Stephen Betzen’s life changed the morning he found a gift from a stranger on the steps of his house. At the time, his wife, Rachel was reeling from a combination of Lyme disease and injuries from a car wreck. If the opiates prescribed by her doctors eased her pain, they left her nearly comatose, Betzen says. If they didn’t, he awoke to her screams.

The gift was a bag of marijuana.

“We had hit rock bottom, and here is this medicine on our porch — and we were actually having to think about [using] it,” he says. The next day, he says. he heard the most beautiful sound: “The sound of silence when my wife wasn’t in tears.”

Betzen is now the executive director of Texas Coalition for Compassionate Care, a Dallas-based nonprofit that, alongside Texas NORML and Medcan University, is lobbying legislators in hopes of reforming Texas’ marijuana laws. The organizations don't agree on strategy, however, with the TCCC pushing only for a limited law allowing medical use as a defense against criminal charges, and the others seeking broader legalization that would include permitting and regulating sales outlets.

If past is prologue, their battles will be anything but downhill. Legislators already are fighting to ban a substance called K2, which is said to be similar to marijuana and is legal — for now. State Sen. Florence Shapiro, R-Plano, has said she intends to seek a ban on K2. "You can get it ... in gas stations, hooka lounges, tobacco stores. They're selling it everywhere," she told Fox News.

Other politicians continue to see any legalization effort as poisonous. The recently elected chair of the Republican Party of Texas, Steve Munisteri, recently “liked” the TCCC on Facebook but promptly “unliked” it when a reporter called to ask whether he supported medical marijuana. (He never responded.) State Sen. Bob Deuell, R-Greenville, a doctor, also removed his Facebook association with the group; an aide says it was all a mistake.

Advocates can count on the Texas Medical Association, however. In 2005, the organization adopted the position that doctors should be able to consider prescribing marijuana for their patients without fear of regulatory or criminal action and to freely study its medical effectiveness.

Betzen believes the proposal he favors could pass next session because it's more conservative than previously rejected legislation. He’s pushing an “affirmative defense” bill that would neither legalize nor decriminalize marijuana and would not sanction the kind of dope dispensaries that have cropped up all over California or official ID cards for approved users. In fact, Betzen says, his limited law wouldn’t affect current penalties for possession at all. It would only allow a judge or jury to hear that a defendant used marijuana on a doctor’s recommendation.

“If we are not going to get all the protection that we absolutely need, then we are going to take the protections that they are willing to give,” he says. “It’s a compromise to get protections on the table to patients as soon as possible.”

Compromise may not be enough. State Rep. Elliott Naishtat, D-Austin, who plans to file an affirmative defense bill next session, has tried before and failed. Dorothy Browne, Naishtat's chief of staff, says the bill failed even to get a hearing in committee in 2009. The same thing happened in 2007. In 2001, former state Rep. Terry Keel, R-Austin, the former Travis County sheriff, filed a similar bill, which languished in committee. In 2005, the bill received a hearing and was left pending.

Those previous efforts failed, Betzen believes, because they lacked clarity. His proposal specifies limits on the amounts users could possess and better details the requirements of legal use.

“When everybody knows how to comply with the law, it makes everybody in the process safer,” he says. “You have to understand the process."

Different strokes

Texas NORML — the state chapter of the National Organization for the Reform of Marijuana Laws — doesn't oppose TCCC’s approach but isn't particularly excited about the compromise, either. The same goes for Medcan University, says Dante Picazo, its chief executive officer. Medcan lobbies for loosening restrictions on marijuana and runs a company that teaches classes to potential cultivators and retailers on how to profit from legal pot.

Picazo and Josh Schimberg, the executive director of Texas NORML, believe an affirmative defense doesn’t go far enough because it doesn’t prevent arrests for medical marijuana use. “What we’d like to see here in Texas is something along the lines of what New Mexico has, where patients who have a doctor’s recommendation can get registered with the state department of health and have an ID card,” Schimberg says. Additionally, he says, growers and distributors should be registered and regulated by the state and identified as the only possible source for registered patients. That would ease lawmakers’ worries about the legislation enriching criminal elements, he says.

“One of the first questions that always comes up is, ‘How are you going to ensure that patients aren’t going to the black market to get product from drug gangs?’” he says.

Such a law would also generate billions for the state, says Picazo, who has drafted a bill called the Texas State Medical Use of Marijuana Act. He envisions a system governed by an agency similar to the Texas Alcoholic Beverage Commission.

“If we are talking about a drug, then I compare it to alcohol. Why don’t we patrol it and police it and regulate it the way we do our nightclubs in the state of Texas?” Picazo asks. “If it’s medication, then it’s a totally different set of values and a totally different story. Then it should be in the hands of CVS, Walgreens or medical dispensaries so that it’s totally and legitimately done as an enterprise.”

Pot for PTSD

Like Schimberg, Betzen points to New Mexico to bolster his argument for legalization. There, he says, about a quarter of medical marijuana users suffer from post-traumatic stress disorder. “Roughly 25 percent of the patients in New Mexico are on the program for PTSD, and I would be willing to bet that most of those patients are veterans coming home from war,” he says. “This definitely represents a large constituency.”

Last month the Veterans Administration clarified its position on returning soldiers who test positive for marijuana use. Previously, veterans who tested positive for illegal drugs faced the possibility of being denied their prescription medication. The new directive gave discretion to doctors in such cases. A spokeswoman at the VA's regional office in Dallas says she's unaware of how often or on what schedule veterans in Texas are tested.

That some doctors believe marijuana can help veterans with PTSD or other ailments is one of Betzen’s main selling points. He acknowledges that illegal marijuana fuels violence south of the border, but he doesn’t seem concerned with lawmakers or citizens making a correlation between medicinal use and smuggling. “I think they can see that there is a difference there," he says. "Would they do the same thing if it was morphine crossing the border?”

Though they are pursuing different strategies, Betzen, Picazo and Schimberg have similar goals and have been busily meeting with lawmakers for weeks. They won’t say which lawmakers, however, as some still view any connection to the legalization movement as a political liability. But they cite a poll that found a majority of Texans support legalizing marijuana for medicinal purposes. A University of Texas/Texas Tribune poll conducted in May showed a similar finding, with the majority of Texans favoring one or more methods of legalization: 42 percent of Texans were open to the idea of legalizing marijuana, 28 percent say possession of small amounts should be legal, and 14 percent said any amount should be legal. Twenty-seven percent said it should be legal for medical purposes only, and another 27 percent said it should be illegal under any circumstances.

“If [those numbers] hold even close, then this isn’t really a political liability with the voting public,” Schimberg says. “It’s just a mental block with the representatives and the senators.”