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	Related links Marijuana Policy Project MPP, which bills itself as the largest marijuana-policy-reform organization in the US, was incorporated in 1995 and claims more than 17,000 dues-paying members. It has helped to rally support for medical-marijuana legislation in Rhode Island. Students for Sensible Drug Policy SSDP works to involve young people in the political process and to provide education about the harm caused by the war on drugs. The group says it neither encourages nor condemns drug use, but seeks to reduce the harm posed by drug abuse and drug policies. Drug Policy Forum of Massachusetts Citing the failure of the war on drugs — as evidenced by how drug are less costly and more pure, and by how Massachusetts continues to have one of the highest rates of youth drug dependence in the country — this statewide nonprofit calls for different, harm-reduction-based approaches to drug control. Rhode Island governor Donald L. Carcieri The popular freshman Republican governor, a corporate executive turned politician, opposes medical marijuana, citing concerns about expanded illegal drug use and the unregulated growth and distribution of the drug. Rhode Island General Assembly Medical-marijuana legislation found strong support across partisan lines in the Rhode Island House and Senate. Office of National Drug Control Policy The office of the so-called drug czar, which oversees billions of dollars in annual taxpayer spending to fight drug trafficking.

Carcieri spokesman Jeff Neal says the governor’s opposition to medical marijuana stems from his belief that insufficient controls exist for the production and distribution of the drug, as well as the related concern that "illegal marijuana use could proliferate throughout the state, and that marijuana could become much more accessible on the streets." The Rhode Island State Police and the chief judge of the Rhode Island Family Court also oppose the measure. Referring to the MPP-coordinated lobbying effort, Neal says, "I think there’s certainly a strategy to pick off states one by one — to select a state, to drive the debate there, and to use that as the thin end of the wedge to force a broader national conversation on the subject."

The governor has also pointed to the Supreme Court’s ruling in explaining his opposition to legalizing medical marijuana in Rhode Island. Critics, however, say Carcieri was less concerned about diverging from national mandates when he allowed a measure legalizing prescription-drug imports from Canada to become law in 2004, despite a warning from the US Food and Drug Administration that federal law would trump it.

For many, the case for medical marijuana also resonates with the larger question of how illegal drugs remain widely available despite the billions of tax dollars spent by the federal government in the war on drugs, especially with regard to youth.

Suggestions that medical marijuana will make the drug more available to children are "a load of bull," says Rhonda O’Donnell, a 42-year-old Warwick woman who was diagnosed with multiple sclerosis in 1994. "I think the federal government should have a lot more on their minds and their plates, like terrorism, rather than coming after people who use it for a medical purpose." Although the former nurse remains unsure whether marijuana would alleviate the stiffness and burning pain in her legs, she holds out hope that others would benefit. O’Donnell, who appears in a television ad urging public support for medical marijuana, attributes heightened legislative backing this time around to feedback from constituents. "I do believe it was the people [driving change], which is how the system is supposed to work," she says.

Democrats expect White House lobbying to have little effect on legislative support for the medical-marijuana legislation. In fact, the Senate overrode Carcieri’s veto, 28-6, on June 30, and support is likely to remain similarly strong when the House takes up the measure, probably within a few weeks.

Although the governor and other critics express concern about increased illegal marijuana use, most observers consider it unlikely that legalizing medical marijuana would bring a tide of users to Rhode Island (the introduction of medical marijuana in Maine about five years ago seems to have had little adverse effect).

And while state-sanctioned patients would have to obtain their marijuana from an illegal source, they appear unlikely to face federal prosecution. Anthony Pettigrew, the US Drug Enforcement Administration’s spokesman in New England, doesn’t even recognize the concept of medical marijuana because, he says, "It is not medicine. It has no proven medical value." Federal studies show that more teens enter treatment centers each year for marijuana, he notes, than for all other drugs combined. That said, Pettigrew adds, "The DEA has never targeted the sick and dying, but rather criminals [involved] in drug cultivation and trafficking. We’ll target major trafficking organizations and take them apart."

Rhode Islanders have a fairly tolerant attitude toward marijuana use. The revelation a few years ago that US Senator Lincoln Chafee had smoked pot as a young man caused little more than a blip. A recent study by the US Substance Abuse and Mental Health Services Administration found a high frequency of marijuana use in the southern part of the state. In the wake of the Gonzalez decision, even the Republican-friendly editorial page of the Providence Journal called on Congress to enact a national law allowing doctors to prescribe marijuana.

Although 10 states have legalized medical marijuana — Alaska, California, Colorado, Hawaii, Maine, Montana, Nevada, Oregon, Vermont, and Washington — moving similar initiatives forward remains a challenge even in a place with as liberal a reputation as Massachusetts (all but two of these states, Vermont and Hawaii, enacted their laws through ballot initiatives). A bill introduced by Senator Thomas McGee (D-Lynn) got a good response during a Senate Judiciary Committee hearing in early June, says Whitney A. Taylor, executive director of the nonprofit Drug Policy Forum of Massachusetts. Still, the outlook remains far from clear. For an advocate like Taylor, who saw how marijuana enabled her cancer-ridden stepfather to interact with his family over dinner during the period before his death, the ongoing disparity between public and political support is vexing. The challenge, she says, remains: "How do we implement laws and get it to work within the system?"

The MPP is pursuing organizing efforts in several other states, including New York, Massachusetts, Connecticut, and to a lesser extent, Illinois and Minnesota. Medical marijuana may remain an uphill battle, but it’s far from settled. "I think this issue is not going to die," says Marc Genest, a professor of political science at the University of Rhode Island. "I think this issue is like gay rights, where advocates, by continuing to bring the matter up, they surmount all obstacles and eventually become accepted."

The mouse that roared

What are the lessons of Rhode Island? Advocates invariably return to the importance of grassroots organizing and the message of compassion. Mirken touts the need to work closely with people in the community, "and you have to be sure to be thoughtful and factual, and prepared to deal with, frankly, the nonsense that comes from the other side. I don’t think there’s any magic formula here. I think it helps to have the truth on your side, but you have to do your homework."

The larger message, Mirken says, "is that the public is several steps ahead of Congress and the White House, at least in terms of being willing to look at drug policy in a pragmatic, common-sense way. A lot of people who don’t like drug abuse and who would like to see the misuse of drugs curbed are willing to look at things with an open mind, and say that if someone with cancer or MS can get a little bit of relief from marijuana, there’s no reason that they ought to be casualties in the war on drugs."

Ian Donnis can be reached at idonnis[a]phx.com