SAN FRANCISCO 

Legalizing marijuana use for medical reasons was easy for California voters nearly a decade ago, but putting the law into practice has been anything but simple for state and local officials struggling to identify bona fide pot patients.

Consider two counties at opposite ends of the political spectrum.

In conservative San Diego, supervisors opposed to marijuana use voted this month to sue rather than offer state-ordered ID cards. In liberal San Francisco, officials postponed issuing the cards over concerns records could expose patients to federal drug charges.

The identification cards are the latest hang-up in the state's ongoing experiment with decriminalizing marijuana since voters in 1996 approved the Compassionate Use Act. To avoid running up against federal drug laws, the ballot initiative passed by 56 percent of voters was deliberately short on details of how it would work, an omission that has given patients' access to pot and the amenability of law enforcement a decidedly local flavor.

While some counties are balking at a California Department of Health Services directive to issue the identification cards, some cities have banned marijuana dispensaries altogether. The tension between the law and marijuana's status as an illegal drug is so bad that even laid-back San Francisco, which with at least 35 pot clubs is home to more than anywhere in the state, clamped down last week by adopting the city's first regulations governing the facilities.

Waning compliance

So far, only six of California's 58 counties have complied with the mandate to process ID applications and forward participants' photos and card numbers to the state. The information collected by local health departments will be entered in an Internet database police can access to confirm someone's status as a legitimate medical cannabis user.

The cards, good for one year, are designed to shield patients or "a primary caregiver" from arrest for possession, transportation, delivery or cultivation of medical marijuana. Each cardholder is allowed to have up to a half-pound of dried marijuana or six mature marijuana plants, although local governments can set laws exceeding the state's limits.

The 2003 follow-up to the ballot initiative makes it clear that county participation is mandatory, but it doesn't set a deadline for counties to offer the cards.

It is too soon to say whether the state will try to force compliance, said Teresa Schilling, a spokeswoman for Attorney General Bill Lockyer. Historically, the state has given local governments a lot of latitude in how they approach medical marijuana because of weaknesses in the original act, she said.

"This is a law that did not get spelled out very clearly, so it's been very, very difficult to implement," Schilling said. "There was so little directive in the initiative itself, it has put a lot pressure on agencies and local governments to have to interpret it."

County Counsel John Sansone said he expects to sue in federal court next month, claiming the law requiring counties to issue the cards is overruled by federal laws classifying marijuana as an illegal drug.

"The question is whether producing and distributing a card like that sanctions, indirectly, the use of a federal criminal substance," Sansone said, adding that he also is researching whether to challenge the medical marijuana law that 56 percent of voters passed in 1996.

Regional disparities in the availability of medical marijuana have been underscored since June, when the U.S. Supreme Court ruled that patients could be prosecuted even in the 10 states that allow people to smoke pot on a doctor's recommendation.

Cracking down

Fourteen California cities have enacted permanent bans on medical marijuana clubs, and as of last month another 56 had enacted moratoriums on them. Last month, an Oakland group representing pot patients, sued four cities - Fresno, Concord, Pasadena and Susanville - claiming the bans violated the intent of the original medical marijuana law.

Although San Diego is the first county to rebel openly against California's stance on medical marijuana, the tension between official state policy and pot's illegal status at the federal level is being felt elsewhere.

Planning officials in Sutter County voted last week to ban pot dispensaries, while supervisors there have resisted issuing the ID cards, saying that's up to the state.

In San Francisco, meanwhile, county supervisors urged the local health department this month to delay adopting the state ID cards until at least January while questions about efforts to safeguard patient privacy were worked out.

The city already issues its own ID cards to about 8,000 medical marijuana patients, but applicants are required to provide little identifying information that could potentially be subpoenaed by federal drug agents, said Supervisor Ross Mirkarimi.

Under the state program, applicants must have their photographs taken and provide proof of county residency, government-issued identification such as a driver's license and a copy of the medical records indicating why they need to smoke pot