While legalization efforts proceed across the U.S., it is increasingly clear that “legalization” is a broad term that is not all it’s cracked up to be.  For anyone.

This is especially true in states where change was brought about by legislative mandate.  Despite all the moans and grumbles if not all out floor fights still going on especially in Washington, in states where legislatures have led the charge, the downstream results to date are even worse.

In the most restrictive states, in fact, rollouts so far have been slow, and the licensing process fraught with charges of political cronyism.  Illinois is no exception.  To date, the state has only approved 2,500 medical marijuana patients since the registration began about 9 months ago.  The low patient count has already prompted at least one company to return the state cultivation license it won back to the state.  The permit winner, Green Thumb Industries, has now decided that it does not want to pay the $200,000 (£150,000) license fee plus establish a $2 Million escrow account and returned the same to the state who in turn offered it to PharmaCann, a company with one existing cultivation permit and four dispensary licenses.

That said, Green Thumb may not be the last ganjapreneur to head for greener pastures.  There are rumblings afoot that other license recipients may do the same thing if patient numbers continue to be so low.  Some fear that the failure to establish a viable regulated business in the state by 2017 may kill the state industry altogether, although others point to the likelihood of federal reform during this period making such distinctions increasingly arcane.

That said, advocates in both the business community and those representing patients are worried about low patient registration turnout this far into the process.  There are several reasons both patient advocates and the increasingly concerned marijuana business community cite for this obvious under-representation of patients in the state registry.  There are an estimated 75,000 marijuana patients in Illinois.  This number may well increase if Illinois approves 11 new conditions for which marijuana may be prescribed (including PTSD) as it is widely expected to do by this summer.  However, the prospect of a criminal background check, fingerprinting and a $150 yearly fee (£120) a year registration fee plus a lot of paperwork is still keeping many potential patients away.

Kris Krane, co-founder and managing partner of 4Front Advisors also said that the lack of access to dispensaries is undoubtedly discouraging more than a few patients.  “The lack of dispensaries contributes to the low patient count.  Without an access point for medicine, many people won’t go through the process or spend the money to become a patient.”  That said, many including Krane believe that the so-far dismal registration rates may change drastically once dispensaries actually start to open. “We’ve seen in other states that patient populations rise with the opening of retail dispensaries,” he said.

But so far at least, with state physicians still reluctant to prescribe medical pot locally, as many are, plus the implications of what would happen if the program disappeared in a state where marijuana is not yet decriminalized for a broader population, it is not surprising that many potential patients are just choosing to stay home.