Issue 6 would allow patients diagnosed with qualifying medical conditions to apply for a state-issued registration card that will let them buy marijuana from licensed dispensaries. Pictured: A marijuana leaf is drawn on a price board at the Outliers Collective, a medical marijuana dispensary in San Diego County, California in October 2016. (Vince Chandler, The Denver Post)

Voters might make Arkansas the first Southern state to legalize medical marijuana

Here's a look at Issue 6, which appears in front of voters asking whether or not they should legalize Arkansas medical marijuana

LITTLE ROCK, Ark. — Voters might make conservative Arkansas the first Southern state to legalize medical marijuana, which could signal a cultural tipping point suggesting it’s just matter of time before patients nationwide will be able to access the drug to treat certain maladies.

Medical marijuana is already legal in half of the states and voters will decide Tuesday whether to allow or expand it in four others, including two in the South, Arkansas and Florida. Like several other Southern states, Florida already allows certain patients to use a version of the drug that is low in THC, the main psychoactive component in marijuana.

Arkansas voters narrowly defeated a similar measure four years ago, and this year’s campaign has led to a last-minute flurry of ads from opponents and supporters and a series of court challenges that disqualified one of the two proposed medical marijuana ballot measures. Here is a look at where things stand with the remaining measure:

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TWO PROPOSALS, BUT ONLY ONE COUNTS

Although both medical marijuana ballot measures, Issues 6 and 7, made it onto the ballot, only votes cast on Issue 6 will be counted. The Arkansas Supreme Court disqualified Issue 7 from the ballot after early voting had started, ruling that those behind it didn’t follow state law regarding paid canvassers.

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CONDITIONS COVERED

Issue 6 would allow patients diagnosed with qualifying medical conditions to apply for a state-issued registration card that will let them buy marijuana from licensed dispensaries. The proposal lists 12 conditions that would qualify, including cancer, Crohn’s disease and post-traumatic stress disorder, along with chronic or debilitating diseases that produces certain symptoms such as seizures or severe nausea. It would also allow the Department of Health to add other qualifying medical conditions.

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WHO REGULATES IT?

Two existing state agencies and a new board would oversee the program if Issue 6 is approved. The Department of Health would be establish the rules for the registry ID cards that will be issued to patients and designated caregivers, and would be in charge of issuing the cards and maintaining the registry. Licenses for the dispensaries and cultivation facilities would be issued by a newly formed five-member Medical Marijuana Commission, which would be appointed by the governor and legislative leaders. The Alcoholic Beverage Control Division will enforce rules and inspect the dispensaries and the cultivation facilities. Twenty to 40 dispensaries would be allowed to operate in the state.

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THE OPPOSITION

Some of the state’s biggest lobbying groups, including the state Chamber of Commerce, the Arkansas Farm Bureau and the state Hospital Association, oppose the measure. Republican Gov. Asa Hutchinson, who led the federal Drug Enforcement Administration, has also been an outspoken opponent. They’ve cited concerns that the measure would make it difficult for employers to enforce drug-free workplaces. They’ve also said the measure would be a drain on state resources, with the state Department of Finance and Administration saying agencies would need as much as $5.7 million in additional funding for enforcement and regulation. Supporters of the measure have criticized such estimates and say state officials are underestimating how much new tax revenue the measure would generate.

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WHAT IF IT DOESN’T PASS?

If voters reject Issue 6, that’s not the end of the medical marijuana debate in Arkansas. A Republican lawmaker who opposes it has promised to file a bill that would allow a more limited form of medical marijuana if voters reject the ballot measure. That bill would allow people with certain conditions to get marijuana that is low in THC, which produces the euphoric state for users, but high in cannabidiol, a compound that has been used to fight seizures.

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Follow Andrew DeMillo on Twitter @ademillo