NEW YORK -- Gov. Andrew Cuomo made a political splash by introducing a medical marijuana plan in the State of the State speech, but his cautious approach has been met with skepticism from pot advocates who question whether the proposal is mostly for show.
While nearly two dozen states have OK'd marijuana for medical purposes and Colorado and Washington have legalized its use for pleasure, Cuomo is tapping a 1980 state law to allow as many as 20 hospitals to dispense the drug to people with certain severe illnesses as an experimental research project.
"I'm absolutely thrilled that he's actually verbalized the words `medical marijuana,' but he's just got to go further," said Susan Rusinko, a 52-year-old central New York resident who said a hit of pot is a "wonder drug" that relaxes immobilizing leg spasms from her multiple sclerosis. It's unclear whether she would even qualify for Cuomo's initiative or whether there would be a participating hospital near her.
The governor's office has yet to detail how the program would overcome key hurdles, including the lack of a legal, unadulterated supply of marijuana in the state and a federal law that still makes it illegal for doctors to write a prescription.
While advocates are frustrated, Cuomo's limited embrace of medical marijuana may be both politically astute and scientifically sensitive.
Some medical experts say that while the marijuana plant holds tantalizing possibilities for treating problems ranging from chemotherapy-related nausea to chronic pain, popular enthusiasm for the drug has outpaced a weak body of medical research.
Cuomo's initiative is styled as a test of whether pot can be effectively used as medicine without being abused.
"This does not start with a premise: `Oh, this is a slam dunk. ... We can do it without any ancillary problems,"' he told reporters Monday. "It's the exact opposite."
Under his plan, people with cancer, glaucoma and possibly some other "life-threatening or sense-threatening" conditions could seek to get marijuana through studies based at hospitals yet to be named, with "stringent research protocols and eligibility requirements."
Cuomo's initiative bypasses a state Legislature that has declined to pass more ambitious medical marijuana laws. He's relying instead on his administrative powers to carry out a 1980 law allowing medical-marijuana research. A number of states passed such measures in that era.
Then California took a broader step, voting in 1996 to let doctors recommend cannabis for various conditions. Nineteen other states have since enacted medical marijuana laws. While the drug remains illegal under federal law, U.S. prosecutors were told in 2009 not to focus on people using it medically under state laws.
Critics feel medical marijuana is an entree to more recreational use of a drug that was widely outlawed in the U.S. in the 1930s. "I think it sends the wrong signal to our young people," said Michael Long, chairman of the New York Conservative Party.
Federal regulators have approved a few prescription drugs containing a synthetic version of the marijuana ingredient THC. But few clinical trials have been done to test whether the plant in its raw form is better than conventional therapies, partly because of federal restrictions on such research, notes Aron Lichtman, a pharmacology professor at Virginia Commonwealth University and the president of the International Cannabinoid Research Society.
"There are all sorts of claims being made, without any proper testing. So it's sort of a conundrum," he said.
Dr. J. Michael Bostwick, a Mayo Clinic psychiatrist who studies medical marijuana issues, sees therapeutic potential in cannabis. But he also has concerns that it is being dispensed in some states by questionable providers who make unsubstantiated claims about the drug's powers and provide little or no actual medical care or evaluation.
He said Cuomo's proposal seems to address some of those concerns by putting dispensaries within hospitals, but he said some New York hospitals might be wary of participating for fear of running afoul of federal authorities.
If hospitals do get on board, it isn't clear where they would get the marijuana. New York's 1980 law envisioned a possibility that the drug could be obtained from law enforcement agencies, but experts say pot seized from drug dealers could pose a safety hazard. The drug can't be imported from states where it is grown legally. Obtaining marijuana grown by federal authorities for research purposes is notoriously difficult.
Still, pharmaceutical pot is popular with New Yorkers. A Quinnipiac University poll in June found 70 percent of voters support it.
And for Cuomo, the issue represents an opportunity to plant a flag on the left -- but not too far -- as he faces re-election amid talk of presidential ambitions in 2016. Cuomo enjoys favorability ratings around 55 and 60 percent in recent polls, but some of the state's Democratic limelight has been shining lately on newly installed, staunchly liberal New York City Mayor Bill de Blasio.
Cuomo had said as recently as April that he opposed medical marijuana but that his thinking was evolving. With his new plan, "he can, at least, say, `I'm pushing forward this conversation,"' said Christina Greer, a political science professor at Fordham University.
Advocates, who want state lawmakers to pass a broader medical marijuana law, question how workable Cuomo's program would be and how many people it would help.
"It moves New York forward, all the way to 1980," said Gabriel Sayegh, the New York state director of the Drug Policy Alliance, a group critical of war-on-drugs governing.
Carly Tangney-Decker isn't waiting for answers. She and her husband believe a particular strain of marijuana available through a Colorado dispensary could help their 8-month-old daughter, Mabel, who suffers from a genetic seizure disorder.
While doctors didn't recommend the marijuana treatment, the mother said, Mabel's neurologist supported the family's quest for alternatives to medications that aren't approved for regular use in infants and could cause permanent vision damage.
"People say that marijuana is a gateway drug," said Tangney-Decker, of Kingston. "Well, people in my situation consider it an exit drug to take us away from all the other drugs."
So she and baby Mabel are moving to Colorado next week.