WASHINGTON -- A Supreme Court ruling means state laws allowing medical use of marijuana don't protect sick people from federal prosecution.

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In a 6-3 ruling Monday, justices found users can be prosecuted under a federal ban on the drug -- even if used under a doctor's order.

The decision is a defeat for marijuana advocates who have gotten 10 states to allow the drug's use to treat various illnesses.

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The use of marijuana for medical purposes is currently legal in Alaska, California, Colorado, Hawaii, Maine, Montana, Nevada, Oregon, Washington, and Vermont, according to the Marijuana Policy Project.

Writing for the majority, Justice John Paul Stevens said Congress can change the law to allow medical use of the drug. But drug opponents say that shouldn't happen until there's proof marijuana actually has a benefit.

In a dissent, Justice Sandra Day O'Connor said state powers "have always included authority to define criminal law and to protect the health, safety, and welfare" of citizens.

Under the Constitution, Congress can pass laws to regulate states' economic activity as long as "interstate commerce" is involved.

The closely watched case was an appeal by the Bush administration in a California case that it lost in late 2003. At issue was whether the prosecution of medical marijuana users under the federal Controlled Substances Act was constitutional.

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Supreme Court Snuffs Out Medical Marijuana

The California marijuana in this case was homegrown, distributed to patients for free and didn't cross state borders.

Angel Raich was one of two women who sued then-Attorney General John Ashcroft for the right to use the pot without fear of federal action.

The California woman said it's pretty simple: If she stops using marijuana, she'll die. Raich said she has no choice but to keep smoking pot to ease several medical problems, including cancer.

She told Associated Press Radio she's more afraid of her medical condition at this point than she is of the federal government, even though she expects more federal raids and arrests.

Ruling Meets Mixed Reaction

Some organizations praised the Supreme Court's ruling, while others argued that it doesn't change as much as it may seem.

Calvina Fay, executive director of Drug Free America Foundation, called the ruling an "important victory for sound drug policy" and a "victory for the future of our children and the hope for a drug-free America."

Dr. Eric Voth, chairman of the Institute on Global Drug Policy, said the decision upholds the "long-established scientific fact that marijuana is not medicine."

"There has been much disinformation about so-called medical marijuana, but the truth is it's an extremely harmful drug that can put the future of our children at risk," Voth said in a statement.

But officials from the Marijuana Policy Project in Washington, D.C. -- which provided funding for the litigation -- said the ruling does not invalidate state medical marijuana laws.

In a statement, the group said the ruling allows federal authorities to enforce federal marijuana laws against patients who are protected under state medical marijuana laws -- preserving the status quo as it has existed since California passed the first effective medical marijuana law in 1996 and leaving it up to Congress to protect patients from federal attacks.

"While we're disappointed, the validity of state medical marijuana laws was never at issue in this case," said Rob Kampia, executive director of the Marijuana Policy Project. "Because the (Drug Enforcement Agency) and other federal agents make only 1 percent of our nation's 750,000 marijuana arrests every year, patients in states with medical marijuana laws retain a high level of protection. Congress should act today to give those patients complete protection from arrest."

Leaders at the American Civil Liberties Union agreed that state laws are still valid.

"The power of state governments to enact and enforce state medical marijuana laws is not affected by the Supreme Court's ruling," said Allen Hopper, a staff attorney with the ACLU's Drug Law Reform Project. "State laws allowing the use of medical marijuana still offer patients significant protection."