Prop 203 -- the Arizona Medical Marijuana Act -- Puts the Chronic in Chronic Pain

Got cancer? Have some pot. Dying of AIDS? Have some pot. Handicapped from the effects of multiple sclerosis? Have some pot.

Chronic headache, heartburn, or painful pimples? Have some pot!

This could well be the case after November 2, if Arizona voters approve Proposition 203, the "Arizona Medical Marijuana Act."

In terms of regulating the number of pot dispensaries and keeping detailed records, Prop 203 is the state's smartest medical marijuana measure proposed to date, and proponents say it's a solid plan to provide seriously ill patients with medication. But like medical marijuana laws in California and Colorado, Prop 203 includes weed treatment for "chronic or severe pain." That's what the vast majority of patients in those states use pot for, not truly debilitating illnesses.

Prop 203 would allow registered patients, both terminal and just "in pain," to purchase medical marijuana from a licensed dispensary. It's an issue that crosses party lines — according to the latest Rocky Mountain Poll, 66 percent of Democrats and 57 percent of Independents favor Prop 203, along with 40 percent of Republicans. Given the poll numbers, Prop 203 is the most popular item on the ballot this year — not surprising, given Arizona's history with marijuana measures.

Arizona voters passed one of the first medical marijuana measures in the country, way back in 1996. It was called Proposition 200, and it softened sentencing for non-violent drug offenders and permitted doctors to "prescribe" marijuana. Although Prop 200 won at the polls with 65 percent of the vote, the state Legislature quashed it over one word — "prescribe." Because marijuana is a federally controlled substance, the U.S. Drug Enforcement Administration prohibits physicians from "prescribing" it. So Proposition 200 was never enacted, and a lot of voters were, frankly, pissed off.

To prevent lawmakers from overruling them so easily in the future, voters passed Proposition 105, the "Voter Protection Act," in 1998. Under this law, the Legislature cannot tamper with voter-approved measures, at least not without three-fourths of the legislative vote. So if Prop 203 passes, it will be a lot harder to kill.

Pot law reform came before Arizona voters again in 2002, but it wasn't just about medical marijuana — this bill, sponsored by the People Have Spoken campaign and also (unfortunately, for current supporters) called Proposition 203, was basically a marijuana decriminalization bill, with such provisions as using taxpayer dollars to fund medical marijuana programs and releasing convicted, non-violent drug offenders from prison. It failed by more than 150,000 votes.

"The measure that failed in 2002 was really wacky," says Andrew Myers of the Arizona Medical Marijuana Policy Project, which authored Prop 203 this year. "There were a lot of crazy things written into it. It called for things like agents to give seized marijuana to patients for free. This measure is nothing like that."

In fact, this year's Proposition 203 is the most detailed medical marijuana measure Arizona's ever seen, and it's more evolved than similar laws passed in other states.

If Prop 203 passes, Arizona will become the 15th state with a medical marijuana law. Critics point to problems with medical marijuana systems in other states, where thousands of pot dispensaries have popped up, offering a smorgasbord of marijuana products to hundreds of thousands of "patients" — the majority of whom are not cancer or AIDS patients, but people under 40 taking marijuana for "pain relief."

There's concern that Arizona will have similar problems. But unlike measures in other states, Prop 203 includes an immediate plan for oversight by the state health department, grants zoning authority to municipalities, and limits the number of dispensaries that can open statewide.

The initiative does bear some resemblance to California's Proposition 215 (passed by voters in 1996) and Colorado's Ballot Amendment 20 (passed by voters in 2000). All eliminate state penalties for patients who use medical marijuana, and include severe or chronic pain among the lists of "debilitating conditions."

But neither California's nor Colorado's initial medical marijuana bills limited the number of dispensaries that could open. Consequently, both states have been flooded with them. There are now close to a thousand dispensaries in Los Angeles alone — more locations than Starbucks, according to a report on National Public Radio.

Prop 203 calls for no more than one dispensary license to be granted for every 10 pharmacy permits issued by the Arizona State Board of Pharmacy. As of this writing, that equates to 124 dispensaries statewide.

"People are concerned about the proliferation of dispensaries. I think a lot of that is because of what happened in California," says Myers. "We're the only state to regulate from the beginning. We wanted to learn from past mistakes in other states. The difference is, we limit the number of dispensary licenses. You're not going to see them on every corner. "


But opponents of Prop 203 are also concerned with the list of "debilitating conditions" in the initiative. In California, it's relatively easy for residents to get medical marijuana for "pain." Patients can receive recommendations from doctors they've just met for things like sore backs and headaches, and there are tons of "patients." The California branch of the National Organization for the Reform of Marijuana Laws (NORML) estimates there are more than 150,000 medical marijuana patients in the state, and that 40 percent report using pot to treat "chronic pain."

