After allowing marijuana to be used for medical purposes in 2000, Hawaii was widely envisioned to be the first state that would legalize marijuana in America.

Instead, 14 years later, there’s no legal way for patients to obtain marijuana without growing it themselves. The law is silent on how the state’s 13,000 patients can get seeds for the seven plants they are allowed to grow.

Even after Colorado and Washington legalized marijuana through voter-backed initiatives, Hawaii legislators remain focused on legislation that would create a statewide medical marijuana dispensary system that — in the best-case scenario — will likely take two to three years to become reality.

"I’m discouraged," said Karl Malivuk, a 66-year-old medical marijuana patient from Moiliili who sits on the Medical Marijuana Dispensary Task Force that’s trying to develop a dispensary system. "I’m worried they’ll have the 20th anniversary of the 2000 act (allowing medical marijuana) before they open the first dispensary. People had been patting themselves on the back saying, ‘Hawaii is the first state to recognize medical cannabis.’ But for 14 years it’s been a useless law. The system was doomed right from the beginning."

So Malivuk — who suffers extreme nausea from treatment for chronic liver disease — buys his marijuana through Hawaii’s underground market.

"I have no say-so over what is available," he said. "Compared to the ’60s and ’70s, it’s so heavily narcotic. So I have a choice of being nauseated or totally stoned."

The upcoming legislative session certainly will see efforts to legalize marijuana, or at least lessen the penalties to mere fines.

Tracy Ryan, chairwoman of the Libertarian Party of Hawaii, last week circulated a bill she drafted that would legalize marijuana and was looking for a sponsor. State Sen. Will Espero (D, Ewa Beach-Iroquois Point), chairman of the Public Safety, Intergovernmental and Military Affairs Committee, once again plans to introduce legislation calling for fines instead of criminal penalties for marijuana possession.

But like other legislators, Espero said the emphasis on marijuana-related bills this session will be on creating a system that would allow patients to legally acquire their marijuana through an unknown number of dispensaries on each island.

"I do expect that bills will be introduced on decriminalization and legalization, as always," Espero said. "But Hawaii’s not ready for legalization. The public is not clamoring for it. My colleagues are not knocking on my door saying, ‘We have to have it. It is now on the radar and it is gaining momentum.’ People are still waiting to see how things are handled in Colorado and Washington and other states."

The number of medical marijuana patients is expected to grow next year when the state Health Department takes over administering the program from the state Department of Public Safety and its law enforcement focus.

But last week, Medical Marijuana Dispensary Task Force members heard testimony that the Health Department likely will need two to three years after a bill is passed to consider all of the complicated issues involved in a dispensary program — and create rules to administer it.

In the meantime, chronic pain sufferers such as Vernon Drury, 54, of Makakilo, remain frustrated that it’s still illegal to obtain marijuana and marijuana plants — even for patients with a state-issued certificate.

"It shouldn’t take that long to get medical marijuana to patients," Drury said. "All we’ve got to do is follow what’s being done in Washington and Colorado. But we like to drag things out here. It frustrates me. Why not make it legal all the way around?"

The answer is that the federal government seems willing to allow medical marijuana in states "with a tightly regulated system," said state Rep. Della Au Belatti (D, Tantalus-Makiki), chairwoman of the House Health Committee, which likely will hear any bills regulating Hawaii’s dispensary system, including one being drafted by the Legislative Reference Bureau.

"We’re focusing on making sure we have a dispensary system that works and operates," said Belatti, an attorney. "The feds — for lack of a better word — respect that. We don’t want our patients to be federally prosecuted. That’s why the focus on decriminalization and legalization is misguided. We should focus on what we can do. But I understand the frustration. I feel their frustration."

There is no shortage of complicated issues that have to be addressed in setting up Hawaii’s dispensaries, said Susan Chandler, director of the University of Hawaii’s Public Policy Center.

"You have licensing issues," said Chandler, who facilitates the dispensary task force’s meetings. "Who’s going to be able to grow it? What’s the fee structure? There are quality control issues and security issues. It’s a very complicated piece of legislation. While other states have done it, we don’t have a quick administrative rules process and procedures."

Until Hawaii creates a dispensary system, Chandler said, "We have a medical marijuana system but you have to begin in the illegal market. How do you get your first seed? You can’t buy it legally. That’s the strangest part."

So caregivers such as Jari Sugano and Reid Kaneshiro of Mililani Mauka struggle on their own.

This year, they went looking for a marijuana plant to cultivate in their backyard so they could create a tincture to help treat their daughter’s seizures.

Five-year-old Maile "MJ" Kaneshiro was diagnosed with Dravet syndrome, a rare form of epilepsy. The couple also has an 8-year-old autistic son, Austin.

A stranger finally gave them a plant, Sugano said.

"We had no idea what we were getting. I had no experience with marijuana and the learning curve is very steep. And I couldn’t get the plants to grow. It was just too cumbersome," she said.

Sugano, who is also on the Medical Marijuana Dispensary Task Force, helps fruit and vegetable farmers on Oahu through her job as an extension agent for the University of Hawaii’s College of Tropical Agriculture and Human Resources. So Sugano is embarrassed that she isn’t doing a better job of cultivating marijuana plants in her backyard, where four of her legal seven plants just died of a white fungus outbreak.

Showing her three surviving, 18-inch marijuana plants, Sugano said: "This is sad for what I do for a living. But this is the best I can do. As the parent of two special-needs children, there isn’t a lot of time left for me to learn how to do this."

With only three plants alive that can provide MJ with enough tincture for a month — and no seeds, seedlings or cuttings, Sugano said, "We don’t have a backup. We’re stuck."

If Hawaii had a medical marijuana dispensary system, Sugano said, she would know the origins of each plant and possibly have access to a testing facility to measure the right amounts of cannabidiol (CBD) and tetrahydrocannabinol (THC) that MJ needs for her tinctures.

Before Sugano and Kaneshiro learned how to turn their plants into medicine for their daughter this year, MJ had seizures daily. Now she’s down to about one seizure per week and her hyperactivity and appetite are better, Sugano said.

But the effort can be overwhelming, she said.

"Managing a family with two special-needs children is difficult," Sugano said. "On top of that, I have to take care of the plants. For many patients, it’s just too much."