WASHINGTON >> Complaints of a “wink-wink’’ headache and the $40 prescriptions that qualify thousands for marijuana in California won’t work in Washington D.C.’s newly opened medicinal marijuana dispensaries.

In July, Washington joined a budding number of states to allow medical marijuana to be sold legally.

But with the Justice Department and Drug Enforcement Agency calling D.C. home, the district’s medical marijuana program varies quite a bit from its California counterpart.

In Washington D.C., the dispensaries actually look like medical offices.

One proposed site is sandwiched between an orthodontist and urologist office on a downtown corridor crowded with lobbyists and attorneys.

One of the dispensaries already open for business is just a short walk from the U.S. Capitol.

By comparison, some Venice Beach dispensaries have featured scantily clad women inviting passers-by inside for “evaluations.”

In Los Angeles, shops like “South Coast Greenz” and “O.C. Farmacy” offer delivery service. Similar ventures offer one-stop diagnosis and shopping, without having to officially register with the state.

Advertisements for “medicated Thanksgiving turkeys” and “$49 medical doctors,” lead many to suspect that California’s dispensaries cater toward recreational use and not the treatment of illness.

Some say that the differences between the programs reflect each coast’s perspectives: California more laid back and Washington more uptight.

“They’re not practicing medicine on Venice Beach,” Eric Sterling, director of the Criminal Justice Policy Foundation said, noting that Washington patients are in dire need.

“D.C.’s average patient is 50 years old, with one 93-year-old patient, all of whom are deeply concerned with obeying the law and are sufficiently sick,” Sterling said.

California cardholders would have a hard time recognizing the restrictions on Washington’s exclusive patient pool.

D.C. dispensaries list only four conditions that qualify: HIV/AIDs, cancer, glaucoma and conditions characterized by severe muscle spasms such as multiple sclerosis. The Department of Health website also permits chemotherapy, radiotherapy, and azidothymidine or protease inhibitors — used for HIV — as treatments that qualify for D.C. medical marijuana.

Patients must fill out a 14-page application with the D.C. Department of Health, pay a $100 application fee, and register with one specific D.C. dispensary in addition to finding one of the few doctors in the area that will recommend the program in the first place. If patients want to change their dispensary, they have to pay a new $90 registration fee and notify the Department of Health 14 days before changing.

Doctors recommending more than 250 patients per year automatically trigger an audit.

The strictness of the program means that Washington currently has only about 70 patients, a number that has been growing very slowly since the program’s inception in July. Los Angeles alone has more than 100 dispensaries, even after Measure D forced hundreds of others to close.

California had an estimated 554,000 card-carrying medical marijuana patients as of December 2012, according to Mason Tvert from the Marijuana Policy Project.

Prices are more expensive in Washington, with an average ounce costing about $100 more than a Californian equivalent.

Some argue that D.C.’s strictness could prevent access for the people who need it most.

For some terminally ill patients that qualify, the time and money required by the application process are two things that the patients may not have.

The D.C. Department of Health declined to discuss the city’s policy for this article.

Conflicting state and federal laws have long created tension for states with medicinal marijuana. The District of Columbia has had a particularly tense history because it falls under the jurisdiction of the federal government. The City Council originally passed medical marijuana laws in 1998, two years after California, but it took more than a decade for Congress to give its approval.

D.C.’s strictness is not by accident; the only way it could win congressional support was by emphasizing the legitimate medical treatment possibilities of cannabis for seriously ill patients, officials say.

The first of Washington’s three dispensaries, Capital City Care, is located just two blocks from the Bureau of Alcohol, Tobacco, Firearms and Explosives in a baby blue building with barred windows. Its website talks about D.C.’s unique legal situation:

“As D.C. moves forward to create patient access to this important medicine, we do so with a wealth of knowledge gained from jurisdictions around the country. Our law is different from that of some other states in that it contains strict rules about how medical marijuana may be produced, packaged, and sold.”

Despite what some see as the federal government’s old fashioned view of “reefer madness,’’ some advocates and policy experts say that federal law does not recognize the legitimate medical treatment potential of marijuana.

“Federal law is locked into a cartoonish view of marijuana that was created 40 years ago and bears no relation to medicine of modern science,” said Sterling of the Criminal Justice Policy Foundation in a phone interview.

Washington and California’s practices represent two ends of the medicinal marijuana spectrum.

Some drug policy experts say the California approach has hurt medical marijuana efforts in other parts of the country.

“California experience has sadly created a barrier for legitimate patients in many states, leading to several bureaucratic obstacles,” Sterling said, explaining that California’s “de facto legalization,” acts like a veneer covering the criminal activity of the California drug trade, the polar opposite of D.C.’s attempt to legitimize “marijuana-folk-medicine” as a lawful and socially acceptable medicine prescribed by a doctor.

Asked whether Washington or California represents the future of medical marijuana, Mason Tvert, communications director for the Marijuana Policy Project, answered: “Neither.’’

He pointed to Colorado, which completely legalized recreational marijuana usage in 2013 and has plans to develop marijuana retail shops and lounges.

“We still have a long way to go,’’ Tvert said.

The California News Service-Washington is a journalism project of the University of California Washington Center and UC Berkeley’s Graduate School of Journalism. Contact the CNS at cns@ucdc.edu.