Arkansas Court Ruling Casts Uncertainty Over Medical Marijuana Program

Patients fear losing access as state lawmakers gain power to amend citizen-led constitutional amendments.

Jan. 27, 2026 at 8:15pm

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A recent Arkansas Supreme Court ruling has created uncertainty around the state's medical marijuana program, which was established through a 2016 citizen-led constitutional amendment. The court decision allows state lawmakers to amend citizen-led amendments with a two-thirds vote, raising concerns among patients that the medical marijuana program could be scaled back or made less accessible.

Why it matters

The court ruling is part of a nationwide battle over citizen-led ballot measures, which are used in 24 states to propose new laws. In Arkansas, the medical marijuana program has become a billion-dollar industry serving over 115,000 patients, so any changes to the program could have significant impacts on patients' access to the treatment.

The details

The court ruling stems from a case challenging the Legislature's passage of laws amending the Arkansas Medical Marijuana Amendment. While the court's decision applies beyond just medical marijuana, to other citizen-led amendments as well, it has raised concerns among patients like Emily Williams and Christopher Duffy about potentially losing access to the treatment they rely on. Lawmakers say they don't intend to overrule voters, but some patients are skeptical and worry the program could be scaled back or made less accessible through increased taxes.

  • The Arkansas Supreme Court issued its ruling in December 2025.
  • Arkansas voters approved the constitutional amendment to create the medical marijuana program in 2016.
  • The state's first medical marijuana dispensary opened in 2019.

The players

Emily Williams

A 69-year-old Fayetteville retiree and medical marijuana patient who is concerned about losing access to the treatment she uses to manage complications from a previous illness.

Christopher Duffy

A 35-year-old Fayetteville resident who said medical marijuana has helped his anxiety and sobriety, and is worried about the impact on others who rely on the program.

David Couch

A Little Rock lawyer who helped write the medical marijuana amendment and is backing a new ballot measure to prohibit lawmakers from changing the Arkansas Constitution without voter approval.

Aaron Pilkington

A Republican state representative who has sponsored legislation on the medical marijuana program, though he notes the party's leaders didn't stand in the way of what voters approved.

Bart Hester

The Republican Senate President Pro Tempore who says lawmakers will only use their new authority to amend citizen-led amendments when "absolutely necessary" and will likely wait until the 2027 legislative session to review measures like medical marijuana.

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What they’re saying

“If I am not able to use this, my life would be completely, negatively impacted.”

— Emily Williams, Medical marijuana patient

“I'm lucky to have such a support system where were things to get tough or I started struggling, I could reach out. There are those that don't have that and I fear for them.”

— Christopher Duffy, Medical marijuana patient

“The thing that bothers me the most is they applied it retroactively, not prospectively. They upended 115 years of work by the people of the state of Arkansas on these initiatives.”

— David Couch, Lawyer who helped write medical marijuana amendment

What’s next

The group Save AR Democracy needs to collect 90,704 signatures by July 3 to qualify a ballot measure for the 2026 election that would prohibit lawmakers from changing the Arkansas Constitution without voter approval.

The takeaway

The court's decision to allow lawmakers to amend citizen-led constitutional amendments has created significant uncertainty around the future of Arkansas' medical marijuana program, which has become a billion-dollar industry serving over 115,000 patients. While lawmakers say they don't intend to overrule voters, some patients remain skeptical and fear the program could be scaled back or made less accessible through increased taxes or other changes.