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By David Adams MIAMI (Reuters) - Jeb Bush is siding with opponents of an initiative on Florida's November election ballot to make medical marijuana legal, despite strong public support for its use as a treatment for debilitating illnesses. Bush, a former Republican governor of Florida who is considering a presidential bid in 2016, issued a statement on Thursday saying the legalization of medical marijuana would hurt the state's family-friendly reputation. "Florida leaders and citizens have worked for years to make the Sunshine State a world-class location to start or run a business, a family-friendly destination for tourism and a desirable place to raise a family or retire," Bush said. "Allowing large-scale, marijuana operations to take root across Florida, under the guise of using it for medicinal purposes, runs counter to all of these efforts," he added. "I strongly urge Floridians to vote against Amendment 2 this November," he said. Support for medical marijuana legalization in Florida is holding steady at 88 percent despite weeks of vigorous campaigning by opponents, a poll released late last month showed. Only 10 percent of those polled said they opposed the measure. The poll also found a smaller majority of Florida voters would support recreational use of small amounts of marijuana by adults, with 55 percent backing it and 41 percent opposed. Ben Pollara, campaign manager for United for Care, which is leading the legalization effort in Florida, said Thursday he was surprised that Bush had taken "a position so out of step with the voters who twice elected him to the highest office in the state." Twenty states and the District of Columbia have some form of laws that permit the use of marijuana for medicinal purposes, though they vary widely. Florida Governor Rick Scott signed a law in June allowing the limited use of a special non-euphoric strain of marijuana, known as Charlotte's Web, to treat state residents with epilepsy, cancer and afflictions causing "seizures or severe and persistent muscle spasms." The amendment, if approved by voters, would allow marijuana to be more broadly prescribed by doctors to treat a range of debilitating conditions. Charlotte's Web is an oil extract not for smoking and is specially cultivated to be very low in tetrahydrocannabinol (THC), the element that gets users high. (Reporting by David Adams; Editing by Steve Orlofsky)