ST. PAUL — Minnesota’s medical marijuana program kicked off in the dead of night Wednesday, as the first three patients filed into a Minneapolis clinic at midnight and emerged with medicine the state’s law had long kept out of reach.

For Kim Kelsey and Kathy Engstrom, each hope a supply of capsules and oils offers a glimmer of hope for finally treating her son’s seizures. Patrick McClellan hopes a small vaporizer can replace the emergency pills he keeps around his neck in case severe muscle spasms strike.

But for all three, Wednesday capped off a long wait. After years spent fighting to coax the legislature to legalize medical marijuana — and after the last 13 months since lawmakers took action and the program was put in place — they could hardly believe what they were holding Wednesday morning.

“It’s so surreal,” said McClellan, a Bloomington 48-year-old who suffers from a rare form of muscular dystrophy. “There have been a lot of people in this fight for many, many years.”

Each patient can expect a similar process to what McLellan, Kelsey and Engstrom experienced at Minnesota Medical Solutions’ Minneapolis clinic: Go past the security guards and through a series of secure doors, into a consultation room to discuss the condition they’re hoping to treat and finally meet with a physician to finalize the dosage and get the medicine.

By Wednesday afternoon, the state’s two medical marijuana manufacturers were handling a steady trickle of patients coming in for their first appointments. Each expected to handle more than a dozen patients on opening day.

Tyler Lafferty was among the first patients at LeafLine Labs’ Eagan facility after it opened at 10 a.m. More than an hour later, he walked out sporting a big grin and snapped a selfie, with a gift bag containing his new vaporizer in hand.

Lafferty is in the midst of chemotherapy to treat lymphoma that struck shortly after he graduated from high school. Now 20, raising a 2-year-old daughter and working full time, he said he’s confident medical marijuana will neutralize sharp pain and nausea better than the carousel of narcotics and other medications he’s tried.

“I’ve been through quite a bit,” he said.  “I’m hoping that from here on out, it’s completely different.”

Both companies say they’ve got a packed schedule through the week. But just how many patients will follow the early adopters is unclear.

Just 90 patients had cleared that hurdle and registered with the state to buy medical marijuana as of Wednesday, according to Minnesota’s Office of Medical Cannabis.  Many have run into doctors or hospital systems hesitant to sign off, citing the federal government’s ban and a lack of enough research about its medical benefits.

As patients start taking the new medicine and the state tracks results, those sort of stories will disappear, said Dr. Kyle Kingsley, who heads up Minnesota Medical Solutions.

“It’s a rolling start,” Kingsley said. “This is not going to be an explosion here in the beginning; it’s going to be a slow, gradual ramp-up of patients.”

Just two dispensaries are opening to start, Kingsley’s facility in Minneapolis and the LeafLine patient center Eagan. Each company will eventually operate four locations, currently planned in St. Paul, St. Cloud, Rochester, Hibbing, Moorhead and a final dispensary somewhere in Minnesota’s 3rd Congressional district.

Despite her own troubles getting registered to buy medical marijuana to treat her Crohn’s disease, Cassie Traun of the medical marijuana advocacy group Sensible Minnesota said she’s confident a few months of experience will eventually bend a restrictive program toward easier access.

“It’s going to take small steps of people seeing that, one, the sky isn’t falling,” Traun said. “Two, we’re actually giving it to sick people and they’re doing better.”