Marijuana may help protect against diabetes, according to a study published in The American Journal of Medicine. (Photo : REUTERS/Jonathan Alcorn)

Who will be prescribed medicinal marijuana in Massachusetts may end up a question to be resolved between patients and their doctors based on draft rules issued Friday by the state Department of Public Health.

Patients with a debilitating condition defined in the 45-page document as impaired strength that limits major life activities, intractable pain or nausea and wasting syndrome, are basically ensured coverage, as are those diagnosed with diseases such as ALS and HIV or AIDS. While such allowances are standard as far as medicinal marijuana goes, there is a part of the document that stands out, stating that doctors and patients are allowed to decide for themselves should they feel they have come upon a situation where treatment would be appropriate.

Should the document go into affect, all treatment centers would be required to be non-profit and to operate their own cultivation and dispensing facilities. State officials added in a news release that no wholesale distribution of marijuana products would be allowed.

The reason for this, explains the release, is to ensure "uniform seed-to-sale control" as well as "maximized security."

All of this comes as citizens of the states voted last November to approve the legalization of marijuana for medical reasons. And while the referendum leaves much of the decision-making process up to the health department, it did include that patients would be allowed to possess as much as a 60-day supply. What exactly this amounts to, however, was not specified.

In all, the draft draws upon the experience of 17 other states that have legalized marijuana for medical use.

"In this proposal, we have sought to achieve a balanced approach that will provide appropriate access for patients, while maintaining a secure system that keeps our communities safe," Lauren Smith, interim public health commissioner, told Boston Globe reporter Kay Lazar.

The Public Health Council will vote on the final rules May 8. Should they be approved, they are scheduled to go into effect May 24.