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The Utah Senate gave preliminary approval to a bill that would legalize medical marijuana in the state, although the ultimate fate of the bill is unclear amid fears some senators may change their vote when the bill comes up for final passage, possibly later this week.

The Senate voted 15-13 to move SB73 to a final vote after tearful pleas from its sponsor, Sen. Mark Madsen, not to "let down" the suffering patients who say they need medical marijuana and warnings from opponents of increased risk of addiction and teen use.

The vote came hours after the LDS Church softened its opposition to the proposal while expressing continued concerns about how the drug would be grown, dispensed and regulated.

An emotional Madsen, R-Saratoga Springs, told the story of Alicia Sperry, whose son Carter has been diagnosed with terminal brain cancer. Chemotherapy can prolong Carter's life, Madsen said, "but Alicia wants to add life to the days he has left. … Please don't let them down."

The temporary victory came as a relief for patients and supporters of Madsen's bill. But Christine Stenquist, president and co-founder of the group Together for Responsible Use and Cannabis Education, said she believes at least one vote may change and lead to the bill's defeat later this week.

"It was a struggle to get those 15 on board this weekend, and I don't think we'll have them [on final passage], which means we're left with no other choice" but to go ahead with an initiative, she said.

Because of the tight timeline this year, the initiative may not go forward until 2018.

Sen. Brian Shiozawa, R-Cottonwood Heights, had expressed a series of concerns about Madsen's bill, but ultimately voted in favor of it. Madsen said he planned to go back to some of those whose backing might be tenuous and some who opposed it to see whether he can solidify support before the final vote.

One of those who was adamantly opposed to SB73 was Sen. Allen Christensen, R-Ogden, who disputed those who said marijuana posed a safer alternative to opiate-based painkillers. Blaming opiates for deaths, he said, "is like demonizing guns because people commit suicide with guns."

"[We're told] whole-plant marijuana cures everything from ingrown toenails to cancer," but the evidence is anecdotal, he said, and the harms to society are not. "By helping the few, are we condemning the many? Addictions, DUIs, public intoxication … teachers high in the classroom. Yeah fears, but it's just as possible as the supposed benefits."

On Monday, in its third statement on the issue, The Church of Jesus Christ of Latter-day Saints said a series of amendments — including only allowing patients to buy refined cannabis products, rather than the "whole plant," including the bud — result in a "substantial improvement" to the bill.

"In our view, the issue for the Utah Legislature is how to enable the use of marijuana extracts to help people who are suffering, without increasing the likelihood of misuse at a time when drug abuse in the United States is at epidemic proportions, especially among youth," church spokesman Eric Hawkins said in a statement.

"We continue to urge legislators to take into account the acknowledged need for scientific research in this matter and to fully address regulatory controls on manufacture and distribution for the health and safety of all Utahns," Hawkins said.

The church is the state's predominant faith, and a vast majority of lawmakers are members. Madsen said earlier that the church's opposition caused at least one member to no longer support the bill.

Madsen said he believes his bill deals with the church's manufacturing and distribution concerns, and he is confident his fellow senators will agree if he can persuade them to listen.

"I think I can address these points, so I'm very encouraged by the statement from the church and I think we're moving in the right direction," Madsen said.

Legalizing medical marijuana should have no impact on use of the drug by children and teens, he said.

"I know that any kid that wants it can get it at any high school in 10 to 15 minutes, and I never suggested that this bill is going to cure that problem," Madsen said. "The final product is going to be so much more expensive than what they can get on the street; the idea this is going to contribute to more youth use is questionable at best."

Meanwhile, the Senate on Monday passed on it's way to the House the competing bill, sponsored by Sen. Evan Vickers, R-Cedar City, which would legalize cannabidiol — or CBD — extracts that do not contain THC. The CBD products have been useful in treating epilepsy and have potential uses for other illnesses.

Vickers has pitched his bill as an incremental approach that will help some people while allowing researchers to develop more reliable studies to potentially expand the program in the future.

"At the end of the day, if you're looking for gold-standard science that says CBD or THC do what we want it to, those studies aren't there," Vickers said. "We do know THC can alter young minds, it can permanently alter a young mind. We know THC can damage adults and change perceptions … so we need to be careful as we move forward."

Madsen, in making his case for his bill Monday, said Vickers' bill "continues to treat most patients as criminals."

Some have had to leave their homes and move to a state where medical marijuana is legal; in at least two cases, parents have taken their children and fled the state after authorities asked about giving their children medical marijuana.

"Too many have become medical refugees," Madsen said.

One of those "medical refugees" is Sierra Riddle, whose son Landon was diagnosed with an aggressive blood cancer at 2 years old. Chemotherapy left the infant at half his body weight and he stopped talking and walking and eating.

"They told us there was nothing they could do. He wasn't tolerating chemo, and he was going to die," Riddle said. The St. George mother took him to Colorado in 2013, and he was the youngest person at the time to get a medical marijuana card. His strength returned. Doctors resumed treatment, and the cancer has been in remission for three years, but the Riddles are still forced to live in Colorado Springs.

"It's super terrifying that they could take my child away because he's a medical marijuana patient," she said of Landon, who will turn 6 on Friday. "It's amazing that Landon is even celebrating a birthday. He was given only an 8 to 10 percent chance to live from his cancer, and, mixed in with his other complications, it's been absolutely amazing to see what medical marijuana did for him."

Vickers' bill is now moving to the Senate. If Madsen's measure passes, Vickers said he hopes the two bills can be reconciled. Madsen said he doesn't believe the two can be merged.

"I do not think it's worth taking what I think is really a half-step back to see if CBD alone might do some of the things we know the whole plant can do," Madsen said.

Twitter: @RobertGehrke