A year ago this weekend, little Harlow Hundley took her first dose of medical marijuana.

By the time her family gathered for their Fourth of July picnic, the little girl, then 3 years old and wracked by seizures that damaged her brain and endangered her life, was giggling and playing with her cousins "like she'd never done before," her mother told reporters Friday as she wiped away tears outside a downtown Minneapolis clinic.

It wasn't a cure, but Harlow's life is better now than it was a year ago. She suffers half as many seizures, even as they weaned her off the harshest medications she was taking. She plays with toys and interacts with people. She communicates with an adaptive iPad.

"It's meant so much to our family, because we've literally been able to see our daughter emerge before our eyes," Beth Hundley said, scrolling through a phone full of pictures of a sweet-faced little girl with soft brown curls, smiling for the camera.

The first year of legal medical marijuana in Minnesota has been marked by small miracles and deep frustrations. It's one of the smallest, most tightly regulated programs in the nation and has struggled with high prices, wary doctors and patients who have labored to get into the program and to find a nearby clinic once they do.

But enrollment has been inching upward, and the 1,588 patients now in the program could be joined next month by a wave of pain patients as the program expands to include intractable pain as a qualifying condition.

The state limits the conditions that qualify for medical marijuana — just nine right now — as well as the number of companies that can grow and sell the crop — two — and the number of clinics that can sell it — eight, scattered across a state of 5.4 million people. The Legislature also limited cannabis sales to pills and liquids, and smoking the plant remains illegal. Since doctors and medical groups can opt out of the program, some patients have struggled to find health care providers willing to confirm to the state that they have a qualifying condition like cancer, epilepsy or a terminal illness.

But for those who manage to make it into the program, medical marijuana seems to be helping. A June survey by the Minnesota Health Department found that 90 percent of patients said they benefited from the medicine, and half of those surveyed reported substantial relief of their symptoms.

An option for pain treatment

A year ago, Patrick McClellan stood on the sidewalk outside the Minnesota Medical Solutions clinic in downtown Minneapolis, waiting for the stroke of midnight when the clinic opened for the first time. Today, he said, he has managed to wean off or cut back on the pharmaceuticals he was taking to ease agonizing muscle spasms brought on by a rare form of muscular dystrophy.

"My neurologist says I look better now than I have in the last 10 years," said McClellan, who spent years lobbying for medical cannabis legalization. "When we first started this process three years ago, it was based on hope, but for a lot of us, that hope has turned to success, including [for] myself."

For the two companies that took multimillion-dollar gambles on the medical cannabis industry in Minnesota, it's been a bumpy start.

In Stillwater last weekend, Dr. Andrew Bachman, an emergency room physician who co-founded the cannabis company LeafLine Labs, marked the program's anniversary by watching a little girl named Amelia cross the finish line of a 5K race his company sponsored to raise money for epilepsy research. After the race, Amelia, who has a strain of medical cannabis named in her honor at LeafLine, got out of her racing stroller and walked off hand-in-hand with her father — the first time Bachman had ever seen her walk.

"That's all I needed to know. That's all the motivation I needed for the next year," said Bachman, whose company has clinics in Eagan, St. Paul, St. Cloud and now in Hibbing, where Amelia lives. Her family had been making the hourslong commute to Eagan each month to pick up her prescription.

Smiling outside the Minneapolis clinic, Minnesota Medical Solutions CEO Dr. Kyle Kingsley, also a former emergency room physician, is looking forward to a new year with new customers brought in by the program's expansion to pain patients.

"Pretty exciting day," he said. The hope is that more pain patients in the medical marijuana program could mean fewer overdoses in the emergency room.

In many states that allow pain patients to use medical marijuana, those patients make up the bulk of the programs' customer base. In Colorado, 93 percent of medical marijuana patients cited "severe pain" as a qualifying condition. But many of those states have also charted sharp drops in opioid overdose deaths once cannabis became an option for pain treatment. One 2014 study found that opioid overdoses dropped an average 25 percent in states with medical marijuana programs.

Minnesota officials are quick to point out that marijuana isn't a magic bullet, is still experimental and doesn't help everyone who tries it. Patients also face the additional headache of trying to pay for treatments that can range from less than $100 a month to well over $1,000. No insurance will cover the cost of cannabis treatments while the drug remains illegal at the federal level, forcing patients to pay out of pocket.

But for families like the Hundleys, a few drops of cannabis oil will make all the difference this Fourth of July.

Harlow suffers from Dravet syndrome, a type of epilepsy that strikes healthy babies with catastrophic seizures that resist standard treatment. Water, sun and heat all used to trigger seizures in the little girl.

This Fourth, her mother said, they're hoping to go swimming.

"To see her enjoying life more, to be able to engage with people and toys like a typical 4-year-old, has been an absolute miracle," Beth Hundley said. "I pray that this can help more people."