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New York is set to soon become the 21st state to legalize medical marijuana use. Governor Andrew Cuomo announced an executive action today that will loosen laws on use of the drug, allowing it to be distributed to patients with serious illnesses at 20 select hospitals. Despite the governor’s very public opposition to marijuana legalization in the past, this turnabout plan will give patients who suffer from illness such as cancer, glaucoma or other diseases limited access to the substance, and could initiate future broadening of medical marijuana laws.

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According to The New York Times, Governor Cuomo is bypassing legislature and introducing the policy action based on a provision in the 1980 public health law called the Antonio G. Olivieri Controlled Substance Therapeutic Research Program. Olivieri was a New York City councilman who died at the age of 39 from a brain tumor and used marijuana to ease the affects of his chemotherapy treatment.

Governor Cuomo’s administration plans to have the infrastructure for the new program in place by this year. However, before the plan can move full steam ahead, there are a few hurdles the New York State Department of Health must address, including the selection of hospitals, regional diversity assurance planning and policy restrictions to prevent abuse. Furthermore, it has yet to be determined where the medical marijuana will be sourced as state and federal laws prohibit the growing of marijuana in any capacity.

According to Ethan Nadelmann, executive director of the Drug Policy Alliance who recently spoke with The New York Times on the action, “Governor Cuomo remains committed to developing the best medical marijuana law in the country and that’s going to require legislative action.”

Via New York Times