If Arkansas’ medical marijuana measure does end up passing, some industry observers and policy experts say it’s not a sure bet that a rash of red states would turn green. Pictured: Marijuana plants grow under sunlight in Pueblo County on Sept. 3, 2016. (Vince Chandler, The Denver Post)

Is marijuana mind-set changing in the Bible Belt?

Medical marijuana is back on the ballot in Arkansas; although it’s looking like another photo finish, the South is starting to show signs of a shift.

Four years ago, Arkansas voters narrowly defeated a measure to allow medical marijuana sales in the state.

The 51-to-49 percent vote elicited a quip from Mark Kleiman, public policy professor and author who specializes in drug law.

“My comment then was, ‘If pot is getting 49 percent in Arkansas, we’re not in Kansas anymore,”’ said Kleiman, who now serves as professor of public policy at New York University’s Marron Institute of Urban Management.

Medical marijuana is back on the ballot in Arkansas this year — albeit via very convoluted and contested paths — and although it’s looking like another photo finish, the legal cannabis landscape is much different this time around:

Half of the nation has medical marijuana laws in place, spurring chatter that Arkansas could be a “bellwether” in the Bible Belt for cannabis legalization.

But even if Arkansas’ medical marijuana measure does end up passing, some industry observers and policy experts say it’s not a sure bet that a rash of red states would turn green.

“There are many counties in the South that haven’t accepted the ending of prohibition of alcohol, let alone marijuana,” said Andrew Schnackenberg, an assistant professor in strategic management at the University of Denver’s Daniels College of Business. “The Bible Belt is littered with these dry counties. That speaks to the same issues of how the treatment of substances are being handled in the Bible Belt.”

The arguments that have been successful for marijuana legalization advocates in other states do not hold the same weight in the south-central United States, said Schnackenberg, who has researched marijuana legalization movements.

The confluence of not only religion and culture, but also legislative structure plays heavily into that positioning for the South, Schnackenberg said.

He noted how several states deeply rooted in Evangelical Protestantism and conservative ideology also do not allow initiated state statutes, in which citizens can petition for ballot measures.

“Most of these changes (adoption of marijuana laws) have come by way of initiative,” he said.

If Arkansas’ medical marijuana initiative doesn’t take, the actions to-date there may not have a negative effect on advocacy groups in neighboring states, said John Hudak, senior fellow in governance studies and deputy director of the Center for Effective Public Management at the Brookings Institution.

And if it is successful?

“Right now, you’re probably not dumping money into Tennessee,” Hudak said. “If Arkansas flips, I think those movements have a better chance (of getting additional funding).”

Hudak said he expects to see an increase in medical marijuana legislative activity in the southern United States during the next two to six years.

Weighing the issue

Medical marijuana was a topic of consideration for legislators across the south-central United States in 2015 and 2016 with states including Alabama, Georgia, Kansas, Louisiana, Mississippi, Missouri and Nebraska weighing legislation on medical marijuana, hemp oil and low-THC cannabis oil, which contains the non-psychoactive compound cannabidiol (CBD) that has been used in treating epilepsy and other debilitating conditions.

And as states such as Alabama and Georgia implemented CBD laws and states such as Arkansas and North Dakota will vote on medical marijuana, the other bills and measures fell short in places such as Missouri and Kentucky, where a proposed bill was assailed by the head of Kentucky’s largest religious organization, the Lexington Herald Leader reported in 2015:

“The very idea of thwarting the authority of the Food and Drug Administration and allowing Kentuckians to smoke marijuana under the guise that it is somehow medically beneficial is absurd,” said Paul Chitwood, executive director of the 750,000-member Kentucky Baptist Convention.

“Just because other states have taken this step doesn’t mean we should legalize another intoxicant, especially one that has been proven to be the first step toward abusing the hard drugs that are claiming so many lives through overdoes,” Chitwood said.

The Marijuana Policy Project, a national cannabis advocacy group and lobbyist, meets with legislators in all 50 states, said Matt Simon, who serves as the organization’s New England political director and covers the states of Kentucky, Massachusetts, New Hampshire and West Virginia.

Some of the legislators in Kentucky and Simon’s home state of West Virginia see legalization as a moral issue as opposed to a policy issue, he said.

“These legislators all formed their political sensibilities in an era in which we had a war on drugs,” he said.

The success of Arkansas’ medical marijuana measure “couldn’t hurt” broader legalization efforts, but it doesn’t guarantee a spread across state lines, he said.

“It’s just an ongoing process of continually trying to educate people,” Simon said. “There’s so much data coming out … it’s clear the sky hasn’t fallen anywhere. Over time, the opposition tends to die down.”

In Oklahoma, proponents of a medical marijuana initiative there say they had strong support, with 70 percent in favor of the measure, said Chip Paul, a sixth-generation Oklahoman who serves as an organizer for Oklahomans for Health.

“That cuts across demographics. It doesn’t matter the religion. It doesn’t matter the race, sex,” he said. “Any way you slice the demographics, even in the religious right, you’re still going to get the 70-30 slice. … But every sort of domino that falls gives us another half a percentage point in favor.

“It’s just knocking down these old walls.”

The Oklahoma measure hit roadblocks on its way to the 2016 ballot and eventually earned court approval for inclusion on the 2018 ballot — if not sooner.

“We may push hard for a special election … may not, but will weigh those decisions after (Nov. 8 election),” Paul said via e-mail earlier this week.

Alternate routes

Kevin Sabet, president of the anti-legalization Smart Approaches to Marijuana, believes the South and the Bible Belt states will remain opposed to marijuana legislation.

“By region, marijuana use is lowest in the South,” Sabet wrote in an e-mail to The Cannabist. “I think the movement to legalize there is also the weakest in the country.”

The South has not embraced medical marijuana to its full extent, but some states have adopted limited legislation involving the narrow allowance of low-THC cannabis oil for qualifying patients with specific medical conditions.

In Arkansas, Rep. Dan Douglas, R-Bentonville, has said he would introduce a bill allowing for CBD oil to be used for certain medical conditions if voters rejected the medical marijuana bill that’s on the 2016 ballot, the Associated Press reported in late-October:

“I’m committed to working with the surgeon general, the health care community, with the Health Department, with the Medical Board, whoever we need to, to come up and draft responsible legislation that gives us the needed oversight to keep this from becoming a substance abuse problem in Arkansas,” Douglas said at a news conference with other lawmakers opposed to the measures.

Douglas’ proposal would be more limited in who would have access to the drug and in what forms. According to a draft of the bill, it would be available for a handful of conditions such as seizures related to epilepsy or trauma-related head injuries and Crohn’s disease. But most of the conditions it covers — including multiple sclerosis and Parkinson’s disease — would only qualify if they were end-stage or severe. Cancer patients would only qualify if their diagnosis was end-stage or their treatment produced nausea, vomiting or wasting illness. The proposal would bar patients from smoking marijuana as a treatment.

From Sabet’s standpoint, such a bill would be “miles better” than the medical marijuana initiative on Arkansans’ ballots, expressing caution that not all low-THC cannabis oil bills are created equal, he said.

“Traditionally, southern states have been the most criminalization-focused with regards to marijuana. We’d like to see a change toward education, awareness, smart enforcement, and treatment, but legalization is going way too far,” Sabet said. “Our worry would be that the marijuana industry would take advantage of poorer people, as we’ve seen with alcohol and tobacco. We want to see science-based drug policies, in the South and everywhere else.

“But saying that our choice is between incarceration and legalization belies more meaningful policies that don’t settle into either category.”