[1][2] The sponsor of the initiative was New Approach South Dakota, a volunteer group headed by Melissa Mentele.

With the passage of Constitutional Amendment A on the same ballot, South Dakota would have become the first state in US history to legalize recreational and medical cannabis simultaneously, but Amendment A was struck down as unconstitutional the following February, pending a higher court's ruling.

[7][8] After the election, South Dakota governor Kristi Noem requested the state legislature delay the implementation of IM 26 from July 2021 until 2022, ostensibly to give the state more time to prepare due to complications stemming from the COVID-19 pandemic.

State House members agreed to reduce the proposed delay from July 2021 until January 2022 and subsequently passed Noem's legislation, but disagreements with the Senate over an amendment to the bill legalizing personal possession of cannabis resulted in the collapse of legislative negotiations on medical marijuana.

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