From the Arkansas Advocate:
Emily Williams struggled to find medication that alleviated chemotherapy side effects like nausea and loss of appetite following her 2010 cancer diagnosis. Eventually, she tried marijuana and it provided relief.
“I was just grateful,” she said. “I just felt grateful.”
The experience prompted the Fayetteville retiree to advocate for a citizen-led constitutional amendment voters approved in 2016 to create Arkansas’ medical marijuana program.
That program has since grown into a billion-dollar industry, with more than 115,000 patients using marijuana to treat conditions from Crohn’s disease to post-traumatic stress disorder. But an obscure legal fight over who can change citizen-led amendments to Arkansas’ Constitution casts uncertainty on the program’s future.
The court ruling is part of a nationwide battle playing out in states like Missouri and Nebraska over citizen-led ballot measures. Arkansas is one of 24 states that allows citizens to propose state laws, according to the National Conference of State Legislatures.
Since the state’s first dispensary opened in 2019, thousands of Arkansans have accessed the program, including Christopher Duffy, a 35-year-old Fayetteville resident who said medical marijuana helped his anxiety and sobriety. Duffy said he’d remain committed to sobriety if marijuana becomes less accessible, but he worries about others.
“I’m lucky to have such a support system where were things to get tough or I started struggling, I could reach out,” he said. “There are those that don’t have that and I fear for them.”
Williams, 69, is afraid of losing access to medical marijuana, which she uses to manage ongoing complications from her illness.
“If I am not able to use this, my life would be completely, negatively impacted,” she said.
These concerns were sparked by the Arkansas Supreme Court upending 74 years of precedent in December with a ruling that declared lawmakers can amend citizen-led constitutional amendments with a two-thirds vote — 67 votes in the House and 24 votes in the Senate.
The decision stemmed from a case challenging the Legislature’s passage of laws amending the Arkansas Medical Marijuana Amendment. However, lawmakers’ newly affirmed authority extends beyond medical marijuana to other citizen-led amendments, including those that affect casinos.
David Couch, a Little Rock lawyer who helped write the medical marijuana amendment, said the court’s decision “absolutely” adds more pressure that a new ballot measure he’s backing be successful.
If the measure, which was proposed by Save AR Democracy, qualifies for the 2026 ballot and is approved by voters, it would prohibit lawmakers from changing the Arkansas Constitution themselves and require voters to approve any new law affecting the initiative and referendum process.
Although he understands how the court arrived at its conclusion, Couch said the justices erred in their application.
“The thing that bothers me the most is they applied it retroactively, not prospectively,” he said. “They upended 115 years of work by the people of the state of Arkansas on these initiatives.”
Knoxville Republican Rep. Aaron Pilkington said the court’s ruling affirmed what he long believed to be true; however, he doesn’t think lawmakers are “chomping at the bit” to alter popular amendments.
Pilkington took office in 2017, just after 53% of voters approved medical marijuana. While Republicans weren’t generally in favor of it, Pilkington noted the party’s leaders didn’t stand in the way of what voters asked for.
“I think we’ve actually shown a history of even if maybe the Legislature doesn’t necessarily agree with it, they’re going to honor the wishes of the voters,” he said. “Because had we not, had we tried to force this issue back then or cause this and that, I think you would have seen repercussions in those next elections.”
Pilkington has since sponsored legislation on medical marijuana, including an unsuccessful effort to allow dispensaries to deliver. Pilkington said there may be some tinkering to the program, but he’s not really open to amending it given the increasing revenue from sales that funds certain programs.
Arkansans spent a record $291.1 million on medical marijuana in 2025, according to the state’s Department of Finance and Administration. Legislation approved last year allows tax revenue from those sales to support free breakfast for students.
Though it may be used sparingly, the authority to amend the state’s constitution could be useful to address policies that aren’t working the way they were intended or to reflect a shift in perspective that’s occurred since an amendment was first approved, Pilkington said.
It also allows lawmakers to address issues that require immediate attention instead of waiting two years to present a measure to voters, Senate President Pro Tempore Bart Hester said.
The Arkansas Constitution can be changed when voters approve a measure proposed by lawmakers or by citizens who must qualify for the ballot by circulating petitions. Proposed amendments may be considered every two years during the general election.
Republicans currently have a supermajority in both the House and Senate, but Hester said a two-thirds vote is a “huge, hard bar to meet,” regardless of which party has a majority.
The Cave Springs Republican said lawmakers will only use this authority when “absolutely necessary” and will likely wait until the 2027 legislative session to review citizen-led amendments, such as those that received a lot of financial support from out-of-state interests. Hester also mentioned reviewing measures related to medical marijuana and casinos because they were “huge amendments” with multiple provisions.
“I think that it might be reasonable that the Legislature look at them a little bit at a time versus holistically, and I think that’s the responsible thing to do,” he said.
Hester noted lawmakers can only amend the marijuana amendment, not repeal it. That leaves some room to scale back or expand the program without ending it entirely.
While the Legislature may not intend to overrule voters, Duffy said he believes there are some lawmakers willing to do so, therefore he’s hopeful Save AR Democracy’s ballot measure will succeed.
The group needs to collect 90,704 signatures by July 3 to qualify for the ballot.
“I don’t see any intent from the Legislature to override the will of the people, but I feel like there are some that are willing to do that and that is what’s concerning,” Duffy said.
Should the measure fail and lawmakers head into the 2027 legislative session with their court-affirmed amendment authority, Duffy said he could see them increasing medical marijuana taxes.
That could prompt patients to purchase from neighboring states like Missouri, where recreational marijuana is also legal, driving revenue out of Arkansas, he said.
Williams is skeptical about lawmakers’ restraint and said she believes they intend “to gut it to the extent that it is almost impossible to use.”
“I would like to ask one of these legislators if they know what it feels like to get up in the morning and wonder how sick you’re going to feel that day,” she said.
