The importance of issue framing is well documented in public opinion and policy literature. While many analyze the impact of frames at the policy subsystem or public opinion level, this article identifies factors that influence frame selection and development in drug policy reform initiative campaigns. This study investigates why policy entrepreneurs choose to sponsor and advance medical marijuana ballot initiatives and draws on campaign literature, advertisements, and interviews to analyze the role of three forces that affect elite frame development: receptivity of public opinion, access to financial and media resources, and availability and credibility of spokespersons. These conditions influenced medical marijuana proponents' emphasis on patient rights, treatment options, and compassion as well as opponents' arguments about lack of evidence of medical effectiveness, the broader agenda of advocates, and conflicts with federal law. The case of drug control policy lends insight into the factors that shape elite frame selection and dissemination and points to avenues for future research.