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Against warnings that Utah would be on a slippery slope to recreational pot legalization, the Utah Senate voted 16-13 Tuesday night to send the medical marijuana bill to a final vote.

SB259 is sponsored by Sen. Mark Madsen, R-Saratoga Springs, who describes medical cannabis as "highly regulated freedom" that is desperately needed by sick Utahns.

Other states have found that deaths from opiate painkillers dropped by 25 to 30 percent after medical cannabis was made legal, he said. "We give them this choice and we're going to see a lot fewer deaths," Madsen told his colleagues.

Sen. Todd Weiler, R-Woods Cross, led the opposition, arguing that Madsen had deliberately kept the bill under wraps to prevent a full airing. "This bill was kept secret. It was hidden," he said, noting that it was published only last week and that state agencies involved in implementing it have not been consulted in more than a cursory way.

"What is the hurry?" asked Weiler. "Marijuana has been banned in this state for decades."

He noted that legislative legal advisers say the bill could face a constitutional challenge, and questioned that the Department of Public Safety has not yet weighed in, even though its driver license database will be used in enforcement.

Weiler argued that the issue should be studied in an interim session, but Sen. Allen Christensen, R-North Ogden, joked that Utah might as well allow gambling next.

Christensen said opening the door to medical marijuana would cause all kinds of problems, even though "some might get relief from being high on marijuana."

His son has amyotrophic lateral sclerosis (ALS), one of the diseases for which a person could get a cannabis prescription in Utah.

"If I thought for a moment that would help cure him, I'd go to the ends of the earth," Christensen said. "It's just too great (a risk to the state) for me to consider it."

Sen. Wayne Harper, R-Taylorsville, said he liked some of the changes Madsen made in the bill, now on its second substitute. The bill may do some good, he said.

But, he said, most of the calls he's getting from purported constituents come from the Denver and Seattle areas.

"They are part of a large organization that is promoting and wanting to legalize marijuana in every state," Harper said, calling medical cannabis "creeping incrementalism."

A physician in the Senate, Sen. Brian Shiozawa, R-Cottonwood Heights, said he would love to be able to treat patients with cannabis, but wants the bill to be more thoroughly vetted and debated. "This is a huge policy change."

In the end, the bill drew bipartisan support.

Sen. Peter Knudson, R-Brigham City, told of a young girl he knows whose seizures have ended now that she's taking cannabis as part of a pilot project at the University of Utah, passed by the Legislature last year.

Sen. Gene Davis, D-Salt Lake City, said SB259 is a way for the Legislature to retain some control over cannabis. Neighboring states that have legalized marijuana for medical or recreational uses have mostly been pushed into it by voter referenda, he said.

"This is a pre-emptive strike for us." Davis said.

Twitter: @KristenMoulton