New York will soon become the 21st state with medical marijuana under a plan announced by  in early January.

According to The New York Times, Cuomo said he would use an executive order to allow a tightly regulated MMJ program in the state. Efforts to legalize medical cannabis by way of the New York Legislature have stalled in recent years.

Andrew CuomoThe program and its regulations would be much stricter than those in states like Colorado and California, both famous for the ease with which residents can get medicinal pot. Just 20 hospitals will be allowed to prescribe weed to patients suffering from glaucoma, cancer and other debilitating conditions.

Cuomo’s reform will mark a small but grudging step forward for a state with a contradictory history on pot.

New York decriminalized possession of small amounts of marijuana in 1977. But police in New York City have a long history of using controversial “stop and frisk” searches to expose cannabis to public view, which allows them to make arrests. The city enforces pot laws more aggressively than almost any other type.

Even as 20 other states have adopted medical marijuana, attempts to do so in the legislature have consistently failed. Four bills have passed the State Assembly but died in the Senate, including one in 2013. That’s because a group of conservative Democrats controls the Senate together with several Republicans, and that coalition has repeatedly blocked medical pot bills.

Until the announcement in January, Cuomo also stood against MMJ in New York, though he said in April that he was keeping an open mind. But voters’ preferences have changed dramatically in recent years, with New York City residents sweeping an avowed progressive into the mayor’s office after 20 years of moderate Republicans.

Attitudes toward marijuana, medical and recreational, have also changed, rapidly. National polls show clear majorities of Americans now want to legalize all weed. A poll taken in May showed 82 percent of New Yorkers favor medical pot.

Faced with those realities and an increasingly liberal party base, Cuomo threw his lot in with the reformers. But the governor also wanted to help patients in need, a source familiar with his views told The Times.

Cuomo’s executive action is based on the little-known Antonio G. Olivieri Controlled Substance Therapeutic Research Program. Started in 1980, the program allows patients with cancer, glaucoma and those “afflicted with other disease as such diseases are approved by the commissioner” to use controlled substances.

State officials hope the new MMJ program will be in place later this year. Medical weed supporters said they’re aiming for a tightly regulated system that doesn’t attract abuse.

“What we are looking at bears no resemblance to the California system,” said Richard N. Gottfried, a Democratic assemblyman from Manhattan. Gottfried heads the health committee and is pushing a medical marijuana bill.

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