Perhaps you've heard folks speculate that this medical marijuana thing is a sham, a way for healthy people to smoke pot with impunity. Or maybe it's a strategy to legalize pot for everybody. Well, they could be partly right. Integrating medical marijuana into society makes pot more palatable to voters generally (it can't be simultaneously destructive and therapeutic, right?). Also possible: A shithead doctor could authorize pot for someone who isn't particularly ill.

Of the roughly dozen ailments that qualify a patient to use marijuana in Washington State, the biggest umbrella is "intractable pain." Skeptics fear that the aforementioned shithead docs could use this catchall for people who suffer garden-variety discomfort, which could be assuaged with over-the-counter medicine. So when folks say they use marijuana because their "back hurts," there are doubters.

But I'll tell you what. I worked for a few years at the ACLU of Washington, where part of my job was taking calls from people who had been arrested after using marijuana as medicine. By far, the most agonizing, inspiring stories were from people who suffered from chronic pain. Many had been in car or motorcycle accidents. Doctors helped them manage the constant pain of crunched bones and permanently disfigured muscles with massive doses of opiates, such as OxyContin.

But those drugs, taken in large doses for months on end, render humans drugged-out blobs. They can't eat right, can't shit properly—can't do anything. Many living like this become reclusive, even suicidal.

The people I spoke to then discovered that marijuana could be used in synergy with painkillers. By smoking a little bit of pot, they could take a fraction of the opiate medications prescribed by doctors and still subdue the pain while maintaining vigor. They wanted to go back to work, to see their friends, to fuck the living shit out of their wives again. Medical marijuana saved their lives. I spoke to about a dozen people like this. (This is to say nothing of pot's nearly magical properties to help cure nausea with the munchies, a benefit for countless people living with HIV/AIDS and wasting away on chemo, or the terminal patients trying to eke out whatever relief they can find in hospice.) So, yeah, some people may take advantage of medical marijuana—to the detriment of... nobody—while other people's lives and livelihoods and families depend on medical marijuana.

So, skeptics: Those are the sort of people who say they smoke pot because their "back hurts." And if you see a medical marijuana patient who "doesn't look that sick," just remember: That's what the best medications do.