ST. PAUL — There will be no baggies of pot awaiting patients next week when Minnesota joins 21 other states in offering medical marijuana. No glass pipes, no plants to tend at home. Instead, the nation’s latest medical marijuana program is a world of pill bottles and vials of marijuana-infused oil.

For the qualifying patients seeking relief from pain, medical marijuana advocates and some lawmakers, Wednesday isn’t the finish line, but the first step. The state’s restrictive approach, unseen in the industry, is likely to mean high costs, long drives and reluctant doctors.

“The door is opening,” said Bob Cappechi of the Marijuana Policy Project, a national outfit that pushes to loosen marijuana laws. “This will start helping people out. That’s really what this is all about.”

Minnesota’s medical marijuana advocates snatched an unlikely victory from the Legislature last year after years of failed efforts, but there was little celebration. What emerged to assuage skeptical law enforcement lobbyists and a wary governor was one of the strictest programs in the nation.

Smoking the plant is forbidden. Pills, oils and vapors are only available to patients suffering from severe conditions, such as cancer, epilepsy, HIV and AIDS. And the medicine can only be sold in eight locations, hundreds of miles away from some in Minnesota’s rural expanses.