Because marijuana possession remains illegal under federal law, Louisiana legislators adopted a linguistic subterfuge when authorizing its use for medical purposes.

Pharmacists will dispense the drug under written instructions from a doctor, but that piece of paper will not be called a prescription. Legislators decided to call it a “recommendation.” Evidently, this word game will ensure that doctors won’t endanger their federal licenses to prescribe drugs.

That the distinction between prescribe and recommend is purely imaginary, however, is obvious to anyone who has read the 19 pages of the marijuana act, which amends legislation passed but never implemented last year.

The new act has two sections. The first authorizes doctors to recommend marijuana so long as the feds continue to classify it as a Schedule I drug, the most dangerous kind. The second says that, if the feds ever decide to reclassify marijuana as Schedule II, we can go ahead and call that piece of paper a prescription after all.

This semantic trick leaves us with the first half of the act authorizing physicians to “recommend” precisely what they are invited to “prescribe” in the second.

The act says a recommendation is “an order (to a pharmacy) from a physician domiciled in Louisiana in good standing with the Louisiana Board of Medical Examiners” that is “patient-specific and disease-specific.”

That is the verbatim definition of prescription lower down. The word does make some difference, however, since “prescribed” marijuana, being Schedule II, would be more widely available.

Last year’s bill did say recommendation in an early version, on the theory that “prescription” would trigger DEA intervention. If a distinction without a difference is enough to throw the feds off the scent, the Republic is at hazard, Donald Trump or no Donald Trump. And we know it will be enough, because the same dodge has worked in several other states that have legalized medical marijuana.

The final version of the bill used the dreaded word prescription, however, thanks to the Louisiana Family Forum, the fundamentalist outfit that had the run of the Capitol during Bobby Jindal’s God-fearing administration.

Family Forum head honcho Gene Mills threatened to oppose the bill unless it said prescription. Mills, evidently a believer in the magic of words, said that would provide “a necessary safeguard.” Lord knows how, written authorization from a physician being required either way, but Jindal agreed and that was that.

The bill passed, but made no difference, since plans for production and distribution were left up in the air. It was the same old story; Louisiana legalized medical marijuana in 1978 and in 1991, but has never figured out how to get it into the hands of sick people whose sufferings could be greatly alleviated by it.

This time, euphemism firmly in hand, we seem likely to get our act together. It will take another 18 months before pharmacists start dispensing marijuana, but LSU and Southern, which are authorized under the act to grow it, have already been approached by private companies looking to provide the necessary $10 million to $20 million in start-up costs. Evidently, there are enough sick people in Louisiana to make a deal with one of the universities a sound investment.

The act identifies diseases eligible for marijuana treatment as “cancer, positive status for human immunodeficiency virus, acquired immune deficiency syndrome, seizure, disorders, epilepsy, spasticity Crohn’s disease, muscular dystrophy or multiple sclerosis.” Only 10 pharmacies statewide will be licensed to dispense marijuana, so long as it remains Schedule I. If it is switched to Schedule II, and recommend becomes prescribe, any licensed pharmacy can get a piece of the action.

Meanwhile, the Louisiana Board of Pharmacy will decide who gets the 10 licenses. Our experience of laws putting a lid on business permits, and thereby greatly increasing their value, is not encouraging. When it happened in the riverboat gambling business, former Gov. Edwin Edwards and friends wound up in the pen for shaking down applicants. Pharmacy Board director Malcolm Broussard said his members want no part of any funny business.

Victims of debilitating disease have waited far too long for relief. Opponents of the act fear it might be the first step towards the legalization of spliffs, but such anxieties are clearly overblown. The act bans “inhalable” marijuana, and pharmacists may be dispensing it as a cream or tincture. We’ll have to see what doctors prescribe. Sorry, recommend.

Email James Gill at jgill@theadvocate.com.