Orange County will begin licensing medical marijuana use and issuing identification cards to patients who are entitled to it under a plan approved by county supervisors Tuesday.
The decision marked a surprise turnabout from just three months ago, when the proposal initially seemed doomed to failure.
Under the plan, the county will create a system to identify patients eligible to use marijuana for medical purposes, and issue them identification cards, validate prescriptions and monitor the qualifications of care providers who dispense the drug.
It was a departure from Orange County's usual conservative position, one that overrode objections by the county's top law enforcement officials and put the county squarely in the middle of a years-long tussle between federal and state governments over the legality of marijuana use for medical purposes.
Federal law treats marijuana as an addictive substance with no medical value, and the U.S. has so far resisted efforts to change that designation or give states leeway to make their own rules.
But Californians, through the adoption of Proposition 215 in 1996, voted to allow doctors to recommend marijuana to their patients. Studies have found that the drug helps patients who have cancer, HIV and other diseases to overcome pain, nausea and loss of appetite.
Since the issue first surfaced three months ago in Orange County, advocates of medical marijuana use have lobbied intensely to convince the supervisors of its worth, and ultimately succeeded in changing enough minds to win a decisive 4-1 vote.
Advocates said their pitch to the all-Republican board focused on fiscal soundness -- that issuing the IDs would eliminate wasted court costs and prosecution time on medical possession cases.
Though 32 other counties, including Los Angeles and Riverside, have already moved forward with plans, getting Orange County's approval was a milestone.
"By having this in Orange County, it sends a message to other counties throughout California that it's time to move forward," said Aaron Smith, the statewide coordinator for Safe Access Now, a medical marijuana advocacy group. "If Orange County can do it, anybody can do it."
The bill's passage was also a testament to the vociferous advocacy of board Chairman Chris Norby, who first floated the proposal, and the consensus-building skill of Supervisor Bill Campbell, who resuscitated the proposal after it failed on a first vote by getting supervisors to find enough common ground to give it another chance.
Campbell and Supervisor Patricia Bates, who both voted against the proposal the first time, switched their votes Tuesday.
This time around, only Supervisor Janet Nguyen voted against it.
By approving the proposal, supervisors declined a recommendation to wait until a court case in San Diego County challenging the legality of the marijuana program is resolved. San Diego lost its challenge at the trial level but is now appealing
In researching the plan's use in other jurisdictions, county staff found that applications for the identification card were fewer than expected, easing concerns that it would be abused by people seeking a false justification for drug use and possession.
Though an estimated 16,000 patients would be eligible for the program in Orange County, officials said they expect to distribute about 800 of the state-processed cards per year. The estimated cost of about $64,000 is expected to pay for itself with the fees assessed on cardholders -- $150 for some patients, and $75 for those with Medi-Cal coverage.
The primary benefit of the program, when it takes effect within the next four months, will be to provide patients with an identification card they can present to law enforcement authorities if questioned about marijuana possession.
Marla Jones, a Huntington Beach resident who was encouraged to use marijuana by her doctor to treat pain from an amputated leg, said it would give her "peace of mind."