Alabama approved a medical marijuana program in 2021. Patients are still waiting for it.

MONTGOMERY, Ala. — When Amanda Taylor lived in Arizona, she used medical cannabis to relieve the symptoms of her multiple sclerosis, gastroparesis and other ailments. She returned to Alabama to advocate for medical cannabis in her home state.

Taylor thought victory was in view in 2021 when Alabama overcame years of resistance in the Deep South and approved a medical cannabis program. But three years later, medical marijuana remains unavailable in Alabama because of an ongoing legal fight over some of the licenses to grow and sell the products.

While licensed cultivators have marijuana plants nearing maturity, cannabis products can't be recommended or sold to patients in Alabama while the entire program remains on hold. The delay is exasperating for patients like Taylor.

''It's beyond frustrating," Taylor said. ''I'm a very calm person and ... I'm always hoping for the best. But at this point, it's anger because greed is causing so much more suffering.''

The Alabama Medical Cannabis Commission has issued licenses to cultivators, processors, and others, but licenses are on hold for five potentially lucrative integrated ''seed-to-sale'' licenses where companies grow, process, and sell cannabis as well as licenses for dispensaries that will sell the cannabis products. The entire program remains stalled while the dispute plays out in state court.

''We want to see the products out there for patients. Almost daily, we get phone calls from those concerned,'' said John McMillan, director of the Alabama Medical Cannabis Commission. ''That is the No. 1 question we get on our website by far. When are the products going to be available? And everywhere I go, if I speak to civic clubs, that's the first question.''

The commission began accepting applications for licenses in 2022 and has attempted to award the licenses three times. The commission rescinded the awards twice after losing applicants raised concerns about the selection process. The panel adopted new rules and awarded licenses for a third time last December. But companies challenged the awards, arguing, among other things that the commission failed to follow the Alabama Administrative Procedures Act.

An attorney for Alabama Always, one of the companies that has pursued litigation after not winning an integrated license, said the commission by law should allow denied companies an opportunity to challenge the qualifications of winning companies.

''That's why this has gone on for so long. They just simply refuse to do it the way it is supposed to be done,'' Will Somerville, an attorney for Alabama Always, said of the commission.

But for companies that received licenses, the delay is frustrating after they have invested millions of dollars into operations that can't get fully underway.

In an unassuming agriculture building, cloaked by fences and security cameras, 1,500 marijuana plants sprout skyward at a south Alabama facility operated by CRC of Alabama. The plants are about 60 days from harvest, said Rob Levy, chief operations officer for CRC of Alabama.

The plants, grown from varieties with names like apple blossom, hella jelly and blueberry pancakes, are moved through a series of rooms designed to mimic the growing season. The company has invested more than $2 million into the operation, including substantial security costs.

''We are all dressed up with nowhere to go,'' Grady Reeves one of the owners of CRC said. ''But the ones that are really suffering are the patients."

Dr. Marshall Walker, an interventional radiologist, said he believes medical cannabis could be beneficial for some of his patients with chronic pain. He said it's ''inhumane'' that manmade problems are blocking its availability.

''The way I conceive of it, it really is just another tool for the toolbox,'' Walker said. Walker said he became convinced of the potential benefit after seeing his mother use cannabis when she had esophageal cancer. It controlled her pain enough to allow her to eat.

A similar fight played out several years ago in Florida. Florida voters in 2016 voted to create a medical marijuana program, but litigation followed over a license cap.

As patients in Alabama remain waiting, more states have moved on to allowing recreational use. Twenty-four states have legalized recreational use of marijuana, according to the Pew Research Center. Florida voters will decide the issue this November.