Marijuana as medicine is increasingly making sense in America. There are now some 40 above-ground marijuana-growing and distributing networks, largely left alone by law enforcement officials. Bainbridge Island until recently hosted the Green+Cross Patient Co-op (Seattle Weekly, 8/2), busted by cops in May. With some 4,000 registered members, San Francisco’s Cannabis Buyers Club is the largest in the nation; it works with the tacit approval of City Hall, in part because it services an AIDS-heavy membership.

In the Bainbridge case, JoAnna McKee and Ronald “Stich” Miller were providing marijuana to some 70 people throughout the Puget Sound region, mostly AIDS cases. Both use marijuana themselves to alleviate pain from nonlife-threatening conditions. (Her pain is caused by spine and neck injuries; he suffers from arthritis.)

McKee and Miller both cut a counter-culture profile, but medicinal marijuana is not an issue owned by the usual suspects. One self-described conservative Christian from Poulsbo with ties to the Religious Right’s Family Research Council has been using marijuana for pain from medical treatments for testicular cancer. He backs the anti-gay rights initiative but also hopes “to bring some credibility to the [medical marijuana] issue and bridge a gap.”

So far, the feds aren’t listening. (Speaker Newt Gingrich has made some comments about being open to the idea of legalizing drugs, but nothing has come of that.) Last July, McKee attended a National Institute of Drug Abuse conference in Virginia, hoping to convince the federal government to grant San Francisco medical researcher Dr. Donald Abrams permission for a study into the qualitative differences between marijuana and Marinol, a pharmaceutical product from the plant. It was no-go. That potential test is a political thicket the War on Drugs prefers not to enter, especially since the study would likely confirm widespread anecdotal evidence favoring marijuana, which costs less and is less potent.

Local courts are listening, however. Last month Tacoma attorney Ralph Seeley won the first round of his legal fight to use marijuana to combat nausea and pain from eight operations to his spine. A Pierce County judge ruled the state constitution required that marijuana be available as a prescription treatment. Seeley, who suffers from a rare form of cancer that has spread to his spine, liver, and lungs, told the court he couldn’t keep pills down and argued that without marijuana he would be forced to suffer. The Attorney General’s office is vowing to fight the decision at the state level. That could bring the legal issue right up to a federal bench. (McKee and Miller had charges against them thrown out of the Kitsap County Superior Court in mid-September due to a bad search warrant. Prosecutors there are considering a state-level fight.)

Devolution of federal power to the states might provide another avenue for liberalization of pot-by-prescription. Daniel K. Benjamin of The Independent Institute in Oakland, California, advises advocates to “forget legalization at the federal level—it’s a pipe dream.” Instead, he proposes a constitutional alternative rooted in the 10th amendment (assigning unreserved powers to the states). “We need simply to amend the Drug Abuse, Prevention, and Control Act to eliminate the federal monopoly on drug policy.”

Serious back-to-the-states Republicans might agree. “State governments would be permitted to pursue any drug policies they choose,” explains Benjamin. “The federal role would consist of preventing interstate violations of the new laws.”