North Dakota Compassionate Care Act (Measure 5, 2016)

The North Dakota Compassionate Care Act — Measure 5 (2016)

On November 8, 2016 North Dakota voters approved Initiated Statutory Measure 5, the Compassionate Care Act, by 63.79% to 36.21%. Codified at N.D.C.C. ch. 19-24.1; substantially rewritten by 2017 SB 2344 (Burgum signed April 17, 2017) which eliminated home-cultivation provision, established Division of Medical Marijuana within NDDHHS, and capped at 2 manufacturers + 8 dispensaries. First dispensary opened Fargo March 2019; 8th opened December 2019. Flower added 2021 HB 1417; edibles added 2025 HB 1203 (lozenges only).

Legal Disclaimer: This information reflects North Dakota cannabis law as of June 2026 and is for educational purposes only. It is not legal advice. Laws and regulations change — always verify current rules with the North Dakota Department of Health and Human Services (NDDHHS) Division of Medical Marijuana or a qualified attorney. Cannabis remains illegal under federal law.

Last verified: May 2026

The Voter Mandate — Measure 5 (2016)

On November 8, 2016, North Dakota voters approved Measure 5 (Compassionate Care Act) at 63.79% YES (commonly rounded to "64%"). Measure 5 created the framework for a state-licensed medical-cannabis program, restricting access to patients with specific debilitating conditions and authorizing licensed "compassion centers" to manufacture, process, and dispense usable marijuana.

The 2017 SB 2344 Restriction

On April 17, 2017, Gov. Doug Burgum signed Senate Bill 2344, which substantially rewrote the voter-approved program:

Eliminated the home-cultivation provision for patients living 40+ miles from a dispensary.
Eliminated the patient petition process for new qualifying conditions (later partially restored).
Established the Division of Medical Marijuana within the Department of Health (now NDDHHS after 2022 agency merger).
Limited the program to two manufacturing facilities and eight dispensaries statewide.
Authorized caregivers and capped patient ID-card fees.

Program Statutory Framework

The program lives in N.D.C.C. ch. 19-24.1 (Compassionate Care Act), supplemented by N.D. Admin. Code Title 33, Article 44 (Medical Marijuana Program). NDDHHS publishes a fiscal-year Medical Marijuana Program Annual Report under § 19-24.1-39 (added by 2021 HB 1213).

Implementation Timeline

November 8, 2016: Measure 5 approved 63.79% YES.
April 17, 2017: Gov. Burgum signs SB 2344.
March 2019: First dispensary opens in Fargo.
December 2019: Eighth (and last under cap) dispensary opens.
2021 HB 1417: Flower added to allowable forms.
2025 HB 1203: Cannabinoid edible lozenges added (effective August 1, 2025).
2025 SB 2293 + SB 2294: Concentrate container limits, two-year card validity, telehealth for initial certifications, fee adjustments.

Program Scale (FY2024 Annual Report)

9,934 registered qualifying patients (+338 from FY2023).
164 designated caregivers.
483 compassion-center agents.
$22.42 million FY2024 dispensary sales (62% dried flower).
~$85.7 million cumulative FY2020-FY2024 sales.
Top patient counties: Cass (24%), Burleigh (14%), Ward (12%), Grand Forks (10%), Morton (5%).
Revenue: $623,275 fees vs. $930,257 expenses; program funded by patient/licensee fees, not general appropriations after the 2017-19 biennium.

Program Leadership

The Division of Medical Marijuana is housed within NDDHHS at 600 East Boulevard Avenue, Department 301, Bismarck, ND 58505 (phone 701-328-1311, email medmarijuana@nd.gov). Jason Wahl has served as the long-time program director.

Key Milestones

The Compassionate Care Act has had three major statutory milestones since 2016: SB 2344 (2017) restriction; HB 1417 (2021) flower addition; the 2025 expansion package (HB 1203 + SB 2293 + SB 2294) addressing patient complaints. The 2025 package was the most consequential update since 2017.