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SPRINGFIELD, Ill. (AP) – Illinois Gov. Pat Quinn must decide if he will sign a measure allowing the use of marijuana for medical purposes after the state Senate approved legislation on Friday.

The proposal has been touted as the strictest in the nation among states that have legalized medical marijuana. It authorizes physicians to prescribe marijuana to patients with whom they have an existing relationship and who has at least one of more than 30 medical conditions listed on the measure.

Lawmakers voted 35-21 to send the measure to the Democratic governor. Quinn has declined to say whether he will support the bill, saying he’s “open-minded” on the issue. Lt. Gov. Sheila Simon, a former prosecutor, said she is in favor after meeting with patients, including veterans.

The proposed legislation creates a framework for a four-year pilot program that includes requiring patients and caregivers to undergo background checks. It sets a 2.5 ounce limit per patient per purchase and calls for 60 dispensaries regulated by the state where patients could buy the drug.

Supporters of the legislation say it is a compassionate measure that could save patients from the agony caused by illnesses such as cancer, multiple sclerosis and HIV. They argue that marijuana can relieve continual pain without triggering the harmful effects of other prescription drugs, including painkillers such as Oxycontin and Vicodin.

Opponents contend the program could encourage the recreational use marijuana, especially among teenagers.

“We are embarking here on a way to achieve relief, compassionate relief, consistent with the law (with) a system which avoids abuse,” said the bill’s sponsor, Democratic Sen. Bill Haine of Alton. “It’s the tightest, most controlled legislative initiative in the United State related to medical cannabis.”

A report issued last month by the Pew Research Center poll showed that 77 percent of Americans say marijuana has legitimate medical uses. Eighteen states and the District of Columbia allow the use of marijuana for medical purposes.

But opponents in the Illinois Senate worry whether the regulations set by the proposed legislation would be enough to prevent abuse of the drug.

“For every touching story that we have heard about the benefits of those in pain I remind you today that there are a thousand times more parents who will never be relieved from the pain of losing a child due to addiction, which in many cases has started with the very illegal, FDA-unapproved, addiction-forming drug you are asking us to make a normal part of our communities,” said Sen. Kyle McCarter a Republican from Lebanon.

Nonetheless, Haine touted his measure as the strictest that the General Assembly has considered on medical marijuana. Haine and other supporters have been trying to legalize it for several years. A measure that had cleared the Senate failed in the House in 2011, when six Republicans and 50 Democrats voted yes.

The current version of the bill received the House’s approval in April.