SALT LAKE CITY — David Cromar and his family are preparing for a move — one aimed at providing his son Holden with a better quality of life.



Eight years ago, at age two, Holden was diagnosed with a rare form epilepsy that left him with debilitating clusters of seizures that could strike sometimes hundreds of times each day.



Failed by a battery of pharmaceuticals, the Cromars sought alternative cures. In late 2013, they moved from Utah to Colorado, where legal medical cannabis finally gave Holden the most consistent relief from his chronic, painful tremors. Even a small amount of THCA oil — 5 milligrams — which Holden started in 2014, brought big results.



“Instantly, we saw a reduction in seizures,” the 37-year-old father of four from St. George said.



The Cromars reluctantly gave up medicinal marijuana some three years later, when the tug of family brought them back to Utah, where the drug remains illegal except in limited form— unless voters pass an initiative in November that would expand access.



The choice between the law and relief is a dilemma familiar to millions of Americans who live in a state where medical cannabis is not legal, or where access is restricted, but for Utahns who are members of The Church of Jesus Christ of Latter-day Saints, the issue is even more thorny.



Consuming medical marijuana here doesn’t just run afoul of state and federal law, it also conflicts with Mormon teachings, so its use could strip members of their good standing in church and leave them shut out of the faith’s sacred temples.



That leaves Latter-day Saints like the Cromar family with a set of emotional and uneasy choices: give up cannabis, quit the church, or uproot and move to a legal-use state where rigid church rules about cannabis use have bent with the law.



“That’s what’s funny,” said David Cromar, whose family is living in St. George, Utah, but plans to head back to Colorado. “In Colorado, we have full support from the church. It was a total non-issue.”



Such frustrations have drawn Cromar and his wife Mandi into political activism. The pair worked through the spring to gather signatures for an initiative petition to put a medical marijuana legalization question on the ballot for Utah voters this November. The drive was successful, despite a strong and strategic opposition coalition that included statements from Mormon church leadership.



“This is a worldwide organization with members not only in different states here in America, but in countries worldwide where patients have found improved quality of life, and they’re coming out against this,” a perplexed Cromar said. “I don’t get it.”



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Proposition 2 would legalize medical cannabis possession for patients suffering from an approved list of ailments such a chronic pain or cancer, and allow products with THC. Currently, only high-CBD products are allowed, and only for intractable epilepsy, so few patients qualify. Prior to January, polling by multiple Utah media outlets found that a healthy majority — 70 percent or more — of voters, including active Mormons, supported the initiative to expand medical cannabis access.



Church officials in April voiced concern over the possible impact that legal medical marijuana could have on the health and safety of Utah citizens. That was followed in May by the release of a 40-plus page legal analysis from a church-paid law firm that cited some 34 areas of possible “serious adverse consequences” of legalized medical cannabis, including that it would allow some individuals to legally grow the plant, that police would have difficulty distinguishing between legal and illegal cannabis, and doctors wouldn’t be required to monitor adverse health effects on patients.



Polls from the The Salt Lake Tribune and Utah Policy Daily conducted within weeks of the statement showed about a 10 point drop in support, down to roughly 66 percent. That’s an indicator of how much sway the church has — no matter the issue — in a place where 63 percent of the population identifies as Latter-day Saints, according to Bill Reel, a Mormon and former congregation leader, known as a bishop, who runs the podcast Mormon Discussion.



“Mormons like to tell you that they are independent thinking,” Reel told Cannabis Wire. “But the reality is that they very deeply do, choose, say, and follow the direction that their church gives them.”



If the church backed medical cannabis use, Reel suspects polling numbers would shoot up past 90 percent support. But don’t expect the church to give any specific direction about how members should vote, he added, because that’s not something the church will do. Instead, the faith’s leaders will tiptoe their opposition right up to the edge of an issue, without actually condemning it.



“That’s the game Mormonism is going to play,” said Reel, who predicts that the initiative will pass. “Because if it comes out and tells its people to vote against it and that marijuana is bad, but the people vote for it anyway … then the church loses credibility and it never wants to do that.”



A church spokesman did not respond to two requests for comment.



In Utah politics, the Mormon church seeks to maintain political neutrality. The church doesn’t endorse candidates or support any political party, but it does, however, speak up when it identifies issues that it believes present significant community or moral concerns.



In the past, that’s included throwing its weight behind campaigns to ban gay marriage and public statements on immigration policy, pornography, abortion, gambling and Utah alcohol laws.



On Capitol Hill, when the church weighs in on an issue pending before lawmakers — a majority of them church members — “it never loses,” said Steve Urquhart, a Mormon who was a Republican state senator for 16 years.



With a whisper or a nod to legislative leaders behind closed doors, bills appear to magically pass or die, including in 2016, when a medical marijuana legalization proposal then-Sen. Mark Madsen, a libertarian from Lehi, failed to advance, he said.



“Madsen had the votes to pass it, but the church shut it down,” Urquhart said.



November’s voter-driven ballot initiative present a far different challenge.



“It’s an open fight,” he said. “And the church does not have the same influence out in the open that it does behind closed doors.”



Proponents of the initiative say the church’s activism against medical cannabis in Utah is inconsistent with its lack of political engagement elsewhere.



Although in 2016 church leaders did speak from the pulpit about ballot measures to legalize marijuana in Arizona, California and Nevada, it has expressed no public position on medicinal uses of the plant in the 30 other states or the District Columbia where it is legal, said Christine Stenquist, founder of of the group Together for Responsible Use and Cannabis Education, or TRUCE.



