Here in California, you have to go through the local county. Some counties are stricter than others. Traditionally counties WITH DISPENSARIES are easier to aquire the cards from than those that don't.
It takes all the excitement out of the industry... and the patients are shuned quite a bit, even by other smokers. REALLY, its treated as a REAL illness and who the hell wants to hang out with a sick person? Right. That's no fun. I like to have fun. See.