New York became the 23rd state in the nation to legalize medical marijuana after clearing the final hurdle—passing the state Senate, where Republicans historically blocked bringing it up for a vote.

The Compassionate Care Act would allow health practitioners to prescribe marijuana to patients with cancer or other life-threatening conditions by the end of next year. The bill overwhelmingly passed the state Senate by a vote of 49-10 Friday afternoon following hours of debate—prompting cheers from proponents in the gallery that traveled to Albany to support the legislation.

“We should be a little flexible,” state Senate co-leader Dean Skelos (R-Rockville Centre) said shortly before voting for the bill. “We should be a little bit more compassionate…even if it’s not affecting us or our families.”

The state Assembly passed the bill early Friday morning—the last day of the state legislative session before lawmakers go on summer break—less than a day after Gov. Andrew Cuomo announced a deal amending the bill to ensure its passage.

“This will be a tightly regulated, tightly controlled system, perhaps the most regulated medical marijuana bill in the country,” said Bryan Clenahan, counsel to state Sen. Diane Savino (D-Staten Island), the bill’s sponsor.

After reaching a deal with the bill’s sponsors, Cuomo waived the three-day period that is usually required before bills can be brought to a state Senate vote. As a part of the deal, the law does not allow medical marijuana to be smoked, and the governor will have the power to stop the program if it is found to cause a “risk to the public health or safety.”

“Somebody said to me today, ‘How can you be passing a heroin bill yesterday and a medical marijuana bill today?’” said Cuomo at a press conference on Thursday. “Well, if this is administered properly, we’re confident that only benefits will occur.”

Among the safeguards are making it a felony for doctors to wittingly prescribe marijuana to patients that don’t medically need it, making it a misdemeanor for patients to resell their prescribed pot and requiring farmers to grow the crops indoors at secure facilities. Since medical marijuana is not federally approved, the five dispensaries statewide will be cash-only. The state also imposed a seven-percent tax on the prescriptions.

The conditions to be treated with marijuana under the bill are cancer, HIV/AIDS, Lou Gehrig’s disease, muscular dystrophy, Parkinson’s disease, multiple sclerosis, spinal cord damage, epilepsy, inflammatory bowel disease, neuropathy and Huntington’s disease. Insurance carriers, Medicare and Medicaid will not be required to cover prescription marijuana.

“We recognize that there may be other conditions that can benefit from medical marijuana and that will be determined by my office as the science evolves,” said Dr. Howard Zucker, the acting commissioner of the state Department of Health.

Once the bill is signed into law by Cuomo, it will go into effect in 18 months and will sunset after seven years—unless it’s reauthorized. Savino requested the lag time to allow enough time to fine-tune the regulations. The legislation also includes options allowing the governor to pull the plug if major problems with the system later arise.

The process for passing the bill had been rife with controversy. State Sen. John DeFrancisco (R-Syracuse), the chair of the Senate Finance Committee, said earlier this week that he would not move the bill out of his committee. The Rules Committee later took it up anyway before it went to the full legislature for a final vote.

Those who voted against the bill mostly did so out of concern that medical marijuana could be diverted onto the black market, although even some law-and-order types came around.

“Lead or get the hell out of the way,” state Sen. William Larkin (R-Newburgh), a retired U.S. Army colonel, boomed to applause. State Sen. Patrick Gallivan (R-Erie County), a former state Trooper, said the “benefits outweigh the negatives.” And state Sen. John Bonacic (R-Orange County), an ex-prosecutor, said he supports easing patients’ pain, but will oppose any attempts to legalize recreational marijuana.

Aside from Skelos, the other seven Long Island state Senators were split on the vote. (The third district seat representing southern Nassau County has been vacant for six months.)

“The unintended consequences are too great,” warned State Sen. Ken LaValle (R-Port Jefferson). State Sen. Kemp Hannon (R-Garden City), chair of the health committee, argued that there hasn’t been enough research to determine the medicinal value of marijuana. State Sen. Lee Zeldin (R-Shirley) voted no, but did not say why.

State Sen. Jack Martins (R-Mineola), who voted for it, said that the bill struck a balance, but Sens. Carl Marcellino (R-Syosset) and John Flanagan (R-East Northport) also did not explain their vote of support during the last round of debate.

State Sen. Phil Boyle (R-Bay Shore) noted that when he was a state Assemblyman he voted against earlier versions of the proposal that he viewed “with a jaundiced eye” before he proposed his own medical marijuana bill last month that included a key provision of the version that finally passed—no smoking. Only oils, edibles or vaporizing will be allowed. Patients would be limited to 30-day supplies.

Jeffrey Reynolds, executive director of the Long Island Council on Alcoholism and Drug Dependence, questioned whether or not state lawmakers can make medical decisions and cites that edible forms of marijuana—brownies, cookies and lollipops—still raise health concerns.

“Part of the problem is when the state does this, it’s in a patchwork kind of way,” said Reynolds. “There’s no common data being shared at a national level…I think folks like me have some concerns and will continue to watch the process, but the million-dollar question is how they’ll maintain it.”

While explaining his vote, Skelos mentioned 14-year-old Oliver Miller of Atlantic Beach, a constituent of his who suffers hundreds of seizures daily as a result of an in-utero stroke. Miller’s mother, Missy, believes that medical marijuana can cut that number to four seizures daily. Missy and Oliver had been traveling to Albany every month since January and met with Skelos in their push for the bill.

“I’m thrilled,” Missy told the Press after the vote. “That was really emotional for me to see him mention my son…That was a proud moment in my life.”

“My faith in this process has been somewhat restored,” Miller added. “In the end the right thing was done and the bottom line is they did it for the people.”

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Timothy Bolger is the Editor in Chief of the Long Island Press who’s been working to uncover unreported stories since shortly after it launched in 2003. When he’s not editing, getting hassled by The Man or fielding cold calls to the newsroom, he covers crime, general interest and political news in addition to reporting longer, sometimes investigative features. He won’t be happy until everyone is as pissed off as he is about how screwed up Lawn Guyland is.