MONTANANS TO DETERMINE LEGALITY OF MEDICAL MARIJUANA

If Paul Befumo had known that marijuana could have eased his father's pain
during the last few months of his life, he would have broken the law to get
it for him. Befumo, a 48-year-old registered investment adviser in Missoula,
lost his father, also named Paul, to lung cancer two years ago after the
family auditioned a long list of drugs to reduce his pain and nausea and to
increase his appetite.

What they didn't try was the one treatment some chronically ill patients say
has been their last, best resort: marijuana.

Since then, Befumo has researched the drug's benefits and hopes Montanans
will reach beyond marijuana's stigma on Nov. 2 when they're asked to vote to
legalize its medicinal use. "If you look up the definition of medicine, it
doesn't say something that's injected, or comes in a pink pill or comes in a
white pill," Befumo says. Befumo is the spokesperson for the Medical
Marijuana Policy Project of Montana, which has been encouraging voters to
pass Initiative 148, the Medical Marijuana Act. If voters approve, Montana
would become the ninth state to allow chronically ill patients to use
marijuana with a doctor's prescription. Others, like Jim Shockley, an
attorney and state legislator from Victor, oppose the initiative. Shockley
fears it would encourage the use of marijuana among the general population,
overwhelming police and doctors who would have to monitor the drug's
legitimate use. Besides, he adds, legal treatment options already exist,
such as Marinol, which contains synthetic versions of marijuana's active
ingredients. If passed, patients could use a limited amount of marijuana to
relieve symptoms from illnesses such as cancer, glaucoma and HIV/AIDS or
treatments that produce chronic pain, nausea, seizures, or muscle spasms and
atrophy.

A patient or caregiver could also register to grow up to six marijuana
plants and possess no more than one ounce if they provide a physician's
certification that they have a debilitating condition and could benefit from
marijuana's use. Befumo says that since the initiative campaign began, he's
had calls from more than 50 Montana patients who say the passage of I-148
would help them. One of the people who called Befumo was Robin Prosser, a
Missoula woman who has suffered for about 20 years from an immunosuppressive
disorder and was arrested in May when police found marijuana and drug
paraphernalia in her home. Prosser has said she used marijuana to treat her
illness because she's allergic to prescription narcotics.

In September, a Missoula judge told Prosser she could continue to use
marijuana medicinally if supported by a physician. She was also told that
charges against her would be dropped if after nine months she has no
additional trouble with the law. Prosser's case marked progress in the
Marijuana Policy Project's national quest to legalize medical marijuana,
Befumo says, but he adds that his own story shows how far there is to go.
Befumo's father tried many drugs, including Marinol, but couldn't keep the
pills down and still suffered from nausea and decreased appetite toward the
end of his life. "My dad liked to be really present and in control of
himself," he says. "When I had gone to visit him the last few times, the
pain medication he was on really kept him as kind of an invalid.

When you talk to people who are in this situation, that's one of the worst
parts of the drugs." Befumo says that for some patients, using marijuana has
cut their opiate dosages in half, allowing them to be more coherent. And
while alternative drugs like Marinol are available, some patients believe
they're not as effective. "When they came out with Tylenol, they didn't take
aspirin off the shelf," Befumo says. "Not everything works for everybody."
Not everyone is as convinced as Befumo of the medicinal need for marijuana.

Michael Spence has been the chief medical officer of the Montana Department
of Public Health and Human Services for seven and a half years.

Before that, he worked with HIV and AIDS patients on the East Coast for more
than two decades.

