The District of Columbia City Council Tuesday unanimously approved regulations for a DC medical marijuana program, but some patient and provider advocates are concerned the measure is too restrictive. The measure must be voted on again next month, and then approved by Congress under DC Home Rule law.

Under the measure approved by the council, DC residents who suffer from HIV, cancer, glaucoma, or a "chronic and lasting disease" will be able to possess up to two ounces of marijuana in a 30-day period after presenting a doctor's recommendation. Patients will not be able to grown their own medicine, but will be able to purchase it through one of five medical marijuana distribution centers. Patients, designated caregivers, and distributors will register with the city Department of Health and be provided with ID cards.

Distributors will be limited to growing no more than 95 plants and must be located at least 300 feet from schools. The original version of the legislation had a 1,000-foot location restriction, but that was reduced after advocates said it would make it nearly impossible to find suitable locations in the city.

"This legislation seeks to avoid problems while assuring the District moves forward with a medical marijuana program that is based on evidence and best practices," said council member David A. Catania (I-At Large), chairman of the Health Committee.

The Tuesday vote is one of the last steps in the more than decade-long struggle to bring medical marijuana to the District. Voters approved a medical marijuana initiative with 69% of the vote in 1998, but DC officials were blocked from implementing the will of the voters by the Barr amendment, named after then Rep. Bob Barr (R-GA). That amendment was only removed last year, after Democrats regained control of the Congress. DC officials are counting on Congress to look the other way when asked to approve the measure later this year since federal law does not recognize medical marijuana.

While many medical marijuana supporters are happy with the measure, others fear it is so restrictive it will defeat its purpose. "We're happy that they passed it -- some cities have yet to enact any legislation -- but we have some concerns with the language that is currently in there," said Nikolas Schiller, secretary for the DC Patients' Co-op and member of Americans for Safe Access DC chapter. "There is no home cultivation for patients. In 1998, District residents voted legal cultivation at home, but this measure removes that language," he said.

"Patients can only use or possess cannabis at home," Schiller went on. "The council is coming from a perspective where they don't want coffee shops or places where people can medicate together, but this will be an onerous restriction on patients. People who rely on medication for work will have to leave work and go home to medicate."

Patient advocate and StoptheDrugWar.org assistant director David Guard took issue with the council's failure to include chronic pain in its list of allowable conditions. "Chronic pain isn't in there, and that's deplorable," he said. "In DC, 3% of the population suffers from HIV/AIDS, but according to national figures, 30% of the population suffers from chronic pain. I'm sick of people turning their backs on chronic pain."

Schiller also criticized the Council's decision to make distributors for-profit operations. "The original language allowed for nonprofit corporations, and Catania is on record as saying they only want to use best practices from other states, but only Colorado has the for-profit model included," he noted. "From a medical perspective, the for-profit model is seen as being part of the larger health care industry. People feel that for-profit distribution works against the best interests and needs of the patients and for the business's shareholders and boards of directors."

He also took issue with the 95-plant limit, saying it could prove insufficient for patient demand and that it could lead to distributors choosing fast-flowering strains instead of those best suited for patients. "The reality is that 95 plants will not be enough at the beginning because they won't know what the demand is," Schiller said. "If they can only grow 95 plants and it's a for-profit business, they will want to produce as much medicine as possible, leading to strains that grow quickly."

The council will vote again on the measure on May 4, and then Congress will have 30 days in which to approve it. That means DC could have a working medical marijuana system before year's end. It also means that advocates will have one more shot at getting a better program.

"We're thankful that the Council has been proactive and understands the need for medical marijuana," said Schiller. "We are hoping to influence the Council to change this for the better, and we are lobbying our elected officials to make those changes."