RALEIGH, N.C. (AP) — North Carolina got a step closer to legalizing medical marijuana on Thursday when the state Senate gave it its initial approval.

The Senate approved a measure legalizing medical marijuana in its first of two votes, 33-9, with nine Republicans breaking from the rest of the party to oppose it. If approved a second time, the bill will go to the state House, which has historically blocked Senate attempts to legalize the drug’s medical use.

Medical cannabis products are legal in 38 states and the District of Columbia, according to the National Conference of State Legislatures. More than 20 states allow the drug to be used recreationally, too.

Legalizing medical marijuana for qualifying patients with a “debilitating medical condition” was added to a bill on Wednesday that originally focused on creating further state regulations for federally legal hemp products. Those hemp products contain a concentration of less than 0.3% of THC concentration, the compound that gives marijuana its high.

Although the hemp regulations remain in the bill, Sen. Danny Britt, a Republican from Robeson County, said on the Senate floor that adding medical marijuana was necessary to “get out in front” of an expected federal reclassification of marijuana from a Schedule I drug to a less dangerous Schedule III drug.

Sen. Bill Rabon, a Republican from Brunswick County who is one of the most vocal proponents of legalizing medical marijuana, said the bill would help sick and dying people in the state. Like in previous sessions, he recounted his own experience smoking pot while undergoing chemotherapy for colon cancer.

“With 18 months to live, I’m here 20 years later because I had a physician who told me to do this, and I did,” Rabon told Senate colleagues.

The bill awaits its second senatorial vote on Monday. Rabon said the chamber might submit additional amendments after reviewing requests from the House.

The House hasn’t clearly indicated if it would pass the bill.

House Speaker Tim Moore said Thursday that he supports legalizing medical marijuana through a Senate measure approved last year, but has said repeatedly that it wouldn’t be considered because not enough House Republicans back the idea.

Moore didn’t know whether combining the legalization with the hemp regulation provisions would persuade additional colleagues. He said he anticipated House Republicans would privately discuss the idea next week.

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Associated Press writer Gary D. Robertson contributed to this report.