Following intense negotiations and a close vote, Ohio's senate passed a medical marijuana bill last week that allows patients in the Buckeye state access to cannabis. However, the bill could still end up in the wastebasket if Ohio governor John Kasich decides to veto it.

Will he or won't he?

Despite admitting to his own use of marijuana when he was young, the Ohio governor has been a sharp critic of the pro-marijuana movement.

At a town hall meeting in February, he said he "totally opposed" marijuana legalization. Kasich also suggested last fall on national television that legalizing marijuana sends kids a mixed message about the dangers of drugs.

Those views are backed up by his opposition to Ohio's failed pro-pot ballot initiative last year. They're also in keeping with comments in 2014, when he said "no, I am not in favor of [medical marijuana]."

Although his comments are worrisome to marijuana advocates, it's not a given that Kasich will veto this bill. Yes, he's remained steadfast in his opposition to recreational marijuana, but he may be softening his opinion on medical use. Earlier this year he said, "Medical marijuana, I think we can look at it."

If that softening tone is any indication, he could follow in the footsteps of his state's legislature and OK this bill. If he does, then it would clear the way for patients with indications such as HIV, epilepsy, and cancer to use cannabis.

However, patients will have to get their medical marijuana from outside of the state at first. Hammering out the details of licensing and opening medical marijuana dispensaries is complex, and it could take a year or more before dispensaries are up and running. Unfortunately, the bill doesn't allow patients to grow cannabis themselves.

Another marijuana change could be coming

Last November, Ohioans overwhelmingly rejected a recreational marijuana proposal appearing on the state ballot. The "vote yes on Issue 3" initiative failed by 65.1% to 34.8%.

Issue 3's failure, however, may not be because Ohioans are overwhelmingly against marijuana reform. Significant opposition to Issue 3 came from many cannabis supporters who viewed it as an attempt by a small number of operators to establish a monopoly in the state.

Curt Steiner, campaign director for Ohioans Against Marijuana Monopolies, told USA Today after the election that "Issue 3 was nothing more and nothing less than a business plan to seize control of the recreational marijuana market in Ohio."

Steiner's comment helps explain why Issue 3 failed even though a Quinnipiac University poll last fall found that Ohioans support recreational marijuana by 53% to 44%.

Because the majority of Ohioans say they support marijuana reform, marijuana advocates remain hopeful that a better-designed proposal can pass. Currently, the influential Marijuana Policy Project is attempting to garner enough signatures to get another pro-pot initiative on the ballot this year.

Looking ahead

If Kasich approves Ohio's medical marijuana bill, then Ohio will become the 25th state in the nation to put medical marijuana laws in place. Although medical marijuana laws vary widely from state to state and many are very restrictive, momentum for medical marijuana appears to be building. If so, then it would appear to be just a matter of time before most states pass similar measures.