NEW YORK (MainStreet) — The initial medical marijuana patient sign up process in Illinois, now in its first month, appears to have generated no controversies just yet, with more than 2,000 people already signed up for the program. But there are looming problems that could affect future patients in Illinois and beyond.

The no-frills sign-ups in Illinois bode well for the viability of medical marijuana in the state, according to Ali Nagib, assistant director of the Illinois National Organization for the Reform of Marijuana Laws (NORML). In September and October, patients with last names starting in A through L can apply, and in November in December patients with last names M through Z can sign up. Beginning Jan 1, 2015, there will be year round open enrollment for all patients.

“There are plenty of legitimate criticisms about the timeline that was created by the law,” Nagib said. “But the state agencies have done a fantastic job of making sure patients don't have to wait any longer than necessary to get access to this medicine.”

It is noteworthy that unlike, for example, the national Obamacare website, the registration process for medical users in the state at least so far has been relatively smooth and bug free.

To boot, the lottery application process itself in the state seems to be relatively lawsuit free at this point, a distinction that cannot be said of Massachusetts which is on about the same timeframe for initiation of its medical distribution system. And in the recreational market in Washington State, within the first month of market start in July, local growers and sellers had come to loggerheads about supply and demand pricing; a suit filed by dispensary owners challenging federal authority over local jurisdiction is headed to the Washington state Supreme Court.

The Green Challenges of Illinois

Still, a big problem facing Illinois patients, even if indirectly, is the very process of dispensary approvals via the state lottery process. Hopeful dispensary owners had much of the first week of the month to submit final applications which were far from either easy or cheap. Given both the length of the approval process and then the time needed to grow and harvest the first fully legal crop, it is unlikely the Illinois market will proceed at a faster clip than the state market in Massachusetts, for example.

Per Nagib, “We don't expect medicine to be available on shelves until late spring 2015.”

That said, advocates like Nagib are encouraged by the fact that the new laws that specifically carve out protections for medical patients may also be implemented smoothly.

There are other challenges the present themselves through the legal haziness of this fledgling market. Overall, the Illinois medical market appears not to have the same “recreational” drama as Washington state, but there are also other comparisons that have many advocates worried, starting with the impact of the state’s strict zero tolerance drugged driving laws on patients. This issue was front and center in the Washington legalization debate and has subsequently begun to pop up nationally. In Illinois this creates an even more confusing situation, because minor possession is still not decriminalized yet for non-medical users.

“The application of DUID laws to Illinois medical cannabis patients is still unclear, but there is a clear exception to our existing per se DUID laws for cannabis that covers medical cannabis patients,” Nagib said. “If a patient is suspected of driving under the influence, rather than immediately being subjected to blood tests to determine the presences of cannabis metabolites, patients will be given the standard Field Sobriety Test to determine actual impairment."

It remains to be seen how this will be implemented, and Nagib hopes patients will not be unfairly persecuted simply for having pre-existing cannabis metabolites in their system.

Perhaps the largest problem still facing Illinois patients is actually finding a doctor to prescribe them medical cannabis in the state.

“Illinois has one of the most restrictive medical cannabis laws and the biggest impact is on the doctor/patient side," Nagib said. "The barriers for becoming a qualified patient are significant, including being subjected to background checks, fingerprinting, a relatively-limited list of qualifying medical conditions and restrictions on doctors that make it difficult for many patients to even find a doctor willing to write a recommendation that will be considered valid by the state.”

Hungry for Progress

Of course, the state has already begun to show flexibility in expanding qualifying conditions.

So overall, it appears that despite the late start to the market, Illinois patients see reform so far as a good thing. As Nagib explained, “While the timeline is far too slow for many patients that have been waiting years for medicine, so far the state agencies tasked with rolling out this program consistently have met or exceeded the original projected timeline.”

--Written by Marguerite Arnold for MainStreet