Idaho is the last holdout. Surrounded on nearly every side by states with legal cannabis, the state has watched Oregon, Nevada, Montana, and Washington build out programs while Idaho’s patients drive across borders to get relief. Now a coalition called the Natural Medicine Alliance of Idaho is trying to change that, and they’re moving fast.

The group has crossed 100,000 signatures with the April 30 deadline bearing down. That’s not a cushion. It’s a sprint. To land a medical cannabis measure on November’s general election ballot, organizers need valid signatures spread across Idaho’s legislative districts, not just a single statewide pile. Amanda Watson, a Boise-based spokeswoman for the initiative, told reporters the pace is holding. “We are collecting thousands of signatures a day at this point to make sure that we get over that threshold in each legislative district,” she said, according to initial reporting by Clark Corbin for the Idaho Capital Sun.

Geography is doing a lot of the work here.

Wyoming is the only neighbor that hasn’t opened some form of legal access. Everywhere else around Idaho, patients can walk into a dispensary. That creates an absurd situation for Idaho residents managing epilepsy, PTSD, cancer, or Alzheimer’s disease. They’re crossing state lines, buying products, and driving home with something that’s still a criminal offense under Idaho law. Watson has heard from many of them directly. “We’ve had hundreds of people email us about how they’re suffering with PTSD or they’re suffering with epilepsy and they’re driving across the border and illegally buying gummies because they would like some dignity in their care, in their state, but they can’t get it.”

The Natural Medicine Alliance’s proposed measure would cover debilitating conditions including cancer, post-traumatic stress disorder, AIDS, epilepsy, Crohn’s disease, and Alzheimer’s. It isn’t a recreational framework. Watson and the campaign’s chair, Rob Cronin, have been consistent about that framing. Cronin’s personal investment runs deep. He’s a cancer survivor and was close with the late Dr. Dori Tunney, a physician and philanthropist who developed glioblastoma. Tunney’s treatment involved opioids that wrecked her appetite, caused serious side effects, and sped up her physical decline. While she was receiving care in California, where cannabis has been legal for medical use since 1996, Tunney tried a medical cannabis gummy. Her appetite came back. Sleep improved. Pain eased. She spent her remaining time advocating for broader access before she died, and her story has become the emotional backbone of the campaign.

Opponents don’t see it that way. Critics of the Idaho Medical Cannabis Act have pushed back hard on the bill’s language, arguing the measure’s scope is far too loose. “The Idaho Medical Cannabis Act lacks safeguards to such an extent that it would effectively legalize widespread recreational use of marijuana.” That objection isn’t new in cannabis ballot fights, but it’s landed with particular force in Idaho’s political environment, which has resisted legalization longer than virtually any other western state.

Supporters counter that the opioid angle changes the calculation. That’s not just a rhetorical move. The CDC’s most recent national overdose data shows synthetic opioids remain the leading driver of drug deaths in the United States, and advocates argue that giving seriously ill patients a documented alternative is the kind of harm reduction even skeptical legislators shouldn’t dismiss.

What happens between now and April 30 matters enormously. If the Natural Medicine Alliance of Idaho can validate enough signatures across the required legislative districts, Idaho voters will decide the question in November. That’s still a big if. Signature drives routinely lose a chunk of what they collect to disqualifications, addresses that don’t match, people who signed twice. Reaching 100,000 is a milestone, but it’s not a finish line.

Watson said the emails keep coming. People with Crohn’s disease. Veterans managing PTSD. Cancer patients who’ve watched what opioids do to a body. They’re not waiting on a political debate. Some of them are already in their cars.