Minnesota’s first medical marijuana patients stepped out of clinics in Minneapolis and Eagan on Wednesday, holding hope in a bottle.

“I’m hoping for quite a bit of relief,” said Tyler Lafferty, 20, of Coon Rapids, who has a full-time job, a 2-year-old at home — and debilitating pain and nausea from chemotherapy treatments for the lymphoma he’s been battling for the past two years.

It was his doctor who suggested that Lafferty try cannabis, after other treatments — including oxycodone, morphine and Vicodin — failed. He walked out of the LeafLine Labs clinic in Eagan on Wednesday with a small cannabis vaporizer he hopes will keep him pain-free and functioning through the next nine months of chemo.

“They said I should be able to take this throughout the day and be safe,” he said. “I’m really excited about this. I’m excited to see the results.”

Medical marijuana became legal in Minnesota at the stroke of midnight Wednesday. Moments later, the state’s first cannabis clinic opened its doors.

“We’ve been waiting a long time for this,” said Kim Kelsey, standing outside the Minnesota Medical Solutions clinic in downtown Minneapolis in the early hours of Wednesday morning. She was one of three patients and caregivers eager to buy medical cannabis the moment it was legal. The clinic opened early to accommodate them.

“We decided we weren’t going to make them wait an extra nine hours,” said Minn­Med CEO Dr. Kyle Kingsley, who opened the clinic long enough to see its first three patients, then reopened at 9 a.m. for the dozen or more patients who had booked appointments during regular office hours. “It’s really an honor to serve the first three patients in Minnesota.”

Kelsey held up the prescription bottle holding the cannabis pills she would be giving her 24-year-old son, Alec, later in the morning. She and other parents and patients have lobbied for years to legalize the medication. Now she will finally see whether it can help ease the seizures and symptoms of Alec’s epilepsy.

Minnesota’s medical marijuana program is one of the most tightly regulated in the nation, and it is also the most clinical. Cannabis will be sold only in pills, oils or liquids, not as smokable plant material. The hope is that the manufacturers will be able to tailor doses, not only to different conditions but to different patients and their needs.

As of Wednesday, there were 90 patients enrolled with the state’s Office of Medical Cannabis. Participation in the program is limited to patients suffering from one of nine serious medical conditions and who have a doctor or other health care professional willing to certify to the state that they qualify for the program.

Patients with epilepsy make up almost a quarter of the 177 patients who have been certified to participate in the program — although not all have paid the $200 annual enrollment fee or completed their paperwork with the Minnesota Department of Health.

Patients with multiple sclerosis make up the second-largest enrollment group, followed by patients seeking treatment for nausea or severe, chronic pain — likely cancer patients or the terminally ill.

Not every qualified patient has been able to sign up.

“I have been banging my head against the wall,” said Duane Bandel, who has been unable to get certified, despite having one of the qualifying conditions, AIDS, and sitting on the state’s Task Force on Medical Cannabis Therapeutic Research. “I have called, I have written, I have begged, I have pleaded. I have an appointment with my doctor next week, but I have been told that nobody at my clinic and nobody at my HMO [HealthPartners] is certifying.”

Because state law allows health care providers to opt out of certifying their patients, large numbers of Minnesota doctors are shying away from the new program. While large practice groups like HealthPartners are still hammering out their internal certification policies, patients are left hunting for a certifying physician, which could delay their enrollment by months.

The Health Department is debating whether to expand the program to include patients in intractable pain in January, and other conditions could follow.

Minnesota Medical Solutions saw 22 patients on the first day of the program. Ten more had appointments at LeafLine — although five patients suffering from seizure disorders had to rebook appointments after the company announced Tuesday that its epilepsy medication was not ready for distribution and would be reformulated over the next few weeks.

Despite the long fight and slow rollout, the program’s first participants were jubilant on the first day of legalization.

“This is a huge day for Minnesota,” said Patrick McClellan of Bloomington, holding the white prescription bag that held a vaporizer pen and $45 worth of cannabis he will use to treat the agonizing muscle spasms of muscular dystrophy. He had been fighting for legalization since 2012.

“It’s going to be a huge difference,” said McClellan, who had been self-medicating with marijuana for the past four years, in addition to the dozens of different prescriptions he takes to manage his rare form of the disorder. “Now I won’t have the fear of arrest.

“But most importantly, I will be able to get medication in a safe environment and I will be able to get medications that are tailored to work for the needs I have, which is extremely important — when you’re finding stuff on the street, you have no idea what it is.”