TALLAHASSEE — What began as a decisive instruction from voters that patients who need medical marijuana should have access to it is shaping up to be a complex and contentious fight in the Florida Capitol.

Lawmakers have put forward competing proposals to implement Amendment 2, which passed with 71 percent of the vote in November and lets patients with debilitating medical conditions such as cancer, HIV/AIDS, epilepsy and post-traumatic stress disorder use cannabis.

On Wednesday, the Senate's Health Policy panel discussed five approaches to implement the voters' will.

Their deliberations, led by Sen. Dana Young, R-Tampa, revealed the first look at what kind of cannabis bill might pass the Senate — as well as early fault lines.

One clear point of disagreement: how to handle would-be patients with conditions not listed in Amendment 2, which names 10 diagnoses and lets doctors recommend cannabis to patients with similar conditions.

Some advocates and lawmakers have suggested allowing patients with chronic pain access to the drug. But others worry that vague language could make it too easy for people to obtain a doctor's recommendation and a state-issued marijuana patient ID card.

This is one of the two toughest questions facing the Senate, said Sen. Rob Bradley, R-Fleming Island, who sponsored one of the medical marijuana bills (SB 406).

"I don't think we're compelled to include chronic pain that isn't related to an underlying debilitating condition," Bradley said.

Lawmakers are also divided on how people should be allowed to consume marijuana under the law.

While a couple of proposals allow for smoking, Bradley is clearly opposed, calling it "by its very nature not a healthy act." There are also differing views on edibles, food products that have been infused with cannabis oil.

The Florida House's lone medical marijuana bill (HB 1397) outlines a more restrictive approach, banning smoking and edibles, as well as "vaping," which is allowed under a current law passed in 2014 that lets some patients with severe epilepsy and cancer use cannabis low in euphoric high-inducing THC.

The Senate's eventual proposal will likely keep the structure of Florida's existing, limited medical cannabis program.

"By using this current structure, it would allow the Department of Health to continue with some of its current programs," Young said. "That may lead to a more efficient implementation of the amendment."

Using the existing program as a starting point will give seven nurseries already licensed to sell cannabis a leg up when the larger, more lucrative medical marijuana industry opens.

It also means that every business that wants to enter the marijuana industry will have to be a one-stop shop, acting as a grower, processer and dispensary.

Just one path (SB 614), filed by Sen. Jeff Brandes, R-St. Petersburg, allowed for businesses to specialize as growers or sellers. But Young said it is unlikely the Senate will adopt that model because four other senators and the House leadership have endorsed keeping the existing structure.

Other senators on Wednesday raised concerns about this, including Sen. Kathleen Passidomo, R-Naples, who pointed out that it would be difficult for each business to develop expertise in farming, lab work and sales.

But Bradley thinks the existing structure will make it easier to regulate the industry.

"I think it should be seed to store under one roof," he said. "I want to be able to have our government be in the position of shutting down companies that are not good actors and people who do not conduct business appropriately."

What the Senate does appear ready to change is the number of those companies that will be in the market. Bradley and Young, who originally proposed a slow expansion of the number of marijuana business licenses in the state, now say there should be faster growth to accommodate a patient base of potentially hundreds of thousands.

Businesses and activists repeatedly pressed that point.

"This is just a testament to the fact that we actually do listen to our constituents," Young said. "I do think that more licenses up front and different thresholds will be something that we almost certainly will move to. The question is: How many and at what thresholds?"

Proponents of a more open market took that as a positive sign.

"Even Sen. Bradley, whose proposal started at the lower number in terms of expansion, said up there today he's not only willing to but believes it should be open for others," said Ben Pollara, executive director of Florida for Care, the group that pushed Amendment 2 and is now advocating for greater patient access. "So I feel pretty good about where this thing's headed."

Times staff writer Justine Griffin contributed to this report. Contact Michael Auslen at mauslen@tampabay.com. Follow @MichaelAuslen.