He says he doesn't recall any patients who couldn't take Marinol or another
synthetic drug. "I really can't say that was an observation that I made," he
says. "I'm not saying it doesn't happen." Shockley, whose own wife is
undergoing chemotherapy treatments, says even if some people can't use an
alternative, it's not a good idea for Montana to pass the law. "Are there
some people in the world who nothing else will help? Probably. But I imagine
they are very, very, very few," he says. "If there are any, they're just
going to have to get by on something else." But Befumo says his group has
received letters and phone calls from many medical officials across the
state who support the initiative. Spence is not surprised. "I think that for
the most part, the medical profession is willing to look at anything that
might be beneficial to our patients' outcome," he says. "If this might be
helpful, why not give it a whirl?" Still, he cautions, there are many
uncertainties surrounding the policy. "Different people have different pain
thresholds," Spence says, adding that he's concerned about the initial
uncertainty that would result from not knowing how much marijuana to tell a
patient to use. Because the law would allow a patient to grow up to six
plants and possess up to one ounce of marijuana, Shockley says he's worried
patients may be allowed to grow too much and there could be a problem with
patients selling or giving away their extra supply. "We'd have marijuana
gardens all over the state," he said. "This law creates a tremendous
loophole for people who want to grow marijuana illegally." But Befumo
insists that the patients who would be allowed to grow marijuana wouldn't
run the risk of being imprisoned and losing their medication. "If you look
at the people they're going after, they're not people you would consider
criminals," he says. "You don't want to be covered under this statute." He
adds that because any authorized user would have to carry a registration
card, the law would not provide an extra burden for police beyond counting
how many plants a person has. "Most police officers I know can count up to
six," he says. But Lt. Levi Talkington, a Lewistown policeman and president
of the Montana Police Protective Association, says the issue is more
complicated than that. "With any new statute, there's always kind of that
gray area that needs to be tested," he says. "At first I would think there
would be some increased workload on the law enforcement." Talkington
suggests the state would need a watchdog force to keep the prescribed use of
marijuana within legal bounds.

He would also like a clearer interpretation of whether police would be able
to search a person's house to see how many plants they were growing. "How do
I know that they have the legal limit of what they're supposed to have and
not an entire grove in the back of their house or something?" he says. He
also worries I-148 is a move toward the general legalization of marijuana.
"It's kind of one step closer," he says. "We are (already) seeing a lot more
marijuana.

It's not uncommon anymore when you arrest someone and search them to find
marijuana on them." Befumo concedes the initiative may change society's
attitudes about marijuana but says its purpose is not to make the drug legal
for everyone. "If you look at the statute, it's just very narrowly defined,"
he says. "But there have to be hundreds of people, even thousands in
Montana, who that could work for." Shockley, Spence and others are also
concerned that marijuana has long been identified as a stepping-stone toward
other, more dangerous drugs. "It's certainly considered by many people as a
gateway drug and legalizing (it) is giving someone entry into a harder line
of drugs," Spence says. Joan Cassidey, chief of Montana's Chemical
Dependency Bureau, says more people are admitted to treatment programs for
marijuana abuse than for the abuse of any other drug except alcohol.

Of nearly 7,000 admissions in 2003, 1,400 were for marijuana.

But Befumo says the "gateway drug" argument is questionable. The fact that
many hard-drug abusers say they've used marijuana doesn't mean most
marijuana users go on to harder drugs.

Nor does Befumo, a father of three, agree with Shockley's concern that
allowing the use of medicinal marijuana usage sends a bad message to
children. "What's the wrong message?" he said. "We shouldn't put sick people
in jail? I don't have a problem with that message." Nor do most Montanans,
according to a Lee newspapers poll conducted in late September. Some 58
percent supported I-148, 29 percent opposed it and 13 percent were
undecided.

California was the first state to allow the possession, use and growth of
medicinal marijuana in 1996. Since then Hawaii, Alaska, Oregon, Washington,
Nevada, Colorado and Maine have been added to the list. Arizona has
legalized its use with a doctor's prescription and Maryland now protects
marijuana patients from incarceration, but not arrest. Befumo says medicinal
marijuana has triumphed in every state where voters have been asked to allow
its use. "I'm cautiously optimistic," he says. He adds that the best part of
this campaign has been educating patients and their loved ones about the
benefits medical marijuana could provide.

He says the way he sees it, those who do know about it have two choices if
their loved ones are sick: Don't use it or use it illegally and risk getting
caught. "I would have tried it," Befumo says. "I would've obtained it
illegally for him. I don't think people should have to face that choice."