LAKELAND — Even as they celebrate the availability of medical marijuana, local patients say the state program is deeply flawed.

Four who spoke to The Ledger say the process of gaining state permission and a doctor’s recommendation is too cumbersome.

And all bemoaned the expense of medical marijuana. The state patient’s license costs $75 and must be renewed annually.

With cannabis still illegal under federal standards, health insurance plans don’t cover doctor visits or the medication itself. Patients said some of the roughly 1,900 approved doctors in Florida seem to regard medical marijuana patients as a main profit source.

Florida’s rules allow doctors to write recommendations covering 210 days, but Betty Patterson of Lakeland said her current doctor requires her to return every 70 days for another appointment.

“At the beginning, there were doctors — it was new, and they were charging outrageous (fees),” said Luke Hamiel, also of Lakeland. “There was one doctor in Lakeland who wanted me to pay $100 a month.”

He said he now pays a doctor less than $25 a month.

Mandalyn Dalton, manager of the Lakeland Curaleaf outlet, said she often hears complaints from patients about doctors’ fees.

“We have doctors who just take every single penny they can from these people who are on disability,” she said. “They’ll give them enough milligrams for one vape pen and say, ‘You have to come back in two weeks and pay another $100 and we’ll talk about how it’s working for you, and we’ll give you enough milligrams for another vape pen,’ and people are like, ‘I can’t afford this,’ and there’s nothing we can do.”

Many patients also struggle to pay for the products. A 150mg supply of CBD vaporizing oil costs $22 at Curaleaf. A 600mg bottle of CBD tincture of CBD oil goes for $90.

Hamiel said he pays about $250 a month for his cannabis oil, in addition to doctors’ fees. "Amy," a mother and college student, said she wouldn’t be able to afford her medication if not for financial help from relatives.

That is equally true for a 20-year-old college student, who asked not to be identified.

“If I had to pay for it myself, I would be unable to,” he said. “I don’t really know where I would be able to find the money. If my parents weren’t supporting me, it would be incredibly difficult for me to have my legal card.”

Patients also face difficulties when they travel. Amy said she is unable to take cannabis oil on a plane, even a direct flight to California, where recreational use of marijuana is legal. When she visits relatives in a state that has not legalized medical marijuana, she must break the law to continue using her medication.

“It’s great that we have it,” she said, “but we're just not there yet where it’s easily accessible for patients.”