Arkansas started 2026 with its medical marijuana program stronger than ever. The state now has 114,643 active patient cardholders according to January 2026 data from the Arkansas Department of Health, continuing a steady climb that saw the program add thousands of new patients throughout the previous year. Combined with record-breaking sales that topped $250 million in 2025, these numbers signal that medical cannabis has become a permanent fixture in Arkansas healthcare.
The growth represents something significant for a conservative Southern state where recreational cannabis remains illegal and possession without a medical card can still land someone in jail. Arkansas operates one of the more tightly regulated medical marijuana markets in the country, with just 38 licensed dispensaries and 8 cultivation facilities serving the entire state. Yet within those constraints, patient participation keeps climbing, and the economics keep improving.
The Numbers Tell the Story
Looking at the trajectory over the past year provides useful context. In mid-December 2025, the patient count stood at 113,265. By early January 2026, that number had jumped to 114,349, adding more than a thousand new cardholders in roughly three weeks. The latest figure of 114,643 as of January 10 shows the momentum continuing into the new year. Compared to the same period in 2025, the program has added several thousand patients, maintaining a pattern of gradual but consistent expansion rather than dramatic spikes.
The sales figures paint an equally compelling picture. Arkansas medical marijuana patients purchased more than $250 million worth of cannabis products during 2025, surpassing the previous record of $283 million set in 2023. This happened despite 2024 being a down year when sales totaled $275.9 million. The rebound suggests the market found its footing after some price fluctuations and continues to mature.
Throughout 2025, dispensaries moved an average of around 6,500 to 6,800 pounds of cannabis per month. October saw 6,883 pounds sold for $25.1 million, while September recorded 6,350 pounds at $22.6 million. Scott Hardin, spokesperson for the Arkansas Department of Finance and Administration, noted that daily sales averaged approximately $800,000 across the state’s operating dispensaries. For a program with only 36 to 38 active retail locations depending on the month, that represents substantial throughput.
What Drives Patient Growth
Several factors contribute to the steady increase in cardholders. Arkansas maintains a relatively broad list of qualifying conditions compared to some medical marijuana states, allowing patients with chronic pain, PTSD, cancer, severe arthritis, and numerous other conditions to access cannabis treatment. The list includes cancer, glaucoma, HIV/AIDS, hepatitis C, ALS, Tourette’s syndrome, Crohn’s disease, ulcerative colitis, fibromyalgia, Alzheimer’s disease, peripheral neuropathy, severe nausea, seizure disorders, and muscle spasms characteristic of conditions like multiple sclerosis.
The intractable pain qualification proves particularly significant. Arkansas allows patients whose pain has not responded to ordinary treatment, surgical measures, or medications for more than six months to qualify for medical cannabis. Given the state’s aging population and the prevalence of conditions causing chronic pain, this provision likely accounts for a substantial portion of the patient base.
Telemedicine has also played a role in expanding access. Since 2021, Arkansas has permitted physician certifications via telehealth appointments, removing the need for patients to travel to in-person evaluations. This change proved especially important for residents in rural areas of the state who might otherwise face long drives to see a certifying physician. Residents interested in obtaining their Arkansas Cannabis Card Online can now complete the entire evaluation process from home, making certification more accessible than ever before.
How the Program Works
For those unfamiliar with the Arkansas system, the process involves several straightforward steps. Patients must be Arkansas residents with valid proof of residency, be at least 18 years old or have a parent or guardian serve as their caregiver, and obtain written certification from a licensed physician confirming they have a qualifying condition. The state charges a $50 registration fee to the Arkansas Department of Health, which is non-refundable.
Once approved, patients can purchase up to 2.5 ounces of medical marijuana within any 14-day period from licensed dispensaries. Arkansas does not permit home cultivation, so all cannabis must come from state-authorized retailers. The dispensaries carry a range of products including flower, concentrates, tinctures, topicals, and edibles, though no individual edible product can contain more than 10 percent THC.
The application process typically takes up to 14 days from the date the Department of Health receives a complete application with payment. Online applications are preferred and allow patients to print their own cards once approved. Telemedicine services offered through platforms like MMJ have streamlined the physician certification portion, enabling patients to schedule evaluations at convenient times without leaving home.
The Dispensary Landscape
Arkansas voters approved a constitutional amendment in 2016 allowing up to 40 dispensary licenses and 8 cultivation facilities statewide. The Medical Marijuana Commission has awarded 38 of those dispensary licenses, with the final two slated to go to Green Remedies Group in Garland County and T&C Management in Texarkana. These last two licenses have been pending for years due to various administrative and legal complications, but recent rule changes suggest they may finally be issued in early 2026.
Currently, 36 to 38 dispensaries operate at any given time, as some have faced license revocations or temporary closures. The businesses are distributed across eight geographic zones designed to ensure some level of geographic coverage, though rural areas still face longer travel times to reach the nearest retailer. Southwest Arkansas in particular has fewer dispensaries relative to patient population, one reason regulators prioritized the Texarkana license among the final two to be awarded.
