The 2004 elections produced the tenth state to legalize marijuana for medicinal purposes. Voters approved the Montana Medical Marijuana Act, known as I-148 on the ballot, by a margin of 62% to 38%. The vote came in a conservative state that voted for President Bush and against gay marriage by nearly the same margin.

The Montana initiative creates a registry system for patients with specified diseases and medical conditions. Upon recommendation by their doctors, patients can apply with the state Department of Health and Human Services for ID cards. Cardholders will not be subject to arrest if in compliance with the initiatives quantity limitations. While this portion of the new law will not go into effect until the Department of Health and Human Services drafts applications and administrative rules, the law also creates an affirmative defense to prosecution for medical marijuana patients effective immediately.

Montana becomes the second state to approve medical marijuana this year. Vermont approved it through the legislative route in January. Alaska, California, Colorado, Hawaii, Maine, Nevada, Oregon, and Washington have workable medical marijuana laws. Arizona voters approved a similar measure in 1996 that has proved unworkable because it calls for doctors to prescribe (as opposed to recommend) marijuana, making them liable to DEA sanctions.  

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