Missouri became the 32nd state to legalize medical marijuana Tuesday, with voters passing an amendment to the state constitution.

“It was a historic day for Missouri patients and veterans,” said Jack Cardetti of New Approach Missouri, which pushed for the amendment.

“Missourians suffering from cancer, epilepsy, PTSD and other debilitating illnesses can now finally work with their doctors to determine if medical marijuana is an appropriate treatment option.”

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The measure, called Amendment 2 on the ballot, will change the state constitution to allow doctors to prescribe cannabis for a slate of 10 medical conditions. It had 65 percent approval with 3,066 of 3,256 precincts counted Tuesday night.

Sales will be subject to a 4 percent state tax, with proceeds going to fund services for military veterans. It’s expected to generate about $24 million a year.

The vote was complicated because two other medical marijuana initiatives were on the ballot.

Amendment 3 would have changed the state constitution under a plan by Springfield physician/lawyer Brad Bradshaw, creating a medical marijuana research institution led by Bradshaw. It had received 32 percent approval.

Proposition C would have changed state law. It was similar to Amendment 2, but with different taxation levels and, because it’s a statute rather than a constitutional amendment, the legislature could change it. It had received 42 percent approval.

Going into Tuesday’s election, 31 states and Washington, D.C., had already legalized medical marijuana. Most other states, including Missouri, allowed for cannabis oil with little or no THC, the ingredient in marijuana that produces the “high” that recreational users crave.

Missouri’s legalization campaign, like others that have cropped up since Colorado and California approved some of the earliest medical marijuana laws, had a good deal of money behind it.

New Approach Missouri raised more than $1.5 million, including $250,000 from Drug Policy Action, a New York nonprofit dedicated to changing drug laws.

The main opposition group, Citizens for Safe Medicine, raised only about $6,000.

Amendment 2 was the broadest of the three legalization efforts on the ballot. It was the only one that allowed people who qualify for medical marijuana to grow their own (up to six flowering plants).

Patients will need a note from their physician certifying that they have a medical condition that qualifies them for marijuana use. Amendment 2 includes some specific conditions like cancer, epilepsy and glaucoma, but also says that any terminal illness qualifies, as does “any other chronic, debilitating or other medical condition,” for which a doctor recommends marijuana.

That makes doctors the gatekeepers to legal marijuana in Missouri, which is a role most of the state’s major physician groups don’t relish.

The medical marijuana ballot questions were opposed by the Missouri State Medical Society, the Kansas City Medical Society and others.

The physician groups, as well as Citizens for Safe Medicine, argued that while some components of cannabis may have medical benefits, they should be taken in products tested by the Food and Drug Administration with standard dosages and potency.

“Cannabis is a raw botanical,” Citizens for Safe Medicine said. “Most modern physicians, pharmacists, and medical practitioners do not treat illness with raw plants.”

The groups also said there are health risks associated with smoking anything, including marijuana, and cognitive risks for frequent marijuana users, especially adolescents.

But Paul Callicoat, a physician from Joplin who campaigned for Amendment 2, said he and some colleagues will be willing to help their patients try it.

“I think the doctors, at least in my neck of the woods, they’ve receptive,” Callicoat said.

To implement Amendment 2, the Missouri Department of Health and Senior Services will now have to set limits on how much people with qualifying conditions are allowed to purchase from dispensaries and how much they’re allowed to possess at one time.

Marijuana remains entirely illegal at the federal level, and Attorney General Jeff Sessions has said he intends to enforce the ban. But a congressional statute in effect since 2014 prohibits federal agents from seizing marijuana grown for medical purposes in states where it’s legal.

Jane Gold (left) said she wants to try marijuana for her arthritis. Julita Latimer said she wants to open a dispensary. The two chatted during a watch party Tuesday for Amendment 2, which legalizes medical marijuana in Missouri. Andy Marso amarso@kcstar.com

Kansas City resident Jane Gold, 69, said she wants to try medical marijuana because she’s in pain from knee and hip replacements and she’s allergic to opioids.

“I have lots of medical issues, the main one being arthritis,” Gold said.

Gold said she had worked on petition drives to get medical marijuana on the ballot for years.

Most of the people at an Amendment 2 watch party in Kansas City Tuesday night were younger than her, but she said she thought the measure probably got strong support from her generation at the ballot box.

“We grew up in the ‘60s,” Gold said. “And we smoked pot back then.”

This story was originally published November 06, 2018 10:37 PM.