The first medical marijuana dispensaries in New York state opened on Thursday, as the state became the latest to launch a comprehensive program for certified patients to legally obtain and use cannabis to treat severe illnesses.

The first dispensary opened its doors in Manhattan’s bustling Union Square, a modest facility run by the Columbia Care medical marijuana company and sandwiched between an urgent care center and a falafel restaurant.

“It’s gorgeous,” one patient, who declined to be named, said as he left the dispensary. “They were as excited about seeing me as I was about seeing them.”

Newly equipped with a state-issued medical marijuana ID card, the patient, 53 years old and based in Long Island, visited the clinic in search of oils to treat the symptoms of neuropathy, a form of nerve disease common to diabetics. He exited the dispensary without buying anything, as the facility only had tinctures in stock on its opening day.

Almost two years after governor Andrew Cuomo signed the Compassionate Care Act that allows qualifying patients to use marijuana to ease symptoms, smokeable and edible marijuana remain prohibited. Patients will only have access to cannabis in the form of tinctures, concentrate for vaporization or orally ingestible capsules.

Under the program, New York has licensed five organizations to make and sell medical marijuana. Each organization is allowed to operate four dispensaries, and all are expected to be running by the end of January. Eight of the 20 dispensaries opened across the state on Thursday, including the Union Square location.

Outside the Manhattan dispensary, curious people approached the doors but didn’t go inside. The business is starting small – patients can visit and consult with pharmacists by appointment to find the right marijuana treatment.

Rory Chong, a 27-year-old who works in real estate, visited the dispensary to find out how he could get a medical marijuana identification card. According to the legislation, patients can only qualify for the ID card if they suffer from severe illnesses such as cancer, HIV/Aids, Parkinson’s disease or multiple sclerosis.



Chong, who had a cancerous brain tumor removed last year and underwent chemotherapy, said he was seeking oils to help reduce tumor growth and help him fall asleep.



“When you have cancer, [sleep] is a major thing.”



Chong was unable to buy anything from Columbia Care, as his medical marijuana card was issued by New Jersey, where he lives. But the monthly drive to the dispensary in Woodbridge from his home in Fort Lee takes about an hour each way, he said, so he hopes to get a New York medical marijuana ID soon.



Chong said he hoped his New York City doctors would be able to certify him. Physicians who want to certify their patients for medical marijuana have to undergo a four-hour mandatory training course, something other state programs do not mandate, according to the National Conference of State Legislatures.

Advocates have said New York’s program has gone too far in limiting the types of patients who could qualify and how patients can use the drug.

Karen O’Keefe, the director of State Policies for the Marijuana Policy Project, said the new law, while “better than nothing at all”, still “falls far short of what it should be”.

“It leaves behind the vast majority of patients who can benefit from medical cannabis, including those who have intractable pain and need a safer alternative to opiates,” she said. “It’s cruel that so many patients are continuing to have to either break the law or needlessly suffer because the governor insisted on a restrictive program.”



O’Keefe highlighted the long distances patients and their loved ones must travel in order to obtain their medicine, with only 20 dispensaries set to open in a state of nearly 20 million people. She also said “doctors must jump through unnecessary hoops”, which discourages them from becoming certified, including taking a four-hour course that costs $249.



Kevin Sabet, a former Obama administration drug policy adviser and president of the group Smart Approaches to Marijuana, conceded that the law is restrictive compared to other states. But since the bill was passed by the state’s legislature and they “don’t typically decide what medicine is, there is a very deep skepticism throughout the healthcare system in New York”. The Food and Drug Administration has not approved medical marijuana as “a safe and effective drug for any indication”.



David G Evans, special adviser for Drug Free America Foundation who has worked against the legalization of marijuana in New York, said the law “was passed on emotional arguments, not based on medical science”.. But Evans said that those pushing for the legalization of medical marijuana had something the opposing camp did not: the monetary resources to support a vigorous lobbying effort.

“The people who opposed it just simply do not have the resources to get the message before the legislature,” he said.

Critics of medical marijuana also worry about where this new law might lead. Sabet is “concerned about the way that lobbyists are trying to expand the law and the way they’ve tried to expand the law the minute it was passed”.

“I’m more concerned about New York selling marijuana gummy bears and calling it medicine in 2018 than I am about what they’re doing today, which is much more restrictive,” he said.

Nicholas Vita, Columbia Care CEO, said launching the dispensary would be a step toward taking people away from opioid drugs like oxycodone and vicodin.

“We fundamentally believe that there should be an alternative to prescription medicine,” Vita said.

Vita said he was not expecting a deluge of patients yet, as the process of getting certified can take time, and people need more education on what the dispensary can provide.

While New York has lagged behind other states in adopting medical marijuana as a legal option for patients, Vita said he thought the state was coming to terms with it in its own time.

“Healthcare is a very personal issue,” Vita said. “We don’t want to push anyone.”