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ALBANY – New York will become the 23rd state in the nation to legalize medical marijuana under an agreement reached Thursday at the Capitol.

However, some advocates say it is too limiting and will take too long to implement for patients who cannot wait the couple of years it could take before the drug’s use can be prescribed by doctors.

The agreement is expected to receive final approval today as the Legislature ends its 2014 session. The measure bans the sale of smokable forms of marijuana and limits its prescription to oil-based pills and vaporization methods that experts say will be more expensive to purchase.

The program will not be effective for at least 18 months and by the time growers and dispensers are selected in competitive bidding programs and the plants are grown, it could be as long as three years before medicinal marijuana can be dispensed.

Over the initial objections of legislators, the final legislation was, according to Gov. Andrew M. Cuomo, sharply limited by design. It covers patients who fall within a short list of covered diseases or health conditions, such as cancer, AIDS and epilepsy; contains tough penalties for doctors who knowingly prescribe marijuana for patients not on that list; and lets a governor at any time cancel the program if he or she feels it is not working. That last provision, along with a clause that has the program ending in seven years unless reauthorized, could dissuade some private marijuana growing firms from entering the New York market to participate. The program envisions five companies growing and dispensing marijuana from 20 sites scattered around the state.

Cuomo said the agreement “strikes the right balance’’ between helping patients with certain medical conditions and protecting broader public health and safety efforts.

Lawmakers pushing the measure, along with advocates, had been insisting for weeks that attempts to drastically weaken their plan, such as banning smokable forms of marijuana, would not be accepted. They argued, for instance, that the smokable marijuana authorization was needed for many patients, such as those undergoing chemotherapy for cancer. In the end, they bowed to Cuomo’s demands with the hope, they said, the law could be amended in the coming years to cover more patients.

Leading the charge most loudly in recent months have been parents of children who suffer from rare forms of epilepsy that can cause hundreds of debilitating seizures in a day. They have been seeking treatment for their children with an oil-based marijuana extract that is available in Colorado and California to legal residents, but they joined with other health groups in insisting that New York enact a more sweeping law, including allowing smokable marijuana sales, to affect more patients than just their children.

Wendy Conte, an Orchard Park resident whose daughter, Anna, 9, has one of the rare forms of epilepsy, said she is grateful that New York is approving medicinal marijuana.

“But my fear is that in 18 months some of the children will not be around to reap the benefits of this legislation,” she said of children who die from the seizures.

Conte earlier this year got a Colorado driver’s license and began the process of moving there so her daughter could obtain the drug. Thursday, she said she had no idea if the family will move there and come back when the product is available in New York or wait it out here until the program begins.

“We are extremely grateful, but there’s a lot of reservations about the restrictions the governor is putting on the program,” she said of, among others, his insistence he be allowed to “pull the plug out of the wall at any moment” on the program upon the recommendation of the Health Department or the State Police.

Prices for the marijuana forms approved Thursday are impossible to predict, given the timetable and other factors. The deal includes a 7 percent excise tax on the product to be paid for by patients.

Doctors will have to undergo training to prescribe marijuana, and only those trained to treat the covered conditions or diseases can participate.

The covered conditions are: cancer, HIV/AIDS, Lou Gehrig’s disease, Parkinson’s, multiple sclerosis, Huntington’s, epilepsy, inflammatory bowel disease, neuropathies and “damage to the nervous tissue of the spinal cord with objective neurological indication on intractable spasticity.”

Details like dosage amounts will be determined by the Health Department, a change from legislation introduced this week that permitted up to two ounces per month per patient. Marijuana for the program would have to be grown in New York.

Critics say the state is taking a dangerous path with a drug that even Cuomo just this week called a gateway to stronger narcotics.

“Marijuana is not a medicine. … It is still an illegal drug. I see no pluses here except sending the wrong signal to our state that we’re on the path to open up full legalization of marijuana, which is a disaster to our state and citizens,” said Mike Long, chairman of the state Conservative Party.

The Assembly has passed a medical marijuana bill almost every year since 2007. This year, a number of Senate Republicans, including Buffalo’s Mark Grisanti and Newfane’s George Maziarz, said they would back the effort, and the effort got a push from State Attorney General Eric T. Schneiderman and his Republican rival, John Cahill. Polls also showed a majority of New Yorkers favoring medical marijuana.

Cuomo for three years opposed the idea, though he softened on the concept earlier this year. Thursday, he said controls put into the new legislation let him sign off on the measure.

“We will have the medicinal benefit to people who need it but we make sure there is no risk to public health or safety,” Cuomo said.

The Drug Policy Alliance, which has pushed medical marijuana laws throughout the country, said it had concerns about the final deal, but that thousands of patients will end up being eligible to receive medical marijuana prescriptions in New York.

email: tprecious@buffnews.com