MEDICAL MARIJUANA ACT

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 spokesman 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, fearing 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.

If the measure passes, patients could use a limited amount of
marijuana to relieve symptoms suffering from illness 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 the patient has 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 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, which contains
synthetic versions of marijuana's active ingredients, 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 said.
"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
house to see how many plants a person was 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."

Paul Befumo is out to change attitudes toward medical marijuana.