy and still received better relief without any adverse side effects. It’s why he said he was willing to pay whatever premium the state required to ensure he had legal, legitimate access to another form of pain management medication.

“It’s not the typical stoner, I’m a successful businessman. I know many successful people who utilize cannabis but not the way people would typically think,” Olson said. “They utilize it to help them relax, to help them sleep and reduce pain.”

While the medical marijuana works for him, Olson says the state’s system is lacking, largely because he had to pay for a medical marijuana card to buy a product that isn’t currently available anywhere in the state. He also foresees some big future problems with the sustainability of the state’s cards.

“This is my South Dakota medical marijuana card that I got for $275. It is a piece of paper,” Olson said. “There’s nothing to this card at all. As you can tell, my picture is already starting to fade away.”

Olson was shocked to see the quality of the state’s card, both as a patient and a business owner who will soon have to check these cards in order to sell his products.

“When I got it in the mail I honestly laughed. I could not believe this is what our state decided would be good enough; on something so highly controlled, so highly regulated and so highly scrutinized, this is something that they would give us to verify if people are able to use the product or not,” Olson said.

Along with the picture on Olson’s card, the ink on the numbers used to certify and verify that he is a legitimate state-registered cardholder is also wearing off after just a couple months in his wallet with almost no use. Olson says once his Hartford Dispensary is open, that quick wear is going to cause problems for patients.

“We’re going to have to turn them away, unfortunately. They’re going to have to contact the state to get a card that I can accept at my dispensary. Because under no circumstance can I allow my dispensary to be at any sort of risk in accepting a card that isn’t legible and that I can’t verify the person in front of me is the person on this card.”

The South Dakota Department of Health says the cards are printed at the DOH office in Pierre and they have received a few requests for reprinted cards.

“This is it, it’s a solid plastic card, has some wear with it. You can scan it,” Pearman said.

It’s another stark contrast to Native Nation’s Medical Marijuana program where their solid cards play a major role in the security of their dispensary.

“We utilize bio track. It has a function where if we input that it can kick out a card that has a unique number or a unique bar code, so when a patient buys a product it will know exactly where they’re at and make sure they’re an actual valid patient,” Pearman said.

But patients who pass the tribe’s requirements are finding the biggest difference between the two cards is the protections they provide.

“They have this but they don’t have this,” Olson said of his Native Nations card vs his state card. “It’s really dangerous if they have cannabis in their possession and they don’t have this [state card].”

While the tribal card protects people on the reservation, some Native Nations Cannabis patients are finding legal issues once they leave the reservation.

“We’re between 10 to 15 arrests that we know about right now,” Pearman said. “It’s a little disheartening that somebody is coming in to get some medicine for themselves and are stopped for a taillight out and having all of their products taken.”

Flandreau Santee Sioux Attorney General Seth Pearman says right now the tribe’s executive committee has made it a priority to pay for the criminal defense of their South Dakota medical cannabis patients charged for having their product.

“The voters of South Dakota said medical marijuana is not a criminal offense anymore, but some states attorneys are still criminalizing it,” Pearman said.

Pearman says the required doctor’s recommendation tied to the tribe’s card provides patients some protection under South Dakota’s medical marijuana law, but arrests are still happening.

“It a really disheartening but we have well over 75,000 transactions; 10 or 15 people out of 75,000 transactions is still very minimal with everything that’s going on,” Pearman said.

But that risk is why Olson says that even though the state’s card and system may be flawed, the protection it provides makes it essential for all cannabis patients in South Dakota.

“Absolutely–this card right here gives me protection in the state currently. Regardless of how I acquired my cannabis, as long as I have this and I’m in possession of this card, then I can’t be prosecuted,” Olson said. “So my word of advice to the public, my public service announcement: if you are going to be a medical cannabis patient in South Dakota, go get your card.”

The Cannabis Industry Association of South Dakota is hosting an educational event on April 20th for the public, providing information on medical cannabis, what to expect at dispensaries that are working to open across the state and how to become a certified patient in South Dakota. The event will also include an on site doctor certified to recommend medical cannabis in South Dakota who will be available to do patient evaluations. The time and location have not yet been announced but will be posted on the CIASD Facebook page.