By John P. Martin
Washingtonpost.com Writer

District voters will do more than elect a new mayor on Nov. 3. They’ll be asked resolve a years-old debate: Should people suffering from AIDS, cancer and other serious illnesses be allowed to use marijuana to treat their conditions?

The only ballot measure this year is Initiative 59, also known as the "Legalization of Marijuana for Medical Treatment Initiative of 1998." Here’s a brief look:

What would Initiative 59 do?
Its purpose is threefold: permit marijuana use as a doctor-approved treatment for serious illnesses, including AIDS, cancer, muscle spasms and glaucoma; legalize the cultivation, possession and distribution of marijuana for such purposes; and require D.C. health officials to devise a plan to safely distribute the drug to patients.

Who would benefit?
Patients who use the drug under a written or oral recommendation from a licensed physician would be exempt from criminal drug laws. Doctors who recommend such treatment would be also protected from prosecution and their identities would remain private in court proceedings related to the law.

Who would grow the drug?
Patients or up to four "caregivers" designated by each would be allowed to grow or buy marijuana for medical use. Any patient, doctor or caregiver who gives the drug to someone not covered under the act would face criminal drug distribution charges.

The legislation also would permit the establishment of nonprofit corporations to legally grow and sell the drug. Advocates say such "growers clubs" are necessary and easier to regulate.

Who supports the proposal and why?
Proponents, including some physicians and AIDS activists, contend that when used responsibly, marijuana can provide unmatched relief in alleviating vomiting caused by some therapies, stimulating the appetites of weak patients, easing pain and improving eyesight.

Locally, Initiative 59 was spearheaded by members of Act Up, a gay-rights advocacy group, and the Green Party of D.C. One of the key supporters, activist Steve Michael, died in May after a battle with AIDS. His partner, Wayne Turner, is named as sponsor of the legislation.

Mayor Marion W. Barry has stated his support for the initiative. Mayoral candidates Carol Schwartz (R) and Anthony A. Williams (D) favor the measure, as do a majority of D.C. Council members including Linda Cropp, Kathy Patterson, Jack Evans, Kevin P. Chavous, Charlene Drew Jarvis, David Catania and Hilda H.M. Mason. Officials at Whitman-Walker Clinic, the city's largest provider of AIDS-related services, have endorsed it as well.

Who opposes it?
Opponents include America Cares, a coalition that enlisted 42 local organizations against the measure. Its members argue there is no evidence that marijuana has medicinal value, but substantial proof as to its medical dangers.

Critics also have included Barry R. McCaffrey, who directs the White House Office of National Drug Control Policy; Joseph Califano, former U.S. secretary of health, education and welfare, and conservatives such as millionaire publisher Steve Forbes, who aired radio advertisements opposing the measure last fall.

They have argued such laws are too loosely structured, impossible to regulate, could stir more drug use by children and are thinly veiled efforts by those who want to legalize drugs. Opponents also note that deserving patients can already get prescriptions for Marinol, a pill form of THC, the active ingredient in marijuana that some say offers the same treatment benefits as smoked marijuana.

McCaffrey wrote: "The setting for marijuana typically has been in classrooms, where it interferes with learning; automobiles, where it interferes with driving, and the workplace, where it interferes with productivity – not in hospitals contributing to healing."

Have other cities or states considered similar initiatives?
California and Arizona voters approved medical marijuana referendums two years ago, but have been untangling the issue in legislative battles ever since. In November, similar measures will be on the ballot in Alaska, Washington, Oregon, Nevada and Colorado.

One of the primary sponsors of measures in those states is Americans for Medical Rights, a California-based group lobbying nationwide for medical marijuana laws. AMR is not affiliated with Initiative 59 in the District.

"We really designed this to specifically to fit the needs of patients here in Washington, D.C.," Turner said.

How did the proposal get on the D.C. ballot?
Local organizers needed roughly 17,000 citizens – or 5 percent of the District’s registered voters – to sign a petition to place the issue on the ballot. They fell short in 1997, but tried again this year and, after several court challenges, won ballot status in September.

Will I recognize it on the ballot?
Initiative 59 is the only measure up for approval this fall, and the ballot includes a three-paragraph summary of the legislation. Voters choose to be "For" or "Against" the proposal.

How many votes does the initiative need to pass?
A majority – in other words, one vote over 50 percent.

What happens if it passes?
Within 30 days of the vote certification, the mayor would be required to formally alert the Congress and president as to the results. The D.C. Health Department would have 90 days to devise and send a plan to the D.C. Council describing how to safely distribute the drug.

If no hurdles emerge, patients with proper physicians’ recommendations could be legally accessing the drug by spring 1999.

[Two weeks before the election, Congress appeared to erect such a hurdle, denying the district the funds to count and certify the results and essentially blocking it from becoming law.]

What happens if it fails?
Turner said he doubts local organizers would launch another ballot attempt on the issue.

AMR has collected petitions to circulate for a similar D.C. measure, now dubbed Initiative 60, but is first waiting to see how Initiative 59 fares at the polls next month, said spokesman Dave Fratello.

He also said his organization will target states for medical marijuana referendums in the next election cycle. "We know this is a long-term process," Fratello said.

Where can I read the text of the legislation?
On our Initiative 59 page.

John P. Martin can be reached at martinj@washingtonpost.com or by phone at 703-469-3179.