In Utah, Prop 2, the initiative that could legalize medical marijuana, has met opposition from religious and moral concerns unique to a state where the majority of voters are Mormon. Legalization efforts, led by the Utah Patients Coalition (UPC) and Together for Responsible Use and Cannabis Education (TRUCE), have had to face off with Drug Safe Utah (DSU), a coalition of ultra-conservative organizations, who hold an outsized sway within the state, and which include the Utah Medical Association, The Sutherland Institute, the Utah Eagle Forum — and, most importantly, the Church of Jesus Christ of Latter-Day Saints (LDS), also known as The Mormon Church.

Fifty-five percent of Utahns identify as Mormon, a religion whose membership is among the most politically and socially conservative in the United States. Mormons practice a strict health code called the Word of Wisdom, a key tenet that forbids coffee, tea, tobacco, alcohol, and mind-altering drugs. Whether that includes medical marijuana, however, is up for debate — but at the very least puts the faith at odds with the national trend of adult use legalization and more lenient medical programs like California's.

“The Church does not object to the medicinal use of marijuana, if doctor-prescribed, in dosage form, through a licensed pharmacy,” says Elder Jack N. Gerard of the Seventy of the LDS Church, and a member of the coalition opposed to Prop 2. “We are deeply concerned by the history of other states that have allowed for medical or recreational use of this drug without the proper controls and have experienced serious consequences to the health and safety of their citizens.”

Since California legalized medical marijuana in 1996, with what was admittedly a fairly liberal, poorly regulated program, cannabis legalization initiatives have seen an astonishing success rate, with more and more states joining the ranks of legalized marijuana year after year. When including medical cannabidiol (CBD), a supermajority of states have some form of legalized adult use and medical cannabis.

Passing legal marijuana laws in progressive states like California, Washington, Oregon, and Massachusetts seems a bit like shooting fish in a barrel, with their fairly left-leaning populaces and greater tolerance toward medical and recreational cannabis use. But as the wave of legalization reaches the middle of the country, reform advocates face different battles than their coastal counterparts.

This election cycle, Utah is among three red-leaning states (and Michigan) that are considering legalization initiatives, including Measure 3 in North Dakota to legalize an adult-use market, and three separate medical initiatives in Missouri.

As legal marijuana continues its march forward, will legalization advocates and drug policy reform organizations continue their winning streak as they venture into more conservative territory?

Prop 2’s largest donor is Washington D.C.-based Marijuana Policy Project (MPP), a drug policy reform organization dedicated to changing state laws to reduce or eliminate penalties for the medical and non-medical use of marijuana. MPP has pitched in $315,257 in cash and in-kind contributions toward the initiative’s success. Opposition efforts have raised $1,262.075.

National Spokesperson for MPP, Mason Tvert, thinks that if there is a difference between legalization approaches in conservative and more progressive states, it might be a matter of degree. “Honestly, I think that they are really quite similar,” he says. “Regardless of the politics of the states, we’re up against decades of anti-marijuana propaganda, and typically law enforcement communities are vocally opposed.”

Tvert believes that Utah may be an outlier when compared to other conservative states considering legalization. “There has certainly been a difference with it being the home of the LDS Church. There really isn’t a similar situation you can point to in any other state.”

When it became clear that Prop 2 was likely to pass without the Church’s stamp of approval, as frequently happens with issues like liquor, gambling, and gay rights, representatives from the Church, the legislature, and UPC went behind closed doors to craft a compromise that mollifies Prop 2 opponents, but has severely crippled support for the initiative.  

Representative Gage Froerer, Republican from Huntsville, Utah, acknowledges that the state legislature is a de facto arm of Mormon Church leadership, saying, “They get away with it because most Utahns are Mormons.” Some 88 percent of Utah legislators practice the faith.

“There’s  definitely a different approach that we would take in more conservative states than more progressive states,” says Jolene Forman, staff attorney at the Drug Policy Alliance, a drug policy reform organization working to end the American War on Drugs. “In conservative states, they’re not interested in real legal marijuana anything beyond medical access. We have to acknowledge that the laws are not about creating a stepping stone to legalization, but to creating access to legal medicine.” So in a state like Utah, cannabis reform advocates may need to maintain a strict medical focus in order to gain support from a conservative electorate.

