This isn't a pipe dream: Medical marijuana may waft into New York through the back door.

With a few sentences in his State of the State address, Gov. Andrew M. Cuomo unveiled a plan to let 20 hospitals give marijuana to patients with serious illnesses as part of a research program created under an obscure state law. State health officials will now have to turn Cuomo's idea into a workable program, and New York is still a year or more away from providing joints to patients. Protocols must be developed to study which patients with which conditions would benefit from marijuana.

But the research is a small step in the right direction. State Health Commissioner Nirav R. Shah said the federal officials he contacted are enthusiastic about the prospect of the program. Washington isn't always enamored of state medical-marijuana initiatives that could possibly pose a conflict with law-enforcement priorities.

As a research program, the Cuomo plan is limited.

It will still be harder for patients to get marijuana than highly addictive opiates like oxycodone and hydrocodone.

Yet the governor has managed to push the issue toward the top of Albany's agenda at a time when a measure for a broader program -- passed by the Assembly four times -- has been stalled in the Senate.

Perhaps Cuomo's gambit is to break the logjam. To bypass the legislature, he dusted off a 1980 law named for Antonio Oliveri, a former assemblyman from Manhattan. He had a brain tumor and advocated marijuana use to alleviate nausea and other effects of chemotherapy. The law permits use of controlled substances for patients with cancer, glaucoma and other diseases approved by the health commissioner.

In any case, Republican Senate leaders need to get real.

Medical marijuana is legal in 20 states. If New York followed their system, its supply would come from licensed growers. Patients would be certified by doctors, registered with the state and issued ID cards. Pharmacies, nonprofits and hospitals, among others, could apply to dispense the drug. That's where New York should be heading.

But until that happens, Cuomo's approach is a start.