AUGUSTA -- One of the key elements of Question 5 is the provision that would allow nonprofit marijuana dispensaries to open in Maine.

For supporters, it addresses a major problem with the current law, which allows patients with a doctor's permission to use marijuana but gives them no easy way to get it.

"The critical thing is we already have medical marijuana legal for patients," said Wendy Chapkis, a sociology professor at the University of Southern Maine who supports the use of medical marijuana. "What we don't have is a fair and legal and safe way to access a substance the physician has said they can use."

But for opponents, the bill does not provide for oversight or strong regulations.

"Basically, the dispensary is a major growing operation and there is no limit to the size of the operation," said Kennebec/Somerset District Attorney Evert Fowle, president of the Maine Prosecutors Association, which opposes Question 5.

Maine is one of 13 states to allow the use of medical marijuana, a list that includes Montana, Hawaii, Rhode Island and California. In Maine, voters approved a 1999 citizen initiative that allows patients to grow their own medical marijuana or appoint a designated caregiver to grow it for them.

When it comes to dispensaries, one state that has recently taken a step in this direction is Rhode Island, where lawmakers overrode a gubernatorial veto earlier this year to approve a bill that allows up to three nonprofit dispensaries called "compassion centers" to open across the state.

The state department of health is working on making changes to draft rules, a process that is expected to be completed by the end of the year, said Annemarie Beardsworth, department spokeswoman.

The law will allow one dispensary to open the first year, with two more permitted statewide after that.

There are 900 patients and 700 designated caregivers in Rhode Island, which has a slightly smaller population than Maine. There is no registration system in Maine, so there's no way to know what the numbers are here, according to the Office of Substance Abuse.

In Rhode Island, Beardsworth said patients have the option of growing marijuana themselves or designating up to five caregivers who can grow and possess -- but not use -- the drug.

As dispensaries open across the state, Rhode Island officials anticipate the number of designated caregivers to drop significantly, she said.

Chapkis, co-author of a book called "Dying to Get High: Marijuana as Medicine," said Rhode Island may provide a good road map for Maine if voters on Nov. 3 approve Question 5. She said because the conditions for which doctors can recommend marijuana include serious illnesses such as AIDS and cancer, it's impracticable to expect people to grow it themselves. That's because Maine has a short growing season, it's expensive to grow it indoors and it takes a bit of skill, she said.

"It was always improbable many of those people would be healthy enough to garden," she said.

Yet not all who support medical marijuana are in favor of Question 5.

Maine Citizens for Medical Marijuana, a group that includes medical marijuana patients, said the oversight proposed for the dispensaries will be problematic.

"What we have for the ballot is government bureaucracy at work," said Don Christen, who recently got out of jail after serving two months on a conviction for violating the state's current medical marijuana law.

Christen, who is a patient and a designated caregiver, said many patients fear the Department of Health and Human Services and that another state agency, such as the Department of Agriculture, should be put in charge. Also, the $5,000 fee to open a dispensary is too high and prohibiting felons from running a dispensary isn't a good idea, he said.

"These are the people who know the most about growing marijuana," he said. "To exclude them would be just plain stupid."

Fowle said the Department of Health and Human Services does not have the type of law enforcement power to properly regulate a marijuana dispensary. Gambling is overseen by the state Department of Public Safety, and Fowle thinks medical marijuana dispensaries should be, too.

"I would think if I were trying to run a respectful, lawful dispensary I'd want state police to oversee it," he said.

Jonathan Leavitt, who leads the Question 5 campaign, said human services was chosen as the oversight agency because medical marijuana is a health issue.

In California, where Chapkis has studied medical marijuana, some dispensaries work closely with local law enforcement to ensure a properly regulated system, she said.

Chapkis said "it's crazy" that Maine would allow patients to get a doctor's permission to use marijuana, but that there's no easy way for them to get it.

"The way the law was drafted in 1999 meant most people were forced onto the black market to secure physician-recommended marijuana," she said.

Susan Cover -- 620-7015

scover@centralmaine.com