North Dakota voters passed legal medical marijuana in 2016. But in the Roughrider state, it’s not religion in the way of legalization, but the legislature. “The impetus for Measure 3 is [that] the legislature dragged their feet on the medical marijuana bill that passed with 64 percent of the vote,” says Cole Haymond, a consultant for Legalize ND. “They took the teeth out of the bill that doesn’t even cover PTSD. No one has access, they just now started accepting applications for medical marijuana, go figure, right before the election.”

LegalizeND is a truly grassroots effort led by David Owen, a student at the University of North Dakota. They have received small donations from travel writer and marijuana advocate Rick Steves, and the National Organization for the Reform of Marijuana Laws (NORML), who have also lent support and time to the initiative.

NORML’s Executive Director Erik Altieri has been encouraged by the lack of “outright resistance” in North Dakota, but still believes there are obstacles to gaining support in conservative states. “What is more the challenge is talking about [marijuana legalization] in a way that resonates with people in that state,” he explains. “In conservative states, it’s a lot more about the issue of state’s rights, personal freedom, and civil liberties. As long as you can talk about it in a way that reflects the values of the community, that’s better.”

Haymond believes that Measure 3, currently polling with 51 percent supporting it, enjoys wide support from conservative folks because North Dakotans have a fierce libertarian streak strong on personal freedom and state’s rights.

But for the opposition, led by former attorney and judge Robert Wefald, it is personal. “He lost his son in a car accident where the driver was drunk and high,” Haymond explains. “I’m sensitive to something like that, and we don’t touch that with this campaign. And while I respect him as a former state attorney and judge, I also respectfully disagree with this reefer madness.”

Meanwhile in Missouri, voters are considering three separate citizen initiatives to legalize medical marijuana: Missouri Amendment 2, Missouri Amendment 3, and Prop C. Jack Cardetti, Spokesman for New Approach Missouri, the campaign supporting Amendment 2, is very optimistic that voters will pass medical cannabis legalization, saying, “it is less a question of, ‘is it going to be legal?’ as to ‘which one?’”

Missouri is the least conservative of the red-leaning states voting on legal marijuana initiatives this election cycle, but President Trump still took the state by more than 19 percentage points, and Missouri’s governor, house, and senate, are all held by Republicans. Cardetti says that Amendment 2, the most likely to pass of the three, has strong bipartisan support, as well as strong support from libertarians and veterans.

New Approach Missouri has received strong financial support from Drug Policy Action, the advocacy and political arm of the DPA, in addition to more than 2400 individual donors. Only one campaign committee, Citizens for SAFE Medicine, registered any opposition to the legalization initiatives, but they have so far failed to raise or expend any funds.

As legalization continues to progress, DPA’s Forman stresses the importance of having local conservative voices at the table, especially patients who are willing to share their stories with legislators, like the children suffering from intractable epilepsy or older folks with Parkinson’s Disease or cancer. “Those stories have really motivated politicians," she says. "It’s hard to see people suffering. It changes how legislators vote. We can’t discount how impactful personal stories are.”

In the end, Forman believes that legalization is only one aspect of larger issues pertaining to human rights and access to medicine. “There are plenty of conservative voices who have seen the benefits, and don’t want to be breaking the law.”

Back in Utah, Rep. Froerer says, “the big question on the compromise bill is, if [Prop 2] doesn’t pass, will the Church still agree to the compromise bill?” Utah’s Republican Governor Gary Herbert has called for a post-election legislative special session on Prop 2, regardless of its success at the polls. “Whether it passes or fails, we’re going to arrive at the same point and conclusion, which is going to be of benefit to the people of Utah,” Herbert said at a press conference, where he announces the session.

But Froerer expresses some skepticism: “If it passes, there’s no question they’ll go forward with the compromise. If it doesn’t pass, the people may say they’re not going to go forward. That’s the interesting part, to see if they’ll live up to what they say.” As for Utahns going to the polls, they may end up feeling like the decision has been already made for them — will their vote on the matter change anything at all?