The 22-member group, headed by Dr. Joshua M. Sharfstein, secretary of the state Department of Health and Mental Hygiene, split almost evenly between two proposals. The first, backed by Sharfstein and the group's medical and law enforcement officials, would treat medical marijuana as an investigational drug. Under that proposal, the state would designate an educational research institution to dispense the drug to selected patients.
Advocates of medical marijuana say it helps treat some medical conditions, such as seizures, chronic pain and severe nausea resulting from cancer treatment.
In an interview Friday, Sharfstein said it was difficult for the group to come to a unified conclusion because everyone was coming from "different starting places." One member of the group refused to sign on to either proposal.
"I think it's an appropriate way to handle medical marijuana, for there to be monitored programs and careful thought for potential uses, to figure out if the benefits outweigh the risks," said Sharfstein, who said it would be "premature" to speculate on how the competing proposals would fare in the legislature.
He called the findings, presented along with draft legislation, "a little rough around the edges" and said they should be viewed as "starting points" for legislative discussions.
State Sen. David Brinkley served on the group and supports the second proposal, which he said would provide "patient access" and would decriminalize medical marijuana for patients suffering from chronic illness.
"I'm trying to get patients out of the black market and prevent them from being treated like criminals," said Brinkley, a Republican representing Carroll and Frederick counties. "There's a polarization on what to do about it. We got to hear all sides. Just focusing on the study side doesn't help anybody. … That's not the reality of what these patients are dealing with."
Raquel Guillory, a spokeswoman for Gov. Martin O'Malley, said the governor does not have plans to include a medical marijuana package in his legislative agenda.
The state Senate has approved legislation to legalize medical marijuana in the past, and a spokesman for Senate President Thomas V. Mike Miller said that the body would likely do so again next year.
Last year's proposal stalled in the House of Delegates after Sharfstein raised concerns about it.
House Speaker Michael E. Busch said the House would "obviously entertain" the work group's recommendations.
However, Busch said he could not guarantee that any particular bill would pass. If one is adopted, he said, it will include strict controls on prescriptions.
"We're not going to let pharmacies just decide to give them out," he said.
Lawmakers did make a change this year to an eight-year-old medical marijuana law, allowing people arrested with an ounce or less of marijuana to use medical necessity as a defense. Defendants can attempt to prove they are not guilty by presenting medical paperwork or a doctor's testimony or note.
More than a dozen states and the District of Columbia now allow the use of medical marijuana. But some state officials have lingering concerns about legal liability. The governors of Rhode Island and Washington state asked the federal government last month to reclassify marijuana in order to protect dispensaries and patients from criminal prosecution, according to news reports.
Sharfstein said the role of the work group was to identify possible models for Maryland and that neither of the proposals have been "reviewed extensively for potential legal issues."
Mike Young, a member of the work group and a vice president of the Maryland Fraternal Order of Police, declined to sign on to either proposal, citing the federal law designating marijuana as illegal.
"Both reports, in my opinion, had good points," said Young. "If there was going to be relaxing of federal laws, I think Maryland has taken the right direction in developing procedures. But the long and short of it remains: Until the federal government relaxes its grip, it's just difficult for the FOP to support a Maryland law not in compliance with federal law."
Dr. Paul Celano, an oncologist at Greater Baltimore Medical Center and a member of the work group who recommended the model emphasizing study by a medical institution, called the proposal "compassionate."
"Whenever we're introducing a new medicine into the community, you look at the conditions you're trying to treat … and there needs to be a proper monitoring … dosage, side effects," said Celano, who is president of the Maryland/DC Society of Clinical Oncology. "With any medicine, there's always a hopeful thing that you're doing something good for patients, but here's also a possibility of a downside."
Baltimore Sun reporters Annie Linskey and Michael Dresser contributed to this article