ST. PAUL – Severe pain soon will be a reason Minnesotans may use medical marijuana, something supporters say will reduce the need for powerful and often-dangerous prescription medicines.

State Health Commissioner Ed Ehlinger Wednesday announced he will add intractable pain to nine specific conditions that