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Possibly the most controversial topic on the issue is the issue's structure or form; should marijuana be "grown" and smoked by patients or should it be provided by doctors in "pill" form to be ingested by those with debilitating and/or terminal illnesses? States like California say that the growing of "pot" in or around a patient's home, in small to moderate amounts, by the patient prescribed, should be allowed, while the federal government says that in order to control the drug, medicinal marijuana, if legalized, should be "manufactured" by pharmaceutical companies, in pill or capsule form, throughout the United States, and distributed only by drug stores and pharmacies. The "structure" on how the drug should be made and distributed is most certainly the prime topic at hand concerning the issue of medicinal marijuana for possible relief of symptomatic debilitating and terminal illnesses and diseases.

Another issue of conflict concerning medicinal marijuana is: should each individual state in the United States hold the power to write, regulate, enforce laws, etc., concerning the use of the drug for medicinal purposes, or should the federal government ultimately hold the power to write, regulate, enforce laws, etc., concerning medicinal marijuana, just as it retains the right to penalize those who grow, use, distribute, etc., marijuana illegally? According to the Associated Press, Justice Sandra Day O'Connor says that legal power concerning the use of medicinal marijuana should be left in the hands of individual states. "The states' core police powers have always included authority to define criminal law and to protect the health, safety, and welfare of their citizens," said O'Connor. However, according to the Coalition for Medical Marijuana-New Jersey, federal authorities argue that currently, "marijuana has no accepted medical uses in the U.S." At least, that was the response when Attorney General Paula Dow asked federal officials in April 2011, "their plans to punish New Jersey's Medicinal Marijuana Program participants." According to many patients with debilitating, terminal diseases, the use of marijuana aids in pain relief, appetite stimulation, etc., and therefore, should be legalized by the federal government. According to the Associated Press, an Oakland, California woman, suffering with scoliosis, says she was partially paralyzed until she was prescribed and began using marijuana for medicinal purposes.

In conclusion, as the United States slowly makes the transition to legalize marijuana for medicinal purposes, controversy concerning the structure of the drug -- if it should be grown or manufactured and distributed, in order to control its use, will be among the issues that must be worked out between the "powers that be": the states, individually, and the federal government. The states and the federal government must also come to a conclusion on which will retain ultimate power to manufacture, distribute and ultimately control marijuana once it is legalized nationwide for medicinal purposes.