Community health centers across Massachusetts are running the risk of losing their federal funding if their doctors prescribe medical marijuana.

Officials from the Massachusetts League of Community Health Centers recently informed physicians working out of the organization’s 36 federally subsidized medical facilities that they should refrain from prescribing medical marijuana to any of their 638,000 patients. The reason is while state law has given the proverbial thumbs-up for the use of medical marijuana, it is still taboo, illegal and mostly unaccepted in the eyes of the federal government.

According to reports, doctors that ignore the facility’s request to withhold prescriptions of medical marijuana could create a potential shitstorm with the Feds and risk legal and financial ruin for the health center.

The quandary between the state and Uncle Sam is creating similar snags for others under the thumb of the federal government. Patients living in federally funded housing and those being treated at Veterans’ hospitals are finding that medical marijuana is not an option either.

Many doctors are not willing to chance it either. In addition to the possibility of a facility losing its federal funding, physicians open themselves up to forfeiting their malpractice insurance, which is also covered by federal funds. A federal conviction also prohibits doctors from accepting patients insured under Medicare and Medicaid.

The National Association of Community Health Centers says that while none of their doctors have been federally prosecuted for prescribing medicinal cannabis, the possibility is very real.

A recent memo from the US Department of Justice to federal prosecutors states that while it is “committed to using its limited investigative and prosecutorial resources to address the most significant threats in the most effective, consistent, and rational way,” their department still has no authority to enforce federal laws, including those regarding marijuana.

The cannabis community waits with bated breath to see how the ongoing struggle between state and federal control shakes out.