Voters in seven states are deciding on initiatives expanding the availability of marijuana, including several on medical marijuana and one that would completely legalize the drug for adults.

Millions of voters in California will also decide on a measure that would force the state to fund $3 billion in controversial stem cell research. The move, if approved, could push the state past federal limits on stem cell funding and put it at the forefront of U.S. research in the field.

Montana voters are weighing in on a medical marijuana ballot initiative that would allow patients to grow or possess limited amounts of the drug with a doctor’s approval. A similar measure is on the ballot in Ann Arbor, Mich., which could allow the town’s residents to use or buy medical marijuana penalty-free and pay a $100 fine for a third offense.

If the ballot measure is approved, Montana would become the 10th state to allow some form of legalized medical marijuana statewide. Oregon, which already allows some medical marijuana use, also has a ballot initiative today allowing patients to buy the drug from state-regulated sources.

Rob Kampia, executive director of a pro-legalization group called the Marijuana Policy Project, says his organization spent $2.1 million on statewide initiatives, including $110,000 spent getting the 22,000 signatures required for the Montana ballot.

Missouri voters living in the city of Columbia are also voting on a pair of propositions authorizing medical marijuana.

In Massachusetts, voters in 12 districts will cast ballots on nonbinding measures that could liberalize laws on marijuana possession.

Medical marijuana has become a flash point between federal drug officials and legalization activists. John Walters, who directs the White House Office of National Drug Control Policy, has sharply criticized medical marijuana policies for sending a mixed message to youths about the dangers of illegal drugs. He has also lobbied against medical marijuana initiatives in various states, sparking accusations of illegal advocacy from legalization supporters.

Walters’ office did not return requests for comment Tuesday.

Meanwhile, Alaska voters are facing a far-reaching ballot initiative that would remove all penalties and prosecutions for marijuana use and possession by adults over 21, making Alaska the only state in the country to completely legalize cannabis. Alaskans are already allowed to possess up to 4 oz of marijuana in their homes under a state court order, but the new measure would allow marijuana transport and also clear the way for regulation and taxation of the drug.

“If this does what it’s supposed to do then you’d have marijuana sold similarly to alcohol,” Kampia says.

If passed, the law would likely spark a confrontation with federal authorities since national drug laws clearly prohibit marijuana sale and use.

"It is immediately an issue that the Supreme Court will have to deal with," says Rosalie Pacula, PhD, an economist at the Drug Policy Research Center, part of the RAND Corp.

The measure faces an uphill fight. Kampia says a private poll sponsored by his group in early October found that Alaskans opposed the measure 50 percent to 42 percent with 8 percent undecided. Government officials, including Republican Gov. Frank Murkowski, have spoken out against legalization.

California Stem Cell Question

Bay-area ballots in Oakland and Berkeley, Calif., include local questions expanding access to already-legal medical marijuana. But statewide ballots also include Proposition 71, which would require the state to issue $3 billion in bonds to fund a stem cell research institute.

The move would help the state sidestep an August 2001 White House directive in which President George Bush ordered the federal government to limit funding of stem cell research to cell lines already in existence at the time.

An Oct. 1 poll of 1,086 likely voters in California pegged support for the measure at 54 percent with 37 percent opposed. The poll, conduced by Field Research Corp., had a 4.3 percent margin of error.

Supporters of the stem cell initiative got a boost from Republican Gov. Arnold Schwarzenegger, who backs the proposal.

By Todd Zwillich, reviewed by Michael W. Smith, MD

SOURCES: Robert Kampia, executive director, Marijuana Policy Project. Alaska 2004 state ballot. Montana 2004 state ballot. Ann Arbor, Mich., 2004 ballot. California 2004 state ballot. Rosalie Pacula, PhD, an economist at the Drug Policy Research Center, part of the RAND Corp.