Opponents of legalization say public perception hasn’t caught up with mounting health concerns
Before the 1990s, a typical marijuana joint contained less than 2 percent of tetrahydrocannabinol (THC)—the psychoactive component that gives cannabis users a high. Today, individuals smoke or vape plants with a 17 percent to 28 percent THC potency, and many edibles, oils, and other concentrated forms of the drug contain a THC content upwards of 95 percent.
James Kinyon, 59, points to that statistic when he explains why his grassroots advocacy group, Protecting South Dakota Kids, opposes a ballot measure that could legalize recreational cannabis in November. “This is not the marijuana that we grew up with,” he said.
In just a few weeks, voters in three states—South Dakota, North Dakota, and Florida—will consider whether to legalize recreational marijuana. Voters in two other states, Arkansas and Nebraska, will weigh medical marijuana initiatives.
So far, 24 states, plus the District of Columbia and three territories, have legalizedcannabis for recreational use, while 38 states have approved it for medical use. But that trend may be slowing. Since 2022, voters in 4 out of 7 states that weighedrecreational marijuana ballot measures and rejected them.
Opposition groups point to the drug’s recent defeats to argue legalization isn’t inevitable. Still, they say educating residents on the growing body of research documenting marijuana’s potential harms is an uphill battle against a widespread perception that marijuana is a low-risk substance and legalization is merely a matter of personal freedom.
South Dakota legalized medical marijuana in 2021. A year earlier, 54 percent of voters approved recreational cannabis, but the state’s Supreme Court struck down the approval because it violated the state’s single-subject rule. Kinyon knew the measure would be back—and that opponents of legalization needed to do more to educate and galvanize voters. Protecting South Dakota Kids started in 2022, the same year that 53 percent of residents rejected the initiative.
“The idea that because [marijuana legalization] goes on the ballot, it’s automatically going to happen, or this is inevitable, is a really big myth,” said Jaime Zerbe, chief of staff for Smart Approaches to Marijuana, a national group that opposes legalization. “The more people see the negative impacts of marijuana in their communities and in their families … the more people that are rejecting this.”
Kinyon, who for decades served as an outpatient mental healthcare provider with Catholic Charities, has personally seen the negative effects of marijuana. He conducted evaluations on Pine Ridge Reservation—the tribal headquarters of the Oglala-Lakota nation located in one of the poorest counties in the state—where he said it was common for even children to test positive for cannabis. He recalled an 11-year-old girl who showed up at the hospital, screaming and vomiting due to a marijuana overdose.
In Canada, hospital and emergency room data show marijuana poisonings among children have increased since the country legalized the drug in 2018. Many of these children consumed edibles, gummies, and other food products that contained highly concentrated forms of THC. In the United States, edibles “are more common in states that have legalized marijuana and also states that permit medical marijuana use,” according to Just Think Twice, an anti-drug site run by the U.S. government. Even adults inadvertently overdose on the gummies: Research also linked Canada’s legalization to increased poisonings in seniors.
Other studies associate high-potency THC with substance abuse and mental health disorders. Research published in The Lancet, a British journal, in 2019 found long-term, daily users of cannabis with a THC content of 15 percent or higher were five times more likely to develop a psychiatric disorder such as schizophrenia or psychosis. Cannabis users with anxiety and mood disorders are also more likely to experience more severe symptoms, a 2018 review of research found. Casual cannabis is especially risky for teens and young adults, research shows, increasing the risk of depression and suicidality. Another study noted young men who consume the drug are particularly susceptible to developing schizophrenia.
“It isn’t just about freedom,” said Rhonda Milstead, Protecting South Dakota Kids’ executive director and a former state representative. “When we as adults make something legal, we’re telling our children, our teenagers, that it’s safe. And there is absolutely nothing safer about a drug that causes psychosis than a drug that causes depression.” Many of the individuals she speaks with think about recreational use in terms of personal choice, without considering the community implications of the marijuana industry moving into the state, she said.
Dr. James Avery, who is board certified in internal medicine and the author of Marijuana: An Honest Look at the World’s Most Misunderstood Weed, pointed out that legalization often disproportionately affects low-income neighborhoods. “One of the fundamental things that Christians should think about is that the poor and the disadvantaged are going to suffer disproportionately,” Avery said.
Following legalization in Washington state, a study revealed that dispensaries were more concentrated in disadvantaged neighborhoods. Dispensaries are also more prevalent in Denver’s low-income, and most diverse, neighborhoods. Elected officials and neighbors say that makes it more difficult for those same neighborhoods to attract other private investments such as grocery stores and recreation centers.