Like California, Arizona's initiative includes "severe and chronic pain" in its list of qualifying conditions, along with cancer, glaucoma, multiple sclerosis, HIV, and AIDS.

Prop 203 opponents assert that, as in California and Montana (where more than 80 percent of pot patients treat pain), Arizona's medical marijuana system won't be used to treat the seriously ill, but will be overrun by young stoners receiving recommendations for stubbed toes and butt cramps.

Under Prop 203, qualifying patients would be protected from discrimination by employers or landlords, solely on the basis of being a registered medical marijuana patient — but they still could be legally fired for smoking pot at work or showing up stoned, provided the employer can prove the patient was under the influence.

Patients will also be safe from state prosecution, provided they don't have more than they're legally allowed to possess. In the case of Prop 203, that's actually quite a lot — 21/2 ounces of marijuana every two weeks. Patients who don't live within 25 miles of a dispensary would be allowed to grow up to 12 marijuana plants inside a "locked facility." (Yes, a house would apply).

"You have to weigh the problems against the benefits," says Ed Gogek, an Arizona doctor and substance abuse counselor opposed to Prop 203. "There will be pot shops in our neighborhoods. Some states even have traveling 'cannabis caravans' now that drive around and sell marijuana."

But Dr. Lesley Meng, an Arizona oncologist who supports Prop 203, says the majority of patients who receive recommendations for medical marijuana will be cancer patients. "For Ed to be speaking about this medication upsets me, because he's a doctor who treats people with addictions. I'm a doctor who treats cancer patients. We're talking about people who can truly benefit from this substance," Meng says. "Ed's talked about pot shops on every corner, and people smoking pot and running wild everywhere. I don't think that's going to happen."

Still, considering the large number of people in other states using marijuana for "pain," it wouldn't be at all surprising if Prop 203 passes and Arizona's suddenly filled with suffering. The bottom line is, some people can find relief from serious health concerns with marijuana, but the majority of people just want to use it recreationally.

That doesn't mean, however, that our state will burn in a cloud of pot smoke or that children will buy "potsicles" from so-called "cannabis caravans" while their parents do bong hits on the lawn.

Sure, there's room for people to abuse a medical marijuana system here, but if the regulations set forth in Prop 203 are followed, Arizona's medical marijuana system could be among the most strictly controlled in the United States.

Prop 203 doesn't protect the possession or distribution of marijuana for non-medical use — that would still be a crime, punishable by fines up to $150,000, up to 18 months in prison for less than two pounds, and up to three years in prison for more than four pounds.

Dispensaries could not open within 500 feet of a school, and — ready or not — cities and towns may enact zoning regulations that limit land for dispensaries. Consuming marijuana will be prohibited at schools, on school buses, in correctional facilities, on public transportation, and in any public place.

The Arizona Department of Health Services would oversee the issuing of all dispensary licenses and registration cards for medical marijuana patients and maintain a database registry.

Here's how it's supposed to work: Potential dispensary owners must submit an application, an application fee not to exceed $5,000, and a set of fingerprints to the ADHS for a state and federal criminal records check. (Sorry, convicted felons — no "pot shop" licenses for you.)

Anyone who wants to buy medical marijuana must have a patient or caregiver registry card from ADHS. In order to get a card, potential patients must submit an application, an application fee (to be determined by ADHS), and a certified, written recommendation from a physician (which includes homeopathic and naturopathic doctors, just in case all the aromatherapy and acupuncture doesn't work).

Children younger than 18 may obtain a card with the written consent of a parent or legal guardian and certified, written recommendations from two physicians.

The ADHS database of medical marijuana patients will include the name, address, telephone number, and date of birth of the patient. (Interestingly, if a patient is homeless, no address is required.) The registry database is supposed to be accessible only by the ADHS, law enforcement, and dispensary owners (who will be required to enter information about all purchases).


If Prop 203 passes, ADHS will have 120 days to set up the registry database and begin issuing dispensary licenses and patient cards. If the department fails to make that deadline, Prop 203 calls for notarized patient statements and a certified physician's written referral to be deemed valid registry identification cards.

ADHS director Will Humble has said the department likely would not be ready to accept applications for dispensaries or patients until April 1, 2011. He also said that setting up a registry database and administering licenses is going to be time-consuming and costly.

But Humble's larger concern is that, as in other states, Arizona's Prop 203 "leaves the door open for recreational users to claim they have pain issues in order to get a card to avoid getting in trouble in case they get caught with marijuana [for their recreational use]."

We can picture it now: "No really, officer, this bag of weed is important to the treatment of my heartbreak of psoriasis/ballistic organ syndrome/tongue blisters."

Depending on how the votes go, Arizonans may be in a lot of "pain" soon.

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