Mississippi voters face two choices to legalize medical marijuana for certain patients this November.

Officially, these measures — both of which will appear on ballots — are called Initiative 65 and Alternative 65A.

How medical marijuana ended up on Mississippi’s ballot

Just 26 states have the option of allowing ballot initiatives or referendums. Mississippi, Florida and Arkansas are the only three Southern states with a ballot initiative option for voters.

In Mississippi, this rigorous ballot initiative process requires creating legislation, collecting voter signatures and obtaining approval through the secretary of state and the attorney general’s office for the initiative to appear on the ballot.

Once the secretary of state and attorney general approve the initiative, the legislature then has the option to:

  1. adopt the initiative by a majority vote in each house
  2. reject the initiative
  3. place an alternative measure on the ballot alongside the original initiative

The Mississippi legislature chose to place an alternative measure on the ballot beside the grassroots initiative. (See Alternative 65A below.)

But there are key differences between the measures, and medical marijuana advocates say the legislature’s alternative measure is “empty.”

Let’s break them down.

Initiative 65

Initiative 65 is a proposed an amendment to the Mississippi state constitution, created through the ballot initiative process that allows individuals and groups to collect signatures to put a question directly to voters.

“The legislature has had more than 20 years to pass a medical marijuana program. More than 20 proposed bills to pass medical marijuana have gone through the legislature and our legislature has blocked every single one of those. For that reason, we gathered signatures from nearly 250,000 Mississippians who say they want this on the ballot,” said Jamie Grantham, spokesperson for the Medical Marijuana 2020 Campaign for Initiative 65.

Initiative 65 is the legislation voters signed off on. The amendment outlines the conditions for which marijuana can be prescribed as a treatment, sets possession limits, tax rates and establishes the Mississippi Department of Public Health as the overseer of the program.

Mississippians will vote on medical marijuana on Nov. 3. There are two initiatives on the ballot, Initiative 65 and Alternative 65A. Here, we explore the differences in the two measures.

Alternative 65A

Comparatively, the legislature’s Alternative 65A, leaves many of these conditions of marijuana prescription and possession limits up to the legislature, as opposed to the details outlined in Initiative 65.

Alternative 65A only allows terminal patients to smoke or inhale marijuana.

Medical marijuana advocates have criticized Alternative 65A, saying it won’t actually create a medical marijuana program in the state. Critics of 65A also say it doesn’t represent what voters want in a medical marijuana program.

Attempts by Reckon to reach Rep. John Thomas “Trey” Lamar, who sponsored Alternative 65A, were unsuccessful.

Grantham worries Alternative 65A could result in the medical marijuana program never being developed.

“65A is very vague. There’s nothing in 65A that requires the legislature to ever produce a medical marijuana program. It only gives an option to do so. There are no guarantees and nothing holding them accountable to produce a program,” she said.

How Mississippi voters might get confused by the ballot

The legislature’s alternative amendment also complicates the ballot.

“When they [created Alternative 65A], it took away the voter’s ability to a simple yes or no vote. A fair up or down. Instead, it created a confusing two-part question,” Grantham said.

The first question on the ballot asks voters to vote for the approval of either Initiative 65 or Alternative 65A OR the approval of neither. Basically, it poses the question: “Would you vote for 1) either of these options or 2) neither of these options.”

The second question on the ballot asks voters to choose between the two amendments, but votes for specific amendments will only be counted if they also voted for the approval in the first question.

Both questions must be answered for the vote to count. Voters cannot simply vote for their preferred amendment, Grantham explained.

Here’s what the medical marijuana initiative will look on the ballot.

Does medical marijuana legalization in Mississippi stand a chance?

Paul Armentano, the deputy director of the National Organization for the Reform of Marijuana Laws (NORML), said the history of medical marijuana legislation in other states suggests Mississippi’s ballot measure will be successful.

“If you look at the history, (marijuana) wins when you get it to the ballot,” Armentano said. “The public consensus has been well ahead of the political will for some time, going back decades. That’s why we (marijuana advocates) have had such consistent and long-standing success at the ballot.”

As of this year, 33 states and the District of Columbia have passed laws legalizing medical marijuana. California was the first state to do so, passing its medical marijuana law in 1996.

Of 34 states with medical marijuana laws, 15 of those laws were approved through voter initiatives. And in the 11 states with laws allowing adult, non-medical use of marijuana, nine of those laws were approved through voter initiative.

“This will help a lot of people. It’s helped so many people across the country and no reason why people in Mississippi shouldn’t have this medical option through the plant God made while under the care of a physician,” Grantham said.

The Mississippi State Department of Health, the Mississippi State Board of Health, the Mississippi State Medical Association and the American Medical Association have all opposed Initiative 65, arguing the initiative would add more burden on state health officials and require the state to distribute a Schedule 1 substance.

In a statement, the Mississippi State Board of Health said Initiative 65 would assign responsibilities to the Mississippi State Department of Health “far beyond the scope and mission of the agency, including oversight of agricultural production of marijuana, oversight of marijuana product processing, and tax collection.”

However, seven Mississippi doctors wrote a letter in support of medical marijuana. The letter also responded to arguments against its medical use.

“While medical marijuana is certainly not a cure-all, Mississippians with debilitating medical conditions deserve to have this option available to them. The experiences in 34 other states show that it can be effective, and we believe the benefits of medical marijuana make it a viable treatment option for many in our state who are suffering,” the doctors said in their statement.