COLUMBUS – The latest effort to legalize marijuana in Ohio stems from frustration with Ohio's nearly four-year-old medical marijuana law.

Supporters of the measure include at least twmedical marijuana businesses, a medical marijuana patient, a mother of twins with autism – a condition excluded from the program – and advocates for recommending cannabis in place of opioids.

Supporters of the Regulate Marijuana Like Alcohol Amendment turned in the petition summary language and an initial 1,000 signatures to the Ohio attorney general on Monday. This is the first step in a months-long process to qualify for the November ballot.

Read the proposed amendment below.

The constitutional amendment would allow adults over age 21 to buy, possess, consume and grow limited amounts of marijuana.

Here are five things to know about the measure.

Lackluster medical marijuana program driving initiative

Ohio's medical marijuana law was passed in 2016 but sales just began last year. The first year of sales lagged business projections and neighboring states. About 30% of registered patients haven't bought anything at an Ohio dispensary. Program rules have kept many patients from getting what they need.

Tom Haren, a Northeast Ohio attorney representing supporters, said there were several catalysts in the medical program that led to the new adult use measure.

"If you're a patient in Ohio, it's hard to participate in Ohio's medical marijuana program," said Haren, who has also represented medical marijuana licensees. "We were promised a program that worked."

Haren confirmed Pure Ohio Wellness, a cultivator and dispensary operator in Springfield and Dayton, and Galenas, a small-scale grower in Akron, are backing the measure. Haren said other medical marijuana businesses support it but declined to name them on Monday.

The Ohio Medical Cannabis Industry Association, which represents 14 Ohio companies, is not supporting the measure.

“We’re focused on the medical program and at this time are not backing a recreational initiative,” association associate director Thomas Rosenberger said.

The purchase and possession limit in the amendment is 1 ounce, with no more than 8 grams of concentrate. Adults could grow up to six plants (limit of three flowering plants) in an enclosed area – home grow is not allowed in the medical marijuana program.

The state's nascent medical marijuana program would remain in place, and state officials would have to ensure patients still have access to products.

The amendment wouldn't change laws against driving under the influence of marijuana or employers' rights to prohibit employee marijuana use.

Supporters include former OSU football player

The four petitioners listed on the measure are a mixed bunch:

Evan Spencer, a former Ohio State University and Washington Redskins wide receiver

Anthony Riley, a Columbus medical marijuana patient who suffered a severe brain injury

Carrie Beebe, Marysville mother of twin autistic sons

Mark Welty, a New Philadelphia mental health specialist

Spencer, who started a cannabis private equity fund last year, said he supports marijuana use in place of pain-relieving and more addictive opioids. Ohio officials have twice rejected adding opioid use disorder as a qualifying condition for the medical marijuana program. The board rejected adding autism spectrum disorder last year but plans to consider the condition this year.

"Due to the restrictive nature of the current medical program, Ohio has failed to provide the necessary access to cannabis its voters deserve," Spencer said in a statement. "Now, it’s time for Ohio voters to take control.”

Existing medical marijuana businesses would be first

The 118 medical marijuana licensees could operate as recreational businesses on July 1, 2021, according to the amendment. The Ohio Department of Commerce, which oversees medical marijuana growers, processors and testing labs, would also regulate the entire recreational marijuana program.

The agency could issue more licenses, but the number of licenses would be capped until 2026. Retail stores would be capped at about 200. Cultivation would be limited to a total of 1.5 million square feet of growing space among all licensees. For comparison, the state's 19 large-scale and 13 small-scale medical marijuana growers are licensed to cultivate 514,000 square feet.

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Local governments could limit the number, location and business hours of marijuana businesses and could ban them altogether. Licenses would be awarded if the applications comply with the rules and regulations; Ohio's medical marijuana business licenses were awarded after a months-long application scoring process.

Tax revenue would help fund diversity programs

The amendment doesn't set a tax rate – that would likely violate an anti-monopoly amendment passed by voters in 2015 to block ResponsibleOhio's recreational marijuana measure. Lawmakers could set a special sales tax for recreational marijuana.

Revenue from marijuana would be split several ways:

25% to a special fund for a Commission on Expungement, Criminal Justice, Community Investment, and Cannabis Industry Equity and Diversity

50% allocated to the state's Local Government Fund

At least 10% must be returned to municipalities where retail sales occurred, proportional to the amount of sales

Equity in legal cannabis programs refers to ensuring African-Americans and members of other traditionally marginalized groups participate in the industry. African-Americans are nearly four times more likely than whites to be arrested for marijuana possession, according to the ACLU.

Ohio's attempt at equity in the medical marijuana program – awarding 15% of all licenses to minority-owned businesses – was found unconstitutional. The amendment requires the Department of Commerce to conduct a study into whether there has been discrimination in awarding medical marijuana licenses.

The initiative has a steep path to the November ballot

The attorney general has 10 days to review the petition language to make sure it's "fair and truthful" summary of the amendment. Most initiatives don't pass the first time.

A bipartisan legislative panel led by the Ohio secretary of state will then decide whether the measure is one or more ballot issues. Then, supporters will have to have to collect at least 442,958 valid signatures of Ohio voters, including a certain percent in 44 of Ohio's 88 counties.

To do that before July 1 – the deadline for the November ballot – supporters will likely need to hire paid signature collectors. Recent statewide ballot issue campaigns have spent upwards of $3 million to collect signatures.

Haren declined to name investors or sources funding the campaign.

"We expect it will be funded by a diverse set of folks including people with licenses as well as folks outside the licensing," Haren said.