LEGALITY OF MEDICAL MARIJUANA ADDRESSED

Pharmacists and doctors are helping the Legislature in advance of a ballot
question expected to gain approval.

Question 9 seems to have no answer.

The ballot initiative, which would allow Nevada doctors to prescribe
marijuana to patients with a variety of illnesses, will likely be reapproved
by voters in November and sent to the 2001 Legislature to become law.

But what about its legality?

No matter what state marijuana easements the Legislature makes, possession
or distribution of the drug remains a federal felony.

"The serious question would be whether a state constitutional amendment
would outweigh federal drug regulations," said Kimberly Morgan, chief deputy
counsel to the Legislature. Morgan said that state lawmakers will be legally
compelled to follow voters' Question 9 initiative demands by amending the
Nevada Constitution to make medical marijuana use lawful next year.

According to Morgan, the Legislative Counsel Bureau has yet to determine how
it will advise lawmakers to deal with Question 9 without breaking federal
drug regulations, since voter initiatives in Nevada must gain majorities
twice before being brought to the Legislature. But since 59 percent of
voters gave the measure their support in November 1998, medical marijuana is
expected to pass overwhelmingly when it again appears on the ballot this
November.

"Well, Nevada has a history of challenging the federal government on issues
like this," Morgan said. "I mean, in how many other places in the U.S. are
gambling and prostitution legal?"

The legal conundrum surrounding the marijuana initiative has stimulated a
concerned band of pharmacists and physicians to address the issue before it
arrives on Carson City's Capitol steps.

The Medical Marijuana Initiative Committee, a 12-member group with
representatives from the state boards of pharmacy and medical examiners, the
attorney general's office and the UNR School of Medicine, met for the first
time Feb. 8 in hopes of hammering out a way for lawmakers to set up medical
use of the drug without violating federal laws. For many members of the
committee, it was their first preview of a problem that could mire state
lawmakers in controversy when they meet to discuss medical marijuana in
spring of next year.

Louis Ling, Nevada's senior deputy attorney general and co-founder of the
committee, said the group should be able to help lawmakers with the
initiative since the committee doesn't have to operate under the Nevada
Legislature's 120-day time limit.

"After being in the attorney general's office for five legislative sessions,
I know controversial issues like this one can get tangled," Ling said.

State laws definitely tangled with federal jurisdiction in California three
years ago when voters passed Proposition 215, a medical marijuana initiative
allowing California doctors to recommend the drug for patients with AIDS,
glaucoma, cancer, epilepsy, multiple sclerosis and a number of other health
problems. After the measure passed, California marijuana advocates formed
buyers' clubs for distribution -- a move legal under the new state law --
but most of the clubs have been shut down by a federal judge.

When Proposition 215 advocates appealed U.S. District Judge Charles Breyer's
May 1998 injunction that closed the clubs, the Court of Appeals sent the
case back to Breyer for reconsideration in September 1999, a victory for
medical marijuana advocates. U.S. Attorney General Janet Reno then stepped
in, asking for another hearing to keep the clubs closed.

Robert Raich, the Oakland attorney who appealed Breyer's decision, says a
major battle in the legal war between California medical marijuana advocates
and the federal government will likely be decided next month, when Reno's
appeal is expected to be denied.

The attorney says Nevada can learn from what has happened in California. "In
Proposition 215, it said the state government should provide a distribution
system, but it doesn't say exactly how patients are supposed to obtain the
marijuana," Raich said. "Things might be a little easier in Nevada since you
have a committee looking at how the Legislature can deal with the initiative
before it actually becomes law."

But legal battles are a prospect likely to be repeated in Nevada if the
Legislature doesn't handle medical marijuana with kid gloves.

According to Ling, the Legislature will likely be sued by Nevadans for
Medical Rights, the petitioning group who lobbied voters to get the
initiative passed, if lawmakers don't implement laws that allow for some
kind of state distribution system for medical marijuana.

"One of the reasons we've formed this committee is that we want Nevada to be
able to avoid some of the problems that California has had with (medical
marijuana distribution)," said Keith MacDonald, the Nevada Board of Pharmacy
executive secretary who co-founded the committee with Ling.

At their first meeting, committee members decided to investigate whether
they will be able to get exemptions from the Drug Enforcement Agency and the
Food and Drug Administration to conduct a state clinical study of
marijuana's effectiveness in treating several illnesses.

"Even if the legislation does pass through, doctors are not going to want to
prescribe marijuana to patients," said Rudy Manthei, an osteopathic doctor
on the committee. Manthei believes doctors will continue to be hesitant to
recommend marijuana as a treatment for anything because there are no
definitive reports on how well the drug works and what kind of medical
effects it produces.

With so little medical investigation into marijuana, Manthei contends the
drug presents a number of other problems. "Can all doctors prescribe it? How
will they know how much to prescribe? How will they know who to prescribe it
to? How will we be able to tell when a physician is overprescribing it?"

If the federal agencies sign off on the committee's proposal, a clinical
study in which marijuana-seeking patients could participate would satisfy
voters' wishes as put forth in Question 9 without violating federal law,
according to a report Ling prepared for the committee.

Backers of the Nevada initiative think the public might have a false idea
about how the federal government regulates medical marijuana.

"No one involved in this fight really believes the federal government is
going to swoop down on Nevada and start arresting people who are using
marijuana for medical reasons," said Dan Hart, leader of Nevadans for
Medical Rights, the group that collected 73,000 signatures in 1998 to put
medical marijuana on the ballot. "This is a battle that's primarily fought
between medical marijuana distributors and the government."

Dave Fratello, head of Americans for Medical Rights, the group that gathered
support for Proposition 215 in California, agrees with Hart. "The feds
generally have shown that they don't have the resources or the interest to
prosecute individuals using pot. It's only heavy trafficking they're
interested in."

Besides working with Hart on the Nevada battle, Fratello has overseen
medical marijuana fights in several other states over the past two years.

While Nevada citizens were making their initial approval of Question 9,
voters in three other states passed similar medical marijuana measures.

Since the summer of 1999, patients in Alaska and Oregon have been placed on
a registry and issued identification cards to obtain medical marijuana. At
last count, Oregon had 700 legally approved marijuana users. Washington
state passed Initiative 692 in November 1998, permitting patients and
caregivers to possess and cultivate up to a 60-day supply of the drug. How
much a two-month supply might be is determined on a case-by-case basis,
taking the severity of patients' diseases into account.

Medical marijuana passed with its largest majority in the District of
Columbia in 1998, but Congress overturned the initiative last September,
specifying in a vote that the district law "shall not take effect." The
results of a 1998 marijuana vote in Colorado are unknown because there was a
dispute over whether petitioners ever had enough signatures to get the issue
on the ballot in the first place.

The activist is optimistic about medical marijuana succeeding in the Silver
State.

"What makes Nevada's initiative unique is that you have a very
forward-looking group of people from the pharmacy board and the attorney
general's office wanting to help before this gets to the Legislature,"
Fratello said. "That should simplify things a bit."