AS STATE WORKS TO PUT NEW MEDICAL MARIJUANA LAW INTO EFFECT, FIND OUT WHAT'S
LEGAL AND WHAT ISN'T

Sick Montanans will be able to light up a marijuana cigarette, inhale
marijuana fumes or grow their own plants under an initiative passed by
voters Nov. 2.

A new Montana law took effect when the initiative passed, although the
law's full protections will not be in place for weeks as the state
works to put the program into effect.

"I'm trying to do it as quickly as I possibly can," said Roy Kemp,
chief of the state Health Facilities Licensing Bureau in the
Department of Public Health and Human Services.

Kemp expects his initial efforts will be wrapped up by year's end,
although the program will not be fully in force until qualified
Montanans with debilitating diseases receive registry identification
cards protecting them from criminal prosecution.

Montanans also voted to re-elect George W. Bush and to ban gay
marriages in this month's election, while electing a Democratic
governor and state Senate.

Throw in medical marijuana, and there may not be a discernible
pattern.

"People in Montana like to be thought of as free thinkers," said Al
Recke, a Great Falls activist who opposes impaired driving.

Montana's vote contained the widest margin of victory for a medical
marijuana law in any state so far.

Some 271,115 Montanans voted for the measure, and 167,459 voted no, or
a split of 62 to 38 percent. That's not quite a 2-1 margin, but it's
pretty close.

"I saw a lot of surprised folks," said 48-year-old Paul Befumo, a
Missoula man who spearheaded the effort to pass the initiative.

But Befumo expected a thumbs-up decision.

"I wasn't surprised at all," Befumo said. "It's really a pretty
common-sense issue."

Died of cancer

Befumo said he has three children and does not support recreational
use of marijuana.

However, he wishes medical marijuana had been an option for his late
father, a lifelong smoker.

"My dad died of cancer a few years ago," he said. "Seeing what he went
through ... that should have been an option that he should have been
able to try."

Voters agreed. Montana became the country's 11th state to allow
medical marijuana, if one counts Arizona, a state that allows
prescriptions to be written for marijuana. All but two of the states,
Maine and Vermont, are out West.

But how exactly is this all going to work?

It's the law

When the marijuana initiative passed, it became law as the Montana
Medical Marijuana Act, according to Befumo.

"Basically, the Legislature doesn't have a role in it anymore," he
said.

"As it was passed by the voters, that's it," agreed Kemp, who was
tagged to handle implementing the law and setting up the medical
marijuana program. "I'm getting quite a number of inquiries."

The main job for Kemp's office in Helena is to set up a registry and
print official registration cards.

"I'm establishing a registry for an approved patient and a caregiver,"
Kemp said.

A physician, after closely examining a patient's medical record, can
approve a patient for the registry, after deciding risks to patients
from marijuana's side effects are outweighed by the potential benefit
to the person who is ill.

The doctor must either be a medical doctor, or M.D., and a doctor of
osteopathic medicine, or D.O., Kemp noted.

"That cuts out all the mid-level practitioners," including
chiropractors, naturopathic physicians and others, he said.

Diseases covered include cancer or glaucoma, HIV or AIDS, wasting
diseases, severe chronic pain, seizures and severe, persistent muscle
spasms.

Setting up a registry will not be complex, and initial work should be
finished in December, Kemp said. But he said it may take more time to
get registration cards printed and ready to go.

State health agency officials are not looking to judge the voters'
decision at this point.

"The law is now in effect," Kemp said. "We have no position whether
it's a good law or a bad law."

Where to get it

Don't ask the state health agency how to get marijuana.

"The department is not a supply source of any kind," Kemp said flatly.
"We don't know where you get seeds or any materials."

Don't ask for your doctor or pharmacy to give you marijuana,
either.

Under federal law, marijuana "cannot be prescribed by any
practitioner," Kemp noted.

Doctors can place people on the registry, however, so a person would
have a defense if arrested. Purchasing marijuana is still illegal, he
noted.

But a person on the registry who possesses six plants or less, or one
ounce or less of marijuana tobacco, could show the registration card
to police or the judge.

While critics maintain smoking marijuana is hazardous to the body,
Befumo said there is a method to take in marijuana without smoking it,
using a vaporizer-like device called a Volcano. That would help
prevent damage to the lungs, he said.

Befumo said it might take a while for a person to grow marijuana
plants, so he said ill people who qualify may need to find marijuana
another way.

That remains one of the confusing parts of the law, since buying and
selling marijuana remains illegal, and it's not clear how people could
obtain the drug.

"There's just an affirmative defense now" in case of an arrest, Kemp
said.

Skepticism remains

Critics of the initiative, including Montana Gov. Judy Martz, said it
wasn't necessary.

Physicians already have the ability to write a prescription for a
marijuana ingredient, Marinol, Martz noted.

And she blasted initiative supporters for promoting smoking of a
"crude weed" over use of prescription medicine.

"Simply stated, there is no compelling scientific evidence that
smoking marijuana relieves the myriad of ailments that its proponents
claim," Martz wrote in an opinion piece for Montana's newspapers
before the election.

Others joined Martz in criticism, including other public officials,
law enforcement officers, physicians and addiction counselors. They
warned the measure could lead to more illicit marijuana use.

Befumo, however, said prescription medicine can make people nauseous,
which is already a big problem for many with debilitating diseases.

Inhaling marijuana with a vaporizer can nip the nausea problem in the
bud, he said.

"Taking it in through the lungs, you don't have to take it through
your stomach," Befumo said.

In addition, Befumo said Marinol contains just one of marijuana's two
major ingredients, THC or Tetrahydrocannabinol. He said Marinol does
not contain canabidiol.

Befumo said marijuana's side effects are limited.

"It's not been physically addictive," he said. "There's never been a
death from an overdose."

Critics of the new law "don't bat an eye when a physician prescribes
Oxycontin or Vioxx that have serious side effects," Befumo added.

Medical marijuana laws don't always see smooth sailing when they take
effect, and physicians may be wary to step into the controversial area.

San Francisco psychiatrist Tod Mikuriya, who has written marijuana
approvals for 8,000 patients since California's law passed in 1996,
clashed with the state's medical board in 2000 over inadequate
paperwork, gaining him a $75,000 fine and five years of probation.
Cautionary note

Recke, the Great Falls activist opposed to impaired driving, worries
about the new law.

"Personally, I'm apprehensive," Recke said. "I think that there's
other options out there to relieve pain and nausea. I'm going to be
watching it really close."

Recke compares marijuana to alcohol, saying both can impair
driving.

In the least, he said, people who are so sick they are using medical
marijuana should not drive after using it.

Recke said he hopes authorities will make clear that driving under the
influence of marijuana, as well as alcohol, violates the law.

"I'd feel better," he said.

The new law does specifically state medical marijuana users may not
operate any motor vehicle, aircraft or motorboat under the influence
of marijuana.

It also says the law will not require any employer to accommodate
medical marijuana use in the workplace, or for public or private
health plans to pay for any of the costs.

Then there is the big picture question.

"If you make marijuana more readily accessible, does that mean you're
going to have more illegal use?" Recke asked.

Recke said approval of the marijuana initiative was not so surprising,
considering the state does not even have an open container law,
prohibiting people from walking or driving around with open containers
of beer or liquor.

Such laissez-faire attitudes toward alcohol and marijuana can
backfire, however. Recke notes Montana has one of the nation's highest
rates of drunken-driving deaths.