Syracuse, N.Y. -- Susan Rusinko uses marijuana daily, an illegal practice she’s been keeping up for eight years.

She has multiple sclerosis, a condition that binds her muscles into cramps so tight she often has to lie down until the pain and fatigue pass.

“If I smoke, within a couple of minutes’ time, I’m back in the game,” said the 51-year-old Auburn woman. “It alleviates the pain and the spasticity. It’s remarkable to me that we’re still fighting for this.”

In New York, two stumbling blocks exist for patients like Rusinko: the Republican-controlled New York State Senate and Democratic Gov. Andrew Cuomo.

But political dynamics are changing in Albany, where the Senate Republicans have allied with five Democrats – including a key supporter of medical marijuana.

“We’re counting heads in the Senate,” said Sen. Diane Savino, D-Staten Island, a member of the Independent Democratic Conference now allied with the Republicans. She plans to reintroduce her bill early next year. “I believe there is sufficient support in both parties in all three conferences in the Senate.”

That leaves Cuomo, a popular governor and much-talked-about potential presidential candidate whose support is vital for any proposal – especially such a controversial one – to become law.

“I’m not in favor of it,” Cuomo said early this month in response to a question. The risks, the governor says, outweigh any benefits.

That’s the argument of opponents, who say little scientific study exists that conclusively shows marijuana does what other FDA-approved, prescription drugs cannot. They say marijuana can be addictive, impair judgment and lead to other drug use.

Supporters say the lack of research is because the federal government classifies the drug as Schedule 1, the most dangerous kind of narcotic. The American Medical Association, without endorsing medical marijuana, is calling for more controlled studies that don’t put participants in legal jeopardy.

Meanwhile, across America, momentum is building behind proponents of medical marijuana. Already, 18 states and the District of Columbia allow patients to use pot to manage pain, spasticity and nausea caused by cancer treatment, epilepsy, AIDs and other diagnoses. Under federal law, the drug remains illegal, even for medical use.

The Pharmacists Society of the State of New York and the Hospice and Palliative Care Association of New York State support using marijuana for treatment; the Medical Society of the State of New York also supports it, specifically when all other options have failed.

And this fall, voters in Washington and Colorado made possession of small amounts of marijuana legal. (Voters rejected a similar measure in Oregon.) In New York, that same amount (25 grams or roughly an ounce) is “decriminalized,” meaning it can lead to a ticket and a $100 fine.

Few political leaders in New York are talking about legalizing pot for recreational use. But when it comes to medical treatment, lawmakers are listening to patients and making decisions based as much on individual experiences as political ideologies.

Sen. John DeFrancisco, R-Syracuse, met with Rusinko and other medical marijuana advocates this fall. He went into the meeting opposed to the idea.

“Quite honestly, they made quite compelling cases,” said DeFrancisco, a lawyer and former chair of the Senate Judiciary Committee. “I’m open to the issue.”

But to earn DeFrancisco’s vote, Savino and others will have to convince him that pot would be grown, sold and used strictly for medical purposes.

“If that balance could be reached, I would look at it very, very seriously,” DeFrancisco said.

Rusinko uses pot when the tingling turns into paralyzing muscle cramps. Some days she makes it till mid-afternoon before smoking or using a vaporizer. Some days, she inhales first thing in the morning.

“It’s the worst leg cramp you’ve ever gotten, times 20,” she said. “You can’t just massage it away.”

Marijuana contains tetrahydrocannabinol, or THC, an ingredient that disrupts natural cannabinoids in the brain that affect “pleasure, memory, thinking, concentration, movement, coordination, and sensory and time perception,” according to the National Institute on Drug Abuse.

The Food and Drug Administration has approved artificial THC for medical use after clinical trials showed it relieved nausea brought on by chemotherapy and stimulated appetites in some AIDS patients. The National Institute on Drug Abuse does not endorse using marijuana as a way to ingest THC because it’s unproven, it contains hundreds of other ingredients that vary in amounts and smoking it can cause respiratory problems.

Rusinko tried the FDA-approved version of TCH, among other traditional treatments. But the pain would last up to 45 minutes until the pills worked, she said. Some of the medicines have side effects, like weight gain, she said. One drug did relax her muscles – and her bladder, which made leaving the house a risk.

Rusinko said she had tried pot a few times after high school, but never used it regularly. Thirty years later, she’s more worried about managing the house with her husband and spending time with her three sons. She doesn’t want her pain to get in the way of sports games, shopping, wrapping the Christmas presents.

“In the end, marijuana got me to their games and their functions,” she said. “It got me to their graduations.”

