For the third time in recent years, Illinois House lawmakers are seriously considering whether to allow state residents to use marijuana for medical purposes.
The bill, which may come up for a vote in the House this week, follows a "green wave" election that saw Massachusetts join 17 other states and the District of Columbia in permitting medical marijuana use, while Colorado and Washington ventured even further, legalizing the psychoactive herb for recreation.
A lame-duck session also has fueled new momentum in Springfield, according to the bill'ssponsor, Rep. Lou Lang, D-Skokie, who said last week that he was close to the 60 votes needed to pass the measure to the Senate, which has approved similar legislation before.
"It is very clear that the tenor is different," Lang said Thursday after lawmakers had adjourned for the weekend. "We're hovering around the votes we need to pass it."
But in the fragmented and emotional realm of state-permitted marijuana use, experts and advocates say that voting "yea" will likely be the easiest part. Even if the legislation is enacted, Illinois will still have to establish its own production and distribution scheme for a substance that the federal government continues to prohibit as a Schedule 1 drug, along with heroin.
"(It) is going to be a difficult and long, drawn-out process," said Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws, which advocates amending laws to permit adults to use marijuana. "That is simply the reality of the fact that we are talking about marijuana and that we aren't talking about, I don't know, kale or something else."
States that have already legalized medical marijuana have spent years tackling a host of questions that have often produced complicated answers, such as deciding who is eligible to light up a joint or purchase and eat a marijuana-infused brownie.
Who would qualify
In most states that allow for the use of medical marijuana, patients with chronic or severe pain can qualify. California's list of conditions also includes a catchall category for any other illness for which marijuana provides relief.
In its current form, Illinois' legislation would roll out as a three-year pilot program that would be more restrictive, naming several dozen distinct medical conditions such as cancer, HIV, wasting syndrome and multiple sclerosis. The Illinois Department of Public Health could add to that list in the future.
"We have clearly defined diseases that a doctor must certify that you have or you're not getting the permit to be able to buy the product," Lang said.
While that has put some critics at ease, scientists and physicians say that medical research has shown scant evidence that marijuana is a safe and effective treatment for many of the afflictions the Illinois bill would cover.
A handful of uses in the bill - such as pain suffered by people with AIDS and cancer - are supported by some solid scientific evidence. But none meets the standards, such as large, well-designed clinical trials, required by the U.S. Food and Drug Administration in approving new drugs.
"We've got a serious issue here," said Dr. Eric A. Voth, chairman of the Institute on Global Drug Policy and a practicing internist and pain specialist. "The fundamental underpinnings of these measures bypass the FDA and I think hurt consumer protection."
Although California does not require ID cards for patients or state licensing for marijuana cooperatives, most states have moved toward an official registration and verification process to instill greater regulation, according to Armentano.
In those states, advocates point out that federal officials have largely not interfered with the medical marijuana programs.
In Colorado, for instance, patients must register with the state's Department of Public Health and Environment, which issues official ID cards. Hundreds of medical marijuana centers, infused product makers and cultivators are also regulated by the state Department of Revenue and local governments.
Registration problems, however, have cropped up in states such as Michigan, where patients and caregivers, who are allowed to provide marijuana to patients, have waited months at times for the state to issue registry identification cards.
Patients and caregivers without the IDs have faced the possibility of arrest and confiscation of their marijuana by police. Even some officially registered patients have been fired by employers after testing positive for pot.
Under Illinois' current bill, employers would still be able to enforce zero-tolerance drug policies. Patients would have to register with the state Department of Public Health, submitting written certification from their physician, before receiving a registry identification card. Active public safety personnel, such as law enforcement officers, paramedics, emergency medical technicians, firefighters, and state or county correctional officers would be barred from the program. Designated caregivers and "nonprofit medical cannabis organizations" would also have to register with the state, which would create a database to track participants.
