New Hampshire residents suffering from severe pain or debilitating diseases such as cancer, AIDS, Alzheimer's and multiple sclerosis could use small quantities of marijuana for relief under legislation adopted yesterday by the House.

The vote in favor of legalizing marijuana for medicinal use, 234-138, would allow ill patients to grow their own marijuana plants or purchase small amounts of the drug. The bill now heads to the Senate. A spokesman for Gov. John Lynch yesterday said Lynch has "serious concerns" about the bill, including the fact that it would put New Hampshire law at odds with federal law.

Yesterday's House vote came a week after U.S. Attorney General Eric Holder said his office would only target distributors of medicinal marijuana when the practice violated both federal and state law. Rep. Evalyn Merrick, a Democrat from Lancaster who sponsored the bill, said the timing of Holder's announcement was "fortuitous" and may have helped galvanize support for medicinal marijuana in the House.

The bill passed yesterday would require a doctor to certify that a patient's condition was severe enough to require marijuana to reduce pain and nausea. The bill's supporters said it was worded carefully enough to ensure that only the sickest patients would qualify for the drug, thereby reducing the potential for abuse. The bill limits each patient to six marijuana plants or 2 ounces of the drug and restricts its use to patients who have suffered debilitating pain for at least three months.

But several opponents of the proposal questioned how patients would get their hands on the drug, since the bill does nothing to legalize the sale of marijuana. Others expressed broader concerns that allowing one use of marijuana would lead to wider abuses.

"There exists no standard of care for pot," said Rep. John Cebrowski, a Bedford Republican. "Each pot smoker is his or her own doctor. Medical use is a Trojan horse for the legalization of marijuana."

Supporters said patients could buy marijuana plants from a person in another state where medicinal marijuana is legal or grow their own supply at home. Thirteen other states, including Maine and Vermont, have legalized marijuana for medicinal uses.

Rep. Roger Wells, a Republican from Hampstead, urged lawmakers to consider the suffering they could help alleviate by supporting medicinal marijuana.

"The only thing standing in the way of compassion for patients suffering from these kinds of diseases is this Legislature. And this bill will change that," Wells said.

The debate preceding yesterday's vote was long and impassioned, but it did not prevent several lawmakers from cracking jokes. At one point, as the chatter of a handful of lawmakers threatened to drown out the proceedings, Rep. Linda Foster, who was presiding over the debate, requested quiet.

"There's just a constant buzz in here that's just getting louder and louder," she said to laughter.