The eight state initiative-created laws, and the laws of Vermont, Hawaii, and Rhode Island, are similar in what they accomplish.13
Each of the 11 states allows patients to grow, possess, and use medical marijuana if approved by a medical doctor.14 Patients may also be assisted by a caregiver, who is authorized to help the patient grow, acquire, or consume medical marijuana. Further, physicians are immune from liability for discussing or recommending medical marijuana in accordance with the law.
To qualify for protection under the law, patients must have documentation verifying they have been diagnosed with a specified serious illness. Most states require a statement of approval signed by the patients physician, but some permit a patients pertinent medical records to serve as valid documentation. To help law enforcement identify qualifying patients, some states have implemented formal state registry programs that issue identification cards to registered patients and their caregivers.
Patients' marijuana possession and cultivation limits are generally restricted to a concrete number: one to 24 ounces of usable marijuana and six to 24 plants, sometimes limiting the number that can be mature. One state, Washington, has a conceptual marijuana limit, permitting a "60-day supply." (California's 1996 medical marijuana law permits enough marijuana "for the personal medical purposes of the patient." A 2003 addition to the law, S.B. 420, guarantees protection from arrest for patients who possess state-issued ID cards and possess up to eight ounces of usable marijuana and six mature plants or 12 immature plants. However, at the time this report was published, only 19 counties had begun distributing statewide medical marijuana ID cards.)
Regardless of whether patients grow their own, get it from a caregiver, or buy it from the criminal market, a patient in possession of an allowable quantity of marijuana and otherwise in compliance with the law is protected from arrest and/or prosecution.
To illustrate how the law works, consider the following prototypical vignette:
"Joe" has AIDS. His doctor advised him that marijuana could boost his appetite, so he has three marijuana plants growing in the closet of his apartment, and he smokes four puffs of marijuana every day before dinner. One day, Joe's neighbor smells the marijuana smoke and calls the police. The officer knocks on Joe's door, and when Joe opens it, the officer sees the marijuana pipe on the table.
13 See Table 1 for specifics on each state law. Also see Appendix F for how these laws are working in the real world.
14 Maryland's law, which protects medical marijuana patients from criminal penalties, contains no explicit provision for cultivation.
Luckily, Joe lives in one of the 11 states with effective medical marijuana laws. Joe acknowledges growing and using marijuana, but then shows the officer a note on his doctors letterhead, which says, "I am treating Joe for AIDS, and in my professional medical opinion I believe that the benefits of Joe's medical marijuana use outweigh any possible health risks." The officer documents or verifies Joe's information, gives Joe his best wishes, and goes on his way.
If Joe lived in one of the 39 other states, he would be arrested, prosecuted, and possibly sent to prison.
As a matter of practice, police often do not arrest and prosecutors often do not prosecute individuals who can readily show that they are qualified patients, thus eliminating the need for a trial. In the unlikely event that a patient is arrested for marijuana possession or cultivation in one of the 11 states with effective laws, the patient is still allowed to argue at trial that his or her marijuana use was medically necessary.15
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