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The state Senate killed Utah's chance of having medical marijuana anytime soon, with President Wayne Niederhauser casting the final, deciding vote.
SB259 sponsored by Sen. Mark Madsen, R-Saratoga Springs, died on a 14-15 vote.
Conservative Republicans and Democrats in the Senate joined together in support of the bill, but members who are medical professionals persuaded moderate Republicans that the issue needed more study and input from doctors and state agencies.
Two women who have traveled out of state for cannabis to treat their maladies were in tears and speechless after the vote.
"I just wish people would take time to educate themselves," said Tenille Farr of Spanish Fork, holding her infant, Gabe, who was born a few months after she learned she had Hodgkin lymphoma.
Christine Stenquist of Kaysville, who said she suffered from fibromyalgia and a brain tumor before getting relief with medical marijuana in Oregon, told Farr, "It's OK. We'll get a referendum."
Five of the six senators who spoke against the bill said they want medical marijuana eventually.
"A no vote doesn't mean you aren't intrigued with the idea, because many of us are, me included," said Sen. Evan Vickers, R-Cedar City.
Vickers is a pharmacist, and raised a host of objections, ranging from zoning ordinances to security cameras at marijuana operations to clerks who could work in the dispensaries.
"You could have a minimum-wage employee dispensing a dangerous controlled substance to a patient," he said, suggesting the Senate take the advice of Colorado's governor and go slow.
Sen. Todd Weiler, R-Woods Cross, said he had hoped to support the bill but "lost heart" when he found the fourth substitute still had flaws.
"This is, I'm concerned, an open door policy for abuse," Weiler said.
Weiler noted discrepancies between the way Madsen described the bill and the fourth substitute published Monday afternoon and debated Monday night.
For instance, Madsen said the Department of Commerce would take the lead in handling the patient medical cannabis cards, but the bill said four state agencies would do so jointly.
Madsen acknowledged that detail must have escaped the bill-drafter's notice.
Sen. Brian Shiozawa, R-Cottonwood Heights, is a physician and said he'd love to be able to offer cannabis to ease patients' suffering.
But, he said, "What I don't support is the way we've rolled this out," said Shiozawa.
SB259 was first published in late February, and Madsen had been scrambling since then to placate law enforcement and state agencies that would be involved in regulating cannabis.
On the floor Monday night, Madsen repeated his argument that legalizing medical marijuana could reduce the number of opioid deaths in Utah.
"I'm disheartened by the fear that seems to be the underlying theme of the opposition," he said. "Over time, [opponents]) became driven [more] by fear and by handwringing than by trying to get relief to the people who need it."