The California Supreme Court on Monday ruled that cities and counties within the state have the right to ban medical marijuana dispensaries, bookmarking a three-year legal battle over zoning against pot.

In a 7-0 decision, the court held that state law does not prohibit municipalities from turning to land use laws to essentially keep the sale of medical weed, which has been legal in the Sunshine State since 1996, from happening inside their borders.

As the San Jose Mercury News pointed out, this means that California may soon become a land where patients can buy marijuana in handful of larger cities, but not in vast expanses between. Take the Bay Area, for instance: San Francisco, San Jose and Oakland all permit dispensaries, while the cities of Petaluma to the north and Moraga to the east disallow them.

Patients who don’t live near the San Franciscos of the state, therefore, may wind up at a loss. The court clarified that state law does not necessarily guarantee “convenient access” to medical marijuana.

Of course, some cities will use the opportunity not to run all dispensaries out of town, but to step up regulation of those that already exist. According to estimates, Los Angeles has anywhere between 500 and 1,000 storefronts selling the drug to card-carrying patients. In August 2007, the city passed an interim control ordinance that put a moratorium on dispensaries. Some 900 that have opened since then are trying to secure their own ballot measure that would allow them to keep operating.

Last fall, federal authorities forced 71 Los Angeles dispensaries to shut down after having closed at least 600 others throughout the state.

Anyone with stoner friends in California will tell you that the law didn’t exactly make it tough for people to obtain a medical marijuana card. Many of the issues cited by plaintiffs in the court case — filed in 2010 as a challenge to anti-dispensary zoning laws in the city of Riverside — involved worries over lax regulation of a drug that, as far as the federal government is concerned, remains illegal.

The whole zoning-against-pot debate tends serve as a drumbeat for a number of different NIMBY causes. Eighteen states and Washington, D.C. allow the sale of medical marijuana. California cities seem primarily troubled by the lack of local control over who, if anyone, gets to distribute the stuff.

“The irony in California is that we regulate everything that consumers purchase and consume, and somehow this has been allowed to be a complete free-for-all,” Jeffery Dunn, the lawyer representing Riverside, told the Associated Press.

In D.C. — where voters approved medical weed in the late ’90s, but licensed its first dispensary only last month thanks to more than a decade of Congressional interference — opposition tends to take a different form. Due to the District having zoned marijuana cultivation centers as light manufacturing, most will end up confined to the relatively low-income Ward 5, in the northeastern portion of the city. Some residents have called it another instance of the city dumping an unsavory-seeming operation in a poor neighborhood. (Ward 5 has a disproportionate share of strip clubs and trash transfer facilities.)

On top of these various citizen concerns, states and cities that have legalized marijuana — both for medicinal and, in the cases of Colorado and Washington, recreational purposes — face pressure from the feds. President Obama has said that he won’t go after smokers and sellers himself. But as localities across California found out last year, that hasn’t stopped U.S. attorneys from trying to clamp down on dispensaries.