ALBANY – One of Gov. Andrew M. Cuomo’s top “progressive” priorities for this legislative session is the decriminalization of 25 grams or less of marijuana – the equivalent of about 0.9 ounce, or 40 to 50 joints – so that young people, especially minorities, don’t get criminal records that haunt them for years to come.

“We want to decriminalize low levels of marijuana so we’re not going to have those arrests for stop-and-frisk anymore,” Cuomo told a gathering of black and Hispanic state lawmakers last weekend in Albany.

And with a shared leadership of Republicans and breakaway Democrats in the State Senate, the prospects for passage are more likely than ever before.

Yet Cuomo so far has declined to back efforts to permit people with certain diseases and chronic painful conditions – from cancer to multiple sclerosis – to legally obtain marijuana as a way to help them cope with pain and the effects of chemotherapy.

“It’s a great disconnect, and it bothers me quite a bit,” said Maxine Murphy, a Buffalo resident and ordained minister who has been out of work since an on-the-job injury in 1995 that forced her to undergo back surgery.

“He certainly doesn’t care about people who need medical marijuana. Help us first,” said Joel Peacock, a South Buffalo resident who has been in chronic pain since a 2001 car accident.

Murphy and Peacock have something in common: They would love to get off or sharply reduce their prescribed painkillers and all the side effects they’ve experienced from the powerful drugs. Limited access to marijuana, which they have both tried and which they both say has relieved their painful symptoms, is a solution if done in a controlled environment and limited to certain kinds of medical conditions, they say.

They don’t understand the logic of Cuomo backing decriminalization of marijuana for recreational use yet not supporting ways for people with life-threatening and chronic conditions to legally obtain the drug.

Is 2013 their year?

A new effort is about to begin this week when lawmakers unveil changes to legislation that has passed in the Assembly but stalled in the Senate. The legislation would create a controlled system in which doctors could write marijuana prescriptions for certain patients, who could then obtain the drug in limited supplies from state-controlled agents.

Backers say the environment is right for passage this year.

For starters, the Senate bill is sponsored again by Sen. Diane Savino, a Staten Island Democrat. She is one of five breakaway Democrats who have formed a coalition with Senate Republicans to control the Senate, which means Savino has far more political power in the chamber this year than she did a year ago.

If Savino, using her new powers, can force a floor vote in the Senate, backers say it would pass there, too, with Democratic and some GOP support.

Savino and the Assembly sponsor, Richard Gottfried, a 42-year veteran Democratic lawmaker from Manhattan who is chairman of the Assembly Health Committee, are scheduled to introduce a new measure designed to address past opposition.

For starters, it will not permit patients to grow their own marijuana, and it would add marijuana to the list of drugs tracked in real time by doctors and pharmacists under a new law scheduled to take effect later this year.

And they are examining how to create a system, similar to Colorado’s, where the drug is monitored from its seed through plant growth to purchase by a patient.

Savino said there is movement on the issue, but that negotiations with the governor’s office won’t take place until after the state budget is adopted near the end of March. Cuomo’s talk about changing marijuana possession laws could benefit the push for medical marijuana.

“Sometimes, all the planets come into alignment, but we’re not there yet,” she said.

Cuomo was asked last week if his position on the topic, which has been one of opposition, has evolved.

“No,” he responded.

A Cuomo spokesman dismissed any notion that the governor is sending mixed marijuana policy messages.

“The two issues are completely separate and distinct,” Richard Azzopardi said of medical marijuana efforts and Cuomo’s plan to decriminalize 25 or fewer grams of pot.

“The governor’s stop-and-frisk reforms are about fixing a system that disproportionately leaves black and Latino youths with a criminal record. The medical marijuana debate focuses squarely on the medicinal value of marijuana and how it compares to federally approved treatments,” Azzopardi said.

Critics said the idea of embracing unproven treatments is risky.

Mike Long, chairman of the state Conservative Party, said his group is “staunchly opposed” to legalizing medical marijuana. Marijuana is a gateway drug, and the state would be sending the wrong signal to young people if it is decriminalized, he said.

“It would be a huge mistake,” said Long, adding concerns about diversion of marijuana from patients to nonpatients.

Legal painkillers have side-effects, but so, too, does marijuana, Long said.

“In all honesty, I think the medical field has enough drugs for people who are in need,” he said.

Medical marijuana legislation would easily pass again in the Assembly.

The 18 states that have legalized medical marijuana have done so through a combination of voter initiative ballot measures or, in the case of Connecticut, the most recent state to do so, by statute approved by lawmakers and governors.

Advocates, who now include the state’s Independence Party, dismiss criticism that the measure would encourage people to get high, noting there are different ways to take the drug to limit its effects and that many patients only take marijuana at night as a way to help them sleep.

Peacock, who first spoke out on the issue in a Buffalo News article five years ago, said the power of the pharmaceutical industry is being felt on the matter.

“Let’s forget about the politics. This is about people in pain. It’s got nothing to do with people being liberal or conservative or Democratic or Republican. It’s to help people,” he said.

Peacock, who can afford prescription painkillers under his Medicare coverage, said they would cost $900 a month if he was paying out of pocket. He said when he took marijuana years ago it stopped the headaches and stomach cramps he suffers from the pills. But he is in a Catch-22 situation. His pain management doctor requires patients to get tested for recreational drug use each month.

“If they catch it in my system, they can’t treat me anymore,” he said.

Murphy said she has permanent nerve damage that affects the right side of her body.

“It’s an uncomfortable, constant pain,” she said, as she talked about her journey through the prescription painkiller route.

“It’s not like we’d be getting high for the sake of getting high. It’s not a leisure drug,” she said of patients who want the medical marijuana bill approved. She also said she favors case studies in New York to test the effectiveness of the idea.

“But until insurance companies and pharmaceutical companies come up with a way to make money off it, it’s not going to happen,” she said.