Where to get it
In the Illinois draft bill, the state would initially limit nonprofit dispensarieswhere marijuana could be purchased to 59, or one per senate district.
Patients, or a caregiver, would then be allowed to buy 2.5 ounces of "usable cannabis" from their designated dispensary during a 14-day period. Patients, who would not be able to legally grow their own marijuana plants, would be allowed to apply for a waiver to receive more.
"They are actually quite a bit more restrictive than other states," said Morgan Fox, spokesman for the Marijuana Policy Project, which has been lobbying for the legislation in Illinois. "While I think it is too restrictive in some ways, getting the law passed is going to be better than nothing."
Teri Robnett, who lives in Denver and has been a registered medical marijuana patient and activist for years, said she prefers buying marijuana and related products from dispensaries as opposed to growing her own, though Colorado law does allow up to six plants per patient.
Robnett, who said she has fibromyalgia, submits her doctor's recommendation to the state every year to have her identification renewed. She then uses that ID about every two weeks to stock up on concentrated cannabis oil known as Phoenix Tears, marijuana-infused brownies, cookies and granola bars and flower buds from the plant that can be smoked.
"It keeps my pain at bay," said Robnett, 53. "It's amazing to see people who never thought this was possible being able to walk into a dispensary, see different edibles and strains, make their choice, and then walk out the door with their bag in hand, not having to look over their shoulder."
Patient experiences in other states, however, have not been as smooth.
In Delaware, which enacted legislation last year, ID cards were issued to patients, but the dispensaries were put on hold. Since the law does not allow patients to grow their own plants, patients say they have been left in an uncomfortable and illegal position of having to find non-state licensed sources of marijuana.
Todd Kitchen, 26, said he helped advocate for the Delaware legislation and visited his doctor in the days after it was signed into law to get his paperwork started. Kitchen said he has chronic back pain and suffered a traumatic brain injury after a 2005 car accident that has kept him on disability.
More than a year later, in November, Kitchen said he received his official medical marijuana registry card. The small laminated card has his photo, eye color, date of birth and unique medical marijuana ID code.
"It's frustrating and annoying," Kitchen said. "You have the ID, but you can't go and use it."
Regulation, monitoring
Oversight issues also have cropped up in various states across the country. In Michigan, where the attorney general has publicly expressed his dissatisfaction with the law, the Detroit Free Press reported that a doctor's license was suspended in 2011 when allegations emerged that she had helped sell medical marijuana certificates from a makeshift clinic located in an appliance store.
"This law was intended to help a narrow group of seriously ill individuals, but criminals are exploiting it for illegal activity that puts everyone's safety at risk," Michigan Attorney General Bill Schuette said in a news release at the time.
Meanwhile, in Los Angeles, some officials have cited complaints from constituents about crime and nuisance wrought by dispensaries.
The Illinois Association of Chiefs of Police has come out against the Illinois legislation for various safety reasons, according to Executive Director John Kennedy.
Kennedy cited language in the bill that would permit medical marijuana patients to drive six hours after consuming marijuana and the possibility that people younger than 18 could qualify for the program if a doctor and parent sign off on it.
"This is bad legislation," Kennedy said. "We just feel very adamant about it."
Although the Department of Public Health would have to submit an annual report to lawmakers, information about the nonprofit dispensaries, including the addresses, would not be available to the general public and would be exempt from the Freedom of Information Act, according to the bill.
Advocates of medical marijuana legislation maintain, however, that problems have been isolated and have not been insurmountable. They also point to continued, widespread support among the public for such laws.
Lang has stressed that Illinois' bill, as written, has safeguards in place that would allow law enforcement to monitor transactions between registered patients and nonprofits in real time. The bill also requires patients to have had an ongoing patient/physician relationship with the recommending physician.
Lang and those opposing the bill said they planned to work through the weekend to secure votes on both sides. But if it fails again, Lang said he doesn't expect to drop the issue any time soon.
"If I don't pass it now," Lang said. "I will try" next session.