But she kept her marijuana use a secret from her boys, now 22 and 19-year-old twins, until the past year.

Rusinko had worried about her sons’ reactions. “Mom,” they told her, “you do way more embarrassing stuff than that.”

Rusinko pays about $150 for a quarter of an ounce of marijuana, which she gets from a friend who gets it from someone else. She declined to say more.

That amount usually lasts her a month. She generally doesn’t drive after she smokes or inhales it, she said. Once, she did drive 45 minutes after using, and she said she was fine.

Experts, both for and against medical marijuana, would not recommend that.

“It’s a psychotropic drug,” says Brad Finn, the executive director of Prevention Network, an alcohol and drug abuse treatment and prevention center in Syracuse.

Finn says he doesn’t believe the relief some find in using marijuana is reliable. Dosage can vary and is hard to control, he said. Any changes brought on quickly by smoking also wear off quickly, he said. He’s also worried any allowance for medical treatment would make it easier for drug abusers.

“There’s a core of us in New York state that work in treatment or law enforcement that just don’t think this is a good idea,” Finn said.

Finn says he’s met with Sen. David Valesky, D-Oneida, another member of the Independent Democratic Conference who supports medical marijuana.

“It’s relatively simple,” Valesky said, adding that many of the state’s medical groups support the idea. “It’s a matter of compassion.”

Finn thinks it’s wrong to weigh the emotional stories from very sick people against the lack of clear medical evidence that marijuana works better than prescription drugs.

Some state lawmakers are on Finn’s side.

“I don’t think now is the right time to consider loosening up on marijuana laws,” said Sen. Patty Ritchie, R-Oswegatchie. “It sends the wrong message to young people.”

Assemblyman Will Barclay, R-Pulaski, agrees with Ritchie.

But he also thinks the votes are there to approve medical marijuana, especially as the proposal has changed over the years to add more restrictions. He’s still against the bill, but “it’s heading in a better direction,” he added. “I think it stands a chance of getting passed.”

A bill to legalize medical marijuana has passed the New York State Assembly three times: in 2007, 2008 and 2012. It has never had a vote in the Senate.

Savino, who sponsors the Senate version, said she’s working on a version to satisfy lawmakers like DeFrancisco. Physicians would approve use for individual patients. The marijuana would be grown in state-sanctioned locations, such as warehouses, with government oversight. Special dispensaries would be established that serve only pre-approved patients with a special, photo identification card.

Only patients with a serious debilitating or life-threatening condition would be eligible for marijuana as treatment, according to Assemblyman Richard Gottfried, D-Manhattan, the bill’s main sponsor in the Assembly.

The latest version of the legislation also calls for revoking the identification card of any patient who breaks the rules, which could include sharing the pot with or selling it to anyone else.

Savino said she’s open to other ideas that would keep the drug in the hands of patients rather than recreational users.

New Jersey, which legalized medical marijuana two years ago and just began dispensing it this month, could serve as an example for New York.

Gov. Chris Christie, a Republican who also is believed to have aspirations to be president, inherited the law when he took office in early 2010. Instead of challenging it, he had state health officials write rules that included criminal background checks of growers and dispensers. Growers competed for state contracts to build facilities in New Jersey. Communities have the right to ban distribution centers, and many have, the Associated Press has reported. New Jersey’s health department is in charge of testing the pot for levels of cannabinoids and toxins, such as mold.

State officials are keeping private the location of the one approved marijuana growing facility “for security reasons,” said Dawn Thomas, a spokeswoman for the state’s Department of Health and Senior Services.

In New Jersey, doctors recommend patients for medical marijuana, and the state issues them a two-year identification card, with a photo. The registration costs $200 per patient, though people on public assistance may qualify for a $20 reduced fee. For now, patients must go to the Greenleaf Compassion Center in Montclair to get their marijuana. If they are too sick, they can request the state approve a surrogate to go in their place.

For now, Rusinko is reconciled to break New York’s laws. She’s been on local television news talking about her marijuana use, and she says no law enforcement officials have contacted her. She’s also encouraged that lawmakers like DeFrancisco are willing to listen.

“He realized we were regular, everyday middle class normal people that just want to live a normal life without having to worry about getting caught,” she said.

But convincing Cuomo remains the biggest hurdle. Gottfried, who’s chaired the Assembly Health Committee for 25 years, knows that all too well.

“If Gov. Cuomo supports a version of a medical marijuana bill,” Gottfried said through an email, “it would be highly likely to pass.”

Contact Teri Weaver at: tweaver@syracuse.com, 315-470-2274 or on Twitter at @TeriKWeaver.