In North Dakota, Traill County Sheriff Steve Hunt worries about legalization’s implications for law enforcement. Hunt is also the president of the North Dakota Sheriffs and Deputies Association, which joined with North Dakota’s Medical Association, Hospital Association, Peace Officers Association, and Chiefs of Police Association to oppose the measure. The state legalized medical marijuana in 2016. Hunt said his deputies already regularly seize marjuana during traffic stops, and he expects legalization to lead to an increase in instances of impaired driving and traffic accidents.
North Dakotans already voted against legalization initiatives for recreational marijuana in 2018 and 2022. From conversations with Traill County residents, Hunt believes the majority of North Dakotans still oppose legalizing the drug, but he worries that many individuals have a nonchalant attitude toward the measure.
Americans’ daily or near-daily marijuana use has climbed as more states have legalized the drug, even surpassing daily alcohol use, a 2022 study showed. In 1992, fewer than 1 million Americans regularly used the drug. By 2022, an estimated 17.7 million people reported consuming it daily. Researchers noted some individuals may be more willing to report their habit due to the drugs’ widespread acceptance. And those who use the drug regularly are more likely to become addicted. National Institute on Drug Abuse data shows roughly 30 percent of users have some form of cannabis use disorder.
In Florida, where voters will consider constitutional Amendment 3 to legalize recreational cannabis, medical marijuana already rakes in about $2 billion in annual sales. Legalizing the drug for recreational use could triple the industry’s revenue, the cannabis data firm Headset estimates.
“We’re already experiencing and smelling marijuana in our communities, and we don’t want that here,” said Jessica Spencer, the director of advocacy for Vote No on Amendment 3, a coalition opposing the amendment.
The amendment requires a 60 percent majority vote to pass and would allow existing medical marijuana centers to sell recreational cannabis and permit the state legislature to license other entities. Florida Gov. Ron DeSantis is a fierce opponent of the measure. “Public use of this will be rampant,” DeSantis told a crowd at a church in Tallahassee. “You can’t point to a state that is better off for doing it.”
In a post on Truth Social in August, former President Donald Trump said he will vote yes on Florida’s Amendment 3. He characterized the measure’s success as inevitable, though he called on the legislature to regulate marijuana use in public if it passes. Both Trump and Vice President Kamala Harris support rescheduling the drug, a process the Biden administration started in 2022 that would move marijuana into a category of less dangerous drugs with a lower potential for abuse. In a podcast interview released Monday, Harris indicated she hopes to go further by fully legalizing the drug at the federal level. As a senator, Harris co-sponsored legislation proposing an end to federal prohibition on marijuana, though she opposed efforts to legalize the drug in California as the state’s district attorney.
Florida’s amendment is locked in a neck-and-neck race. A September poll from Emerson College Polling/The Hill found the measure has enough bipartisan supportto exceed the supermajority threshold, but most polls show the race is essentially tied. Zerbe with Smart Approaches to Marijuana is optimistic about the race’s outcome: “I think that Florida is a potential win. I think that any of these states are really very winnable.”
Together, groups supporting and opposing the measure have spent roughly $105 million, surging past the previous record of $27.14 million spent on California’slegalization measure in 2016. Supporters of Amendment 3 have far outspent the opposition. Proponents of Florida’s amendment have contributed $90.4 million to Smart and Safe Marijuana, the committee advocating for the measure in Florida, and the medical marijuana company Trulieve has provided the majority of the funding.
Milstead with Protecting South Dakota Kids expects the results of that state’s vote to be close. But she pointed to Oklahoma’s sound rejection of legalization in 2023—62 percent of voters and all 77 of the state’s counties voted no, despite voters approving medical marijuana in 2018. Grassroots organizations played an instrumental role in opposing the measure. Oklahoma Faith Leaders, a coalition of six Christian denominations, held a news conference at the state capitol and encouraged churches to speak out about the issue, raising awareness by drawing on mailing lists and personal contacts.
Supporters of the Oklahoma legalization outspent the coalition and other groups opposing the legalization by more than 20 to 1. “And I think that’s one of the big revelations of last year,” said Paul Abner, the coalition’s director. “If you have the contacts and are working the grassroots hard, you can beat money,” he said.
Protecting South Dakota Kids president Kinyon is urging pastors to address the issue from the pulpit so church members turn out to vote in November. “We’re all calling our friends, relatives and neighbors,” Kinyon said. “We don’t have an industry supporting us.”