At the beginning of 2017, few marijuana law reform advocates would have put West Virginia at the top of the list of states considered most likely to enact new cannabis policies this year.

But on Wednesday, that all changed when the state Senate unexpectedly approved a comprehensive medical marijuana bill by a vote of 28-6.

If enacted into law, S.B. 386 would create a regulated system through which patients with doctors’ recommendations could purchase medical cannabis from dispensaries. They would also be allowed to cultivate up to two mature plants at home.

“Who am I to say no to people who can achieve relief or peace?” asked Judiciary Committee Chairman Charles Trump (R) during a floor debate before the vote. “We are now in the minority of states [without medical marijuana laws]. The majority of states have already done it.”

Pointing to medical cannabis’s role in treating post-traumatic stress disorder, Sen. Richard Ojeda (D), the bill’s lead sponsor, said the bill will help military veterans “get through the times that whenever they close their eyes, the only thing the see is the faces of the ones they served with that didn’t come home.”

Ojeda, an army veteran who served in Iraq and Afghanistan, also addressed the notion that marijuana is a “gateway drug,” saying that it is a “gateway away from opioids,” a class of powerfully addictive drugs which many West Virginians have struggled with in recent years.

Gov. Jim Justice, a Democrat, said earlier this month that he supports medical cannabis, reiterating a campaign pledge he made late last year.

.@WVGovernor said he "just can't turn his back" on medical marijuana, but says he's "just not there at all" on full legalization. — Eyewitness News (@wchs8fox11) March 14, 2017

But House Speaker Tim Armstead, a Republican, says that the state shouldn’t act on medical marijuana until the federal Food and Drug Administration (FDA) approves it.

“I truly believe myself that a federal agency, the FDA, tests and analyzes any substance used for health care and to determine whether those should be subject to use through prescriptions or otherwise,” he said last month. “Let the FDA do its job first to see whether this is a substance they believe that the advantages outweigh the disadvantages. They have yet to do this.”

The Senate Health and Human Services Committee advanced the bill by a 6-5 vote last week and the Judiciary Committee followed suit on Tuesday, approving it 13-3.

If the legislation is passed by the House and signed by the governor, the state’s medical marijuana program would be regulated by a 17-member panel called the West Virginia Medical Cannabis Commission.

Patients would be allowed to possess a 30-day supply of marijuana, the definition of which would be determined by the commission.

In order to recommend medical cannabis, physicians would need to register with the state every two years.

The legislation states that the regulatory commission is “encouraged to approve physician applications” for a number of medical conditions:

(A) A chronic or debilitating disease or medical condition that results in a patient being admitted into hospice or receiving palliative care; or (B) A chronic or debilitating disease or medical condition or the treatment of a chronic or debilitating disease or medical condition that produces: (i) Cachexia, anorexia, or wasting syndrome; (ii) Severe or chronic pain that does not find effective relief through standard pain medication; (iii) Severe nausea; (iv) Seizures; (v) Severe or persistent muscle spasms; or (vi) Refractory generalized anxiety disorder. (C) Post-traumatic stress disorder

It also says that the commission “may approve applications that include any other condition that is severe and for which other medical treatments have been ineffective if the symptoms reasonably can be expected to be relieved by the medical use of cannabis.”

Separately, senators approved a resolution on Wednesday calling on Congress to reschedule marijuana. And on Monday, the body passed a resolution commemorating Industrial Hemp Day.

The Senate defeated a floor amendment to the medical cannabis bill that would have significantly limited drug testing for THC.

A separate medical cannabis bill has been introduced in the House, but hasn’t yet been scheduled for a vote.

“For many patients, medical marijuana is a far safer alternative to opioids and other prescription drugs,” Matt Simon of the Marijuana Policy Project, a West Virginia native and graduate of West Virginia University, said in a statement. “Any delegates who are serious about addressing the opiate crisis in West Virginia need to consider the substantial benefits this law could have on that front. We hope Speaker Armstead will review the facts and give this bill a fair shake in the House.”