Proponents of Initiative Measure 13, an act to legalize medical marijuana in South Dakota, are optimistic about their chances in November. Even some of their opponents expect to lose.
"I think it's going to pass. I think South Dakota people are a caring people," said Vermillion Police Chief Art Mabry, president of the South Dakota Association of Police Chiefs.
Mabry, who opposes the initiative, believes the South Dakota Coalition for Compassion campaign will "tug at the heartstrings" of voters, using plenty of national money to do so.
But Rep. Martha Vanderlinde, D-Sioux Falls, a registered nurse who co-sponsored a bill to legalize medical marijuana in the 2008 Legislature, said the Coalition for Compassion and supporters of the bill aren't manipulating anyone.
The campaign simply gives a voice to those helped by medical marijuana, she said.
"As a nurse, I have seen the results," Vanderlinde said.
Vanderlinde said she now works with a multiple sclerosis patient who can get relief from muscle spasms only with medical marijuana. With just a tiny amount of the drug, she has seen cancer patients completely relieved of their nausea.
"I feel so strongly about this," Vanderlinde said.
Initiative Measure 13 would allow medical marijuana in South Dakota under a specific set of guidelines. For instance, medical marijuana users will have to be registered with the state Department of Health.
They will need a prescription from a medical doctor for treatment of one of the following "debilitating medical conditions" - cancer, glaucoma, HIV or AIDS, amyotrophic lateral sclerosis, Alzheimer's disease or any condition that causes wasting, severe nausea, debilitating pain, seizures or muscle spasms.
Medical marijuana patients will be required to have an established relationship with a physician and must be seen by that physician every six months. Patients will not be able to drive while using medical marijuana, Vanderlinde said.
A medical marijuana user who has a prescription can only obtain marijuana from a "designated caregiver" who must be 21 years of age, a resident, registered with the state and have no previous felony arrests. Each caregiver can provide medical marijuana for no more than five patients.
Caregivers cannot charge patients for medical marijuana, but patients can provide payment to cover the costs of growing it.
There will be no marijuana dispensaries, said Vanderlinde, calling the initiative "one of the strictest medical marijuana bills in the United States."
Medical marijuana has gradually ebbed its way into the mainstream in the past 10 to 15 years. Fourteen states currently have laws allowing the use of it, despite federal law that still labels marijuana illegal.
Colorado passed its medical marijuana law in 2000, and Montana voters passed its law in 2004.
The Department of Veterans Affairs this year formally moved to allow patients being treated at VA facilities to use medical marijuana in states where it is legal. VA doctors will not be allowed to prescribe marijuana, however.
In 2009, the American Medical Association seemed to add some support when it suggested that marijuana be removed from the schedule 1 drug category: a category reserved for drugs deemed unsafe, at high risk for abuse or having no medicinal use. The AMA also called for more controlled studies of the effectiveness of the drug. By contrast, the South Dakota Medical Association does not support Initiative 13, said president Dr. Thomas Huber of Pierre.
Huber argues that there is no proof that marijuana helps patients. But Dr. Kevin Weiland, a Rapid City internist, disagrees.
"There is some evidence when we use medical marijuana for appetite (enhancement) for end of life issues." He said the drug can also help with pain.
Weiland said he has treated patients who weren't helped by prescription medications. He believes those patients deserve as many options as possible.
"I just think it's another option, and I think we shouldn't ignore this issue anymore," he said.
Mabry can't speak from a medical standpoint, but he has clear thoughts on the initiative from a law enforcement stance.
"Montana is telling us that it's a nightmare," he said. "For one thing, they feel it's being abused."
Lt. Steve Brester, a detective in the Missoula, Mont., police department, said the Montana Legislature is preparing to make changes to portions of the law that have caused problems.
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They will look at regulating the number of times a patient can fill a prescription and the overall patient/caregiver relationship.
Although the Montana law was intended to address a one patient/one caregiver relationship, "It's grown away from that," Brester said. Instead, Montana has seen a plethora of dispensary-type establishments popping up. In Missoula alone, there are 55 storefront businesses that advertise medical marijuana.
"There's been a lot of in-your-face advertising," he said.
Brester said he isn't opposed to the law, but looks forward to the Legislature clarifying some of rules surrounding it.
His advice for states like South Dakota - make sure Initiative Measure 13 spells out everything. "The worst laws are the ones that are not clear or are ambiguous," he said.
As a law enforcement officer in Vermillion, home to the University of South Dakota, Mabry worries about a growth in marijuana use among young adults and the potential problems enforcing such a law.
"We already deal with fake ID driver's licenses," he said. "I can't imagine how they're going to be able to control fake medical marijuana cards."
Mabry also wonders about the tax dollars that will go into regulating the law. Other states have been forced to beef up staff to manage applications.
For instance, Colorado's original law limited the number of patients a caregiver could provide for to just five; the same limit in South Dakota's law.
After a legal challenge, the court removed that restriction in 2009 and the state saw an "influx of applications," said Mark Salley with the Colorado Department of Public Health and Environment. Salley said the department has struggled with a backlog of medical marijuana applications ever since.
On Dec. 31, 2009, the department had 41,039 registered medical marijuana patients. By August of this year, that number reached 114,000. The department hired 50 temporary employees to keep up.
"We were seeing abuse of the law from what most people thought Coloradans really intended when they passed the law," Salley said.
During its last session, the Colorado Legislature tightened some of the regulations. Application numbers have been on the decline ever since, Salley said.
Emmett Reistroffer, campaign director for the Coalition for Compassion, said the last thing supporters want is for the law to be abused.
"We want to work together to bring down drug abuse," he said.
Reistroffer said the coalition worked hard to make sure its initiative is restrictive enough to prevent abuses. The coalition does not support full legalization of marijuana, an issue California will consider in November.
Mabry isn't convinced that full legalization isn't the ultimate goal.
"Don't tell me this is not the first step," he said. "There's a part of me that just says, ‘Either legalize it or don't. Let's not play these games.'"
Reistroffer, however, remains adamant that full legalization has never been the goal.
"We are not interested in fully legalizing it," he said. "I don't think that would be the best thing for South Dakota ... I don't see the vast majority of South Dakotans really liking marijuana."
When Vanderlinde co-sponsored the medical marijuana legislation in 2008, fellow legislators warned her she was committing "political suicide."
That scenario has not played out. Vanderlinde said she has talked to more than 700 constituents over the past months and "there has not been one person who is opposed to it," she said. "I don't know who the people are who are really opposed to it."
Even her 82-year-old father supports its use for people who are suffering. She believes he's far from alone.
"If it's an herb that doesn't have a lot of side effects, why not? It's not hurting anyone," she said. "I have seen it work."
Contact Lynn Taylor Rick can be reached at firstname.lastname@example.org or 394-8414.