When it comes to weighing the options for regulating medical marijuana through the law passed this year, Dunedin city commissioners declared local governments face a "conundrum" and "a false dilemma."They said they would welcome a dispensary in the city and want residents to have it as an option for chronic pain. They noted how the overwhelming majority, 71 percent statewide and 75 percent in Pinellas County, voted in 2016 to amend the Constitution and legalize medical marijuana for certain illnesses.But the state law enacted in June gave local governments only two choices for regulating dispensaries: ban them all together or give them the same rules as pharmacies like CVS or Walgreens. Cities are unable to restrict the number of dispensaries or shape zoning rules specifically for medical marijuana. Facing an all-or-nothing scenario, many governments across Tampa Bay are choosing to prevent dispensaries from opening. Like the Dunedin City Commission, which voted 4-0 last week on first reading to ban the facilities outright, it’s not always because they are opposed to the concept."We believe medical marijuana ought to be available to people," Commissioner Maureen Freaney said. "We were ready to put in place something where somebody can come and open a dispensary in our city. Then the Legislature comes in and basically says hey, all or nothing. … It’s infuriating, quite frankly."After a slew of beach cities including Belleair Bluffs, Madeira Beach and North Redington Beach enacted bans, and others enforced moratoriums to stall through next year, Clearwater voted unanimously last week to allow dispensaries. Indian Rocks Beach was one of the few beach communities to allow dispensaries last month.Clearwater Mayor George Cretekos said given the city’s two options, he could not support banning dispensaries outright since voters made their voices clear with the passage of the Constitutional amendment.Seven companies were originally approved to grow and dispense medical cannabis in Florida, and 10 more were approved this year. Of the 21 dispensary locations now open in the state, Trulieve has locations in Clearwater, Tampa and St. Petersburg and Surterra Therapeutics has one in Tampa.As of the most recent count Nov. 8, more than 50,000 patients have signed up through the Florida Department of Health to receive medical marijuana for a list of qualifying illnesses since the registry opened in 2016. The law lets terminally ill patients buy and use full-strength marijuana in the form of vapor oils, capsules and lotions. Certain other patients, including children with cancer and severe epilepsy, can use low-THC cannabis. Doctors can decide whether to recommend cannabis to patients diagnosed with a debilitating medical condition listed in Amendment 2 passed in 2016, such as Lou Gehrig’s disease, epilepsy, HIV/AIDS, PTSD and other conditions. The flower used for smoking is not legal in Florida.Casey Cook, legislative advocate for the Florida League of Cities, said the lack of legal flexibility to shape zoning codes for dispensaries to suit each individual community has been problematic.He said many cities are expecting the Legislature to come back with changes to the law next year and have leaned on moratoriums to buy time. "Any sort of one-size-fits-all approach restricts their ability to address policy issues at the local level," Cook said. "Cities in Florida are drastically different depending on where you go. The solution to a problem in Pensacola wouldn’t solve that problem in Cutler Bay."Ben Pollara, executive director of Florida For Care, founded in 2014 to advocate for the legalization of medical marijuana, said restricting the ability of dispensaries to open restricts patient access. Driving dozens of miles can be burdensome for patients in need. And although cannabis companies are also licensed to deliver the product to qualified patients, there are still limits. Pollara said he visited a dispensary in Miami recently and met two patients in the waiting room who had driven 75 miles from Palm Beach County. "It is wrong-headed on the parts of these communities," Pollara said. "In almost every case, what’s best for sick and suffering patients who are authorized under the state Constitution to get medical marijuana after a doctor’s recommendation is to be able to get it locally."Dunedin Mayor Julie Ward Bujalski said because this industry is new, it would have been too drastic to allow dispensaries everywhere a pharmacy is permitted, which would have included downtown’s Main Street. She said "baby steps" are important and that the city can re-evaluate the ordinance next year. "We’re all struggling with the same thing," she said. "We’re all ready to implement it, and boom, they took all of our rights away."Contact Tracey McManus at [email protected] or (727) 445-4151. Follow @TroMcManus.