More and more states are saying yes to medical marijuana. But local governments are increasingly using their laws to just say no, not in our backyard.
In California, with the nation's most permissive medical marijuana laws, 185 cities and counties have banned pot dispensaries entirely. In New Jersey, perhaps the most restrictive of the 17 states that have legalized marijuana for sick people, some groups planning to sell cannabis are struggling to find local governments willing to let them in.
Dispensaries have also been banned in parts of Colorado and have run into opposition in some towns in Maine.
Local politicians have argued that pot is still illegal under federal law, that marijuana dispensaries bring crime, and that such businesses are just fronts for drug-dealing, supplying weed to people who aren't really sick.
Cities and towns are prohibiting dispensaries outright or applying zoning ordinances so strict that they amount to the same thing. The ordinances typically set minimum distances between such businesses and schools, homes, parks and houses of worship.
The township manager of Maple Shade, N.J., where the zoning board last year turned down an application for a dispensary at the vacant site of a former furniture store, said his town was just following zoning law. But Gary LaVenia said it is easy to see why people would be nervous about legal pot-dealing in their communities.
"People read the accounts of what's going on in the other states, like Colorado, like California," he said. "Regardless of the fact that use here is the most regulated, people still read those accounts and assume that that's what's going to happen here."
Medical marijuana advocates say the resistance is going to hurt people in desperate need of relief.
"It prevents patients with mobility issues from getting their medication," said Kris Hermes, a spokesman for Americans for Safe Access, an Oakland, Calif., group. "It also pushes patients into the illicit market."
States such as California and Colorado have seen an explosion in the number of pot dispensaries, along with criticism that the rules are so lax that practically anyone can buy weed. Also, there have been cases of violence involving people trying to steal pot from dispensaries.
Local governments are within their rights to restrict or keep out pot businesses, said Lars Etzkorn, program director for the National League of Cities.
"Land-use and business regulation are the most fundamental decision-making that local officials are entrusted with," he said. "Local communities, the local electorate, can decide what sort of level of regulation they want."
But medical marijuana is particularly thorny, he said, because it can place mayors and town councils in an awkward position of deciding whether to follow federal law, which makes marijuana possession and use a crime, or state law. Several state laws that say pot is OK for medicinal purposes were passed by the voters.
Advocates say the drug can relieve pain, nausea and other symptoms, especially in people with cancer, AIDS, glaucoma and multiple sclerosis.
Some states, including Oregon and Michigan, have legalized medical marijuana but not dispensaries. Patients are expected to grow their own or obtain it some other way.
In 1996, California voters made their state the first to legalize medical marijuana, and there are now an estimated 1,000 dispensaries around the state. A clarifying state law passed in 2003 left a lot of the specifics up to city and county governments, and many have relied on that measure to adopt their own regulations.
According to ASA's tally, 60 governments in California have rules for local dispensaries, often including where they can be located. Several, like San Diego, have zoning regulations so restrictive that they are effectively an outright ban, Hermes said.
In Los Angeles a little-enforced part of the local law bars pot sales within 1,000 feet of any home — a measure that would ban dispensaries nearly everywhere.
In recent years, though, California cities have become more likely to ban dispensaries altogether. Since 2004, three times as many city and county governments in California have enacted bans as they have rules. The most populous city with a ban so far is Fresno, with a half-million residents.
The legality of several of the regulations and bans is being slugged out in court. But last year, a court found that the city of Riverside was within its right to nix any dispensaries.
Elsewhere around the country, Maine has amended its medical pot law to block towns from imposing tighter zoning restrictions than those included in state law.
In New Jersey, lawmakers made pot legal for patients with certain conditions in January 2010, but there is still no place where they can get it legally.
The state has authorized six nonprofit groups to grow and sell cannabis. So far, only one has announced that it has secured local approvals — in Montclair, a liberal New York City suburb where no zoning hearing was required. Three others have been shut out of their chosen locations by local government bodies, despite assurances that security at the dispensaries would be tight and that pot would be given only to patients who are truly sick.
One of those communities, Upper Freehold Township, adopted an ordinance last month banning zoning approvals for any business purpose that defies federal law.
Charles Kwiatowski, a 40-year-old MS patient who lives nearby, spoke at the meeting about how marijuana eases his symptoms better than any combination of the 27 prescription painkillers, muscle relaxers and other drugs he has tried over the years.
He said that a few weeks ago, he thought he was buying marijuana from a dealer in Asbury Park but ended up with Spice, an herbal mix that resembles marijuana and can cause hallucinations that last for days. He said it didn't ease his symptoms.
"It didn't help me to waste my $50 on something that wasn't going to help my problem," he said. "It only forced something far worse than marijuana into my life."
Andrei Bogolubov, spokesman for a group that was denied permission for a medical marijuana business in Maple Shade, N.J., said he is going to keep looking for a more welcoming town and realizes he is going to have work harder to change people's minds.
"Since this is new and there's a lot of misunderstanding out there, you've got to do more," he said.