UPDATED: April 20, 2016 at 12:22 p.m.

Like many college students, Julia Mannino uses marijuana. But unlike many, she does so legally.

Since Mannino was diagnosed with epilepsy at age eight, her parents have looked into all different types of treatments for their daughter’s neurological disorder. This past fall, after a year of visits with her doctor, Mannino received a medical marijuana card in the state of New Jersey. From there, she began receiving prescriptions so she could purchase marijuana from a dispensary.

“I struggled a lot last year, so my parents were willing to try anything,” said Mannino, a junior writing major at Syracuse University.

Despite having this card in New Jersey, Mannino is unable to use her prescription in her school’s state, New York. She said since New York is so strict about the marijuana usage, she is left to fend for her own.

Currently in New York state, there are 10 medical conditions permitted to obtain a medical marijuana license. In addition, there are five permitted marijuana producers and 20 allowed dispensaries.

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THC, the main active ingredient of recreational marijuana, is known to cause relaxation in its users and effective in treating chronic pain. Another active ingredient found in medical marijuana is cannabidiol, or CBD. This ingredient is non-psychoactive and has been found to be effective in treating certain forms of epilepsy, such as Dravet syndrome. The right combination of these two ingredients can lessen or even end the number of seizures a patient with epilepsy has a day.

When it comes to medical marijuana, there also are a limited number of oil strains, and no allowable smokable forms, said Julie Netherland, the director of the office of academic engagement for the Drug Policy Alliance.

Netherland said her group is trying to educate lawmakers about the importance of medical marijuana. But even though the Compassionate Care Act legalizing medical marijuana was signed into law in June 2014, it took much longer — 18 months later — before patients could fill their prescriptions.

The law allowed just five facilities in New York state to get licenses to grow marijuana, and licensees weren’t announced until August 2015. Each facility was allowed to open four dispensaries, with the first ones opening in January.

And some patients have had an even longer road. In order to obtain a medical marijuana card in New York, a patient must work with a licensed physician — licensing requires the physician to take a course and pass a test. Annette Simiele of Multiple Sclerosis Resources of Central New York, Inc. said that out of the over 80,000 physicians in New York, only 551 took the certification course to license medical marijuana cards.

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What’s more, Simiele said, patients looking for medical marijuana cards are discouraged from “shopping” for physicians just because they are licensed. Instead, lawmakers prefer patients to be “established” with a physician before receiving a card.

“It’s a tough spot to be in, where you work so hard to get the legislation passed, and then your doctor says, ‘I’m not going to participate’ — you’re back at square one,” Simiele said.

Simiele explained perhaps a lack of knowledge among politicians could be contributing factors as to why legislation is so tight. As none of them have doctorate degrees, she said they don’t have the foresight to understand the concept.

“(Lawmakers) don’t know the heartache that many of these people have,” Simiele said. “Especially the parents who are watching their children suffer daily with two or three hundred seizures, when they know that a few drops of medical cannabis under this child’s tongue is going to allow them to be seizure free.”

Another possible explanation could be simple politics — she thinks politicians may believe the decision will come back and bite them in the butt come election season.

Either way, playing a waiting game is not something some patients can afford. Simiele said she has seen parents not even bother waiting for legislation to pass, and have since moved to states with looser laws, like Colorado or California.

Etain is one of three companies that opened dispensaries in the Syracuse area. Their dispensaries currently offer three strains of hemp oil, each one with varying degrees of THC and CBD, catered for different conditions.

Etain plans to offer options and forms of marijuana further down the line. But Steve Stallmer, a spokesperson for the company, said it’s not an easy process.

Stallmer said first, they need to get New York’s Department of Health on board. Right now, Etain is just adapting to the current legislation.

Netherland and her advocacy group are currently working to expand current legislation and allow greater access to medical marijuana for those who need it. However, this additional legislation could take months to pass. This can seem like an eternity for families like Mannino’s, who just want help for their daughter’s illness.

One of the major questions patients and advocates have is why legislation remains so strict despite popular support. Simiele said one reason could be the reputation surrounding marijuana.

“There is always that stigma when you hear the word, ‘marijuana.’ You think 1970s, you think of people that were uncapped and free-for-all,” she said. “That’s not what this is about. This is not about recreational use, or getting high. It’s about getting release from your illness.”

CORRECTION: In a previous version of this article, the number of conditions that qualify a patient for medicinal marijuana was misstated. There are 10 conditions. The Daily Orange regrets this error.

Published on April 19, 2016 at 9:44 pm

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