It may have started with a Cuomo initiative but the budding debate over allowing the use of medical marijuana in New York is shifting to the state Senate.

That's because advocates are increasingly pushing for legislation, rather than going with the governor's proposal to use his executive powers to start a limited medical marijuana program.

And they see Senate Republicans as the only potential barrier, since the Democratic-led Assembly has already approved a medical marijuana bill.

As a result, medical marijuana advocates are planning to pressure the Senate, starting with a demonstration in the Senate chambers on Monday.

"There's going to be a focus on the Senate," said Gabriel Sayegh state director of the Drug Policy Alliance.

Cuomo in his State of the State speech said he wanted to issue an order that would ignite a little-known 1980 law that allows limited use of medical marijuana. That law was passed but never acted on.

Under the governor's plan, 20 hospitals could dispense marijuana to people with specific diseases such as cancer or glaucoma.

But advocates like Sayegh, as well as lawmakers who have put forth medical marijuana laws, believe the 33-year-old law would pose complications that were not contemplated when it was passed.

Hospitals could face liabilities or even see their ability to borrow money impacted, largely due to federal regulations that list marijuana as a controlled substance.

There are also questions about where hospitals would obtain their marijuana and whether it would be good quality or not.

"Problematic doesn't begin to describe it," Sen. Diane Savino, a member of the Independent Democratic Conference said earlier in the week when asked about details of the Cuomo proposal.

Savino has sponsored a medical marijuana bill.

Her bill would need enough GOP votes to pass. And that could be difficult given the pressure from Conservative Party Chairman Mike Long, who could back primary or general election challengers to Republicans who support a marijuana bill. A similar scenario played out in 2012 when two GOP senators who supported gay marriage, Roy McDonald of Saratoga and Stephen Saland of Poughkeepsie, were knocked off by challenges.

Those fears are real, despite indications that a majority of people are OK with medical marijuana. A June Quinnipiac College poll found that New York voters by a 70-26 percent margin support allowing medical marijuana. For Republicans, it was 58-39 percent.

Another more recent private poll of all the state's Republican-held Senate districts found support running at 76-19 percent with just over 5 percent undecided.

That's not a surprise to Kevin Jones of NY NORML.

He supports starting with the governor's plan, in part because he worries that any debate about medical marijuana could get caught up in a political turf fight.

"I don't think we can count on these politicians not to (play) politics," said Jones.

rkarlin@timesunion.com • 518-454-5758 • @RickKarlinTU