The never-ending debate about marijuana usually pits activists on one side and law enforcement on the other, with a smattering of politicians in between. But marijuana, at least in part, is supposed to be a medical issue. So where are the doctors?

“There’s a lot of ignorance,” explains Gregory Carter, a rehabilitation-medicine specialist at Providence Hospital in Olympia and Centralia. Like the general public, he says, many docs believe there isn’t a lot of research on the subject, when in fact there’s a ton—some of it his.

Carter says that’s why he spent months working on Governor Chris Gregoire’s petition, released last week, asking the the feds to reclassify marijuana as a legal drug. “There are now literally thousands of peer-reviewed papers,” Carter says. Nearly 50 reach what is considered the “gold standard” of research: double-blind, placebo-controlled studies in which patients don’t know whether they’re getting cannabis, a placebo, or a different type of medication. These gold-standard studies have shown marijuana to be helpful for alleviating chronic pain—specifically nerve pain—and other symptoms, such as nausea.

More than a decade ago, before medical marijuana became legal in this and other states, Carter knew next to nothing about the plant’s medicinal uses. Much of the early scientific literature on pot, based on recreational rather than medical use, was negative. In his practice, though, Carter saw a lot of patients with Lou Gehrig’s disease, and one told Carter he was finding pot helpful. “I was shocked,” the doctor says. “In fact, I didn’t really believe him.”

But after medical marijuana become legal here in 1998, more patients started saying the same thing. Carter kept track of his patients’ experiences with marijuana, and in 2001 published a seminal paper that he says launched a body of research looking at cannabis’ potential use in neurodegenerative diseases.

Carter, who also holds a position at the University of Washington, has continued to research cannabis, but it has not been easy. Because marijuana is illegal, the feds as well as UW require exhaustive paperwork before they will authorize its use in research. To get approval for a recent study using human subjects, Clark says he had to hire a lawyer. The process took six months.

And those are only the barriers to research. Doctors considering whether to recommend marijuana to patients have something more serious to think about: punishment from the feds. Carter points out that the DEA can take away a doctor’s ability to prescribe drugs like morphine, which can put a physician out of business.

That helps explain why most of the doctors signing off on marijuana authorizations are affiliated not with mainstream practices, but with dispensaries or other pot businesses. Carter, however, does give such authorizations. He says he protects himself by following the state law. And, he says, “I try to keep a low profile”—something he may have lost with his participation in the governor’s petition.