“They have never intervened in any other state,” said Stenquist, who was diagnosed with a rare brain tumor in 1996 that doctors could only partially remove. “This is absolutely a case of ‘not in my backyard.’”



Stenquist speaks openly about vaping marijuana to relieve her severe chronic pain and migraines, remnants of the surgery that put her in a coma, left her deaf in one ear, and triggered a stroke. For years, the single mother was weak, and struggled to walk and speak. Internet research led her to consider medical marijuana five years ago, but she didn’t try it until she had the blessing of her father, who is a retired narcotics officer.

“After two weeks I was walking. Six months later I started driving,” said Stenquist, for whom advocacy naturally followed.



Already a lapsed church-goer, Stenquist said she formally resigned from the church last year in anticipation of a “tricky” fight over the voter initiative. Going forward, Stenquist said, she decided it was better to engage the church from outside the fold, where she would not be swayed by pressure to conform to its teachings or risk her membership.



“Now I feel like I can walk in a way with them that is just purely business,” she said. The church has “to react differently to me now than they do with LDS members,” she added, “because I don’t bow on bended knee to [their] words.”



In June, Stenquist said, a group of patients, many of them faithful LDS members, went to a meeting with a church lobbyist to essentially bear their “testimony about cannabis.” The room was full of religious compassion, she noted, but ultimately it did nothing to alter the church’s position.



For most Latter-day Saints, particularly the more orthodox, the pressure to cling to church teachings is very real; being seen as unworthy or straying from the rules can carry both social and religious consequences, Reel said.



Medical marijuana — which even church leaders have acknowledged appears to provide health benefits for some — presents a complication for members, most of whom likely perceive it as outside the boundaries of what they could use. That’s because as an illegal substance it violates the faith’s proscribed health code known as the “Word of Wisdom,” Reel said.



Drawn from Mormon scripture (Doctrine and Covenants 89), the health code prohibits the use of alcohol, coffee, tea, tobacco, and illegal drugs. Adhering to it’s guidelines is just one of several rules Mormons must keep — including maintaining a belief in God, supporting church leaders, being honest and paying tithing — in order to maintain good standing in the church.



That standing is evaluated annually by a local bishop through a series of questions. Falling short, can mean being unable to hold leadership roles in church, or the loss of one’s “recommend,” the endorsement needed to access church temples, where the most sacred Mormon rituals and ceremonies are performed.



In states where medical marijuana is legal, Reel said, the church doesn’t loosen its rules, but it does twist in acknowledgment of the law, even if the faith may still object in principal to marijuana use.



“If medical marijuana passes, it could become a gray area,” he said. “The wouldn’t prevent it, but a local bishop might still say you can’t use it because it’s still viewed as a questionable choice for good Mormons.”



Church insiders sometimes refer to such situations as “bishop roulette,” in which one leader follows strict standards, while another’s response may not. And even then, it can depend on the individual church members needs.



Four years ago, Brian Stoll was inactive in church and using marijuana to cope with severe lingering pain after he plunged 10 feet and landed on a steel beam in a darkened theater on the campus of the church-owned Brigham Y0ung University in 2012. Stoll broke his neck and back.



“Lots and lots” of opioids provided some relief, he said, but also left him so altered that he couldn’t function well-enough to work. He lost his job, had to quit school, racked up thousands in medical debt and fell away from church.



Six months after stumbling onto marijuana, “it all came back,” Stoll said. “I start feeling better. I can go back to school, back to work and I can get my spiritual life back as well, and maybe start going back to church.”



Stoll’s bishop was well-aware of his medical struggles and raised no objection. Then Stoll wanted to get married. His then-girlfriend, Rachael, was a “straight-laced” follower who made it clear it would be “a temple wedding or nothing,” he said.



The bishop balked. Despite protestations that returning to opioids would set him back both physically and emotionally, Stoll was told he had to give up marijuana and stay off it for at least six months before he would be allowed the necessary recommend.



“Come what may, I was not going to lose her over something I could control,” Stoll said.



Now, almost three years after his November 2015 temple wedding, the Stolls have a five month-old daughter and are regulars at church.



Stoll said giving up marijuana for opioids was “the hardest thing I’ve ever done” and something he never wants to do again. That’s why he’s joined the ranks of activists who have testified at legislative hearings and are working to get the voter initiative passed. No one, he said, “should have to choose between their health and their freedom.”



For their part, the Cromars believe the best choice is to return to Colorado, where Holden’s suffering can be eased through doses of various cannabinoids.



Even if the voter initiative passes, David Cromar said, access won’t be available until 2021 and Holden shouldn’t have to endure another year of medical instability. But he and his wife are still committed to helping change Utah law. Cromar has appealed to friends and family in social media posts, imploring them to vote in favor.



“We’re 100 percent invested in this effort,” said Cromar, who with his wife Mandi spent a late July week in Colorado looking at new homes. “Because, we want to come home for Thanksgiving and Christmas and we don’t want to be felons when we do.”



Despite bouts of anger, religious doubt, and plenty of seemingly unanswered prayers, Cromar said his family’s journey from traditional prescription medications to medical cannabis in all its forms has actually bolstered his faith.



“I actually have a stronger belief in God and that everything we need on this earth is given to us by him,” Cromar said.



Given a chance to sit down with his church’s president, Russell M. Nelson, Cromar said he would ask whether the former heart surgeon who now shepherds the 16 million-member faith believes only in seeking health through interventional medications, or if he also believes in natural cures.



“I would say, do you believe that God put everything we need on earth to thrive?” Cromar said. “Because I do … and I side with God’s creation.”