Top-selling dispensaries include Suite 443 in Hot Springs, which moved over 700 pounds monthly during peak periods in 2025, and Natural Relief Dispensary in Sherwood, which consistently ranks among the highest-volume locations. Plant Family Therapeutics in Mountain Home serves patients across north-central Arkansas as that region’s primary option. The variation in sales volume reflects both population density differences and the distances some patients must travel.
Political Headwinds and Policy Stagnation
Despite the program’s growth, Arkansas cannabis policy has hit a wall under Governor Sarah Huckabee Sanders. The governor has repeatedly voiced opposition to any expansion of marijuana access and has used her executive authority to block reform efforts. In April 2025, she vetoed HB1889, a bill that would have allowed dispensaries to offer drive-through windows for pre-ordered products and loosened regulations around delivery services.
The veto came even though the bill had passed both legislative chambers with bipartisan support. Representative Aaron Pilkington, the bill’s sponsor, noted that the legislation would not have increased the number of cardholders or the amount patients could purchase. It simply would have made access more convenient for existing patients, many of whom have mobility issues or live far from dispensaries. The disconnect highlighted ongoing tensions between patient needs and the governor’s stance.
Ballot initiatives have fared no better. In 2022, a recreational legalization measure failed with only 44 percent support despite polls showing majority approval for the concept. A 2024 effort to expand the medical program through a constitutional amendment was blocked by the state Supreme Court in a controversial 4-3 decision. That ruling came after two original justices recused themselves and Governor Sanders appointed temporary replacements, both of whom sided with the majority to keep the measure off the ballot.
The Delta-8 Crackdown
Adding another layer to the state’s cannabis landscape, Arkansas enacted Act 629 in 2023 to ban delta-8 THC and other intoxicating hemp-derived cannabinoids. Legal challenges delayed enforcement, but the Eighth Circuit Court of Appeals ruled in June 2025 that federal hemp law does not preempt state authority to regulate these products. As of July 2025, enforcement began in earnest, with the Tobacco Control Board and local police warning retailers to cease sales immediately.
The crackdown on delta-8 products may push some consumers toward the regulated medical market. Before the ban took effect, delta-8 products were widely available at convenience stores and smoke shops, offering an alternative for those unwilling or unable to obtain medical cards. With that option closed off, patients with qualifying conditions now have stronger incentive to pursue legitimate certification and access dispensary products that meet state testing and labeling requirements.
Economic Impact and Tax Revenue
Since the first dispensary opened in Hot Springs in May 2019, Arkansas patients have spent more than $1.5 billion on medical marijuana. The state collects a 6.5 percent sales tax plus a 4 percent privilege tax on these sales, generating substantial revenue. In 2024 alone, medical marijuana produced over $31 million in state tax revenue, split roughly evenly between the two levies.
That revenue initially went primarily to the University of Arkansas for Medical Sciences to fund research. More recently, the legislature redirected medical marijuana taxes to address food insecurity, funding free school breakfast programs and summer food assistance. The shift illustrates how the program has matured from a healthcare initiative into a meaningful component of state finances, funding priorities that extend well beyond cannabis policy itself.
For the 38 dispensaries and 8 cultivators licensed to operate, the economics have improved as the market stabilized. Lower wholesale prices in 2024 initially squeezed revenue even as pound volume increased, but 2025 saw both metrics trend upward. The limited number of licenses creates natural constraints on competition, allowing established operators to maintain profitable margins while serving the growing patient base.
Looking Ahead
Arkansas enters 2026 with its medical marijuana program firmly established but constrained by political opposition to expansion. The patient count will likely continue climbing as more residents discover they qualify and as telemedicine makes certification increasingly convenient. Sales should remain strong, particularly if the final two dispensary licenses are issued and begin serving underserved regions.
Governor Sanders has announced she will seek reelection in 2026, meaning the current policy climate is unlikely to shift significantly in the near term. Reform advocates face the challenge of either waiting for a change in administration or finding ways to advance ballot initiatives that can survive legal scrutiny. The failed 2024 effort demonstrated that even popular measures face substantial obstacles when powerful opponents control key institutions.
For patients, the practical reality remains positive despite the political frustrations. Arkansas offers legal access to a wide range of cannabis products for a broad set of qualifying conditions. The application process has become more accessible through telemedicine, prices have stabilized at reasonable levels, and product variety continues to improve. While neighboring states like Missouri have moved to recreational legalization, Arkansas patients at least have a functional medical program that serves their needs and shows no signs of contracting.
The 114,643 patients currently enrolled represent roughly 3.8 percent of the state’s population, a participation rate that suggests genuine demand rather than mere novelty. As medical research continues validating cannabis for various conditions and as the stigma around medical use continues fading, that number will likely keep growing. Arkansas may not be leading any cannabis reform movements, but for the patients who rely on the program, the steady expansion means continued access to treatment that improves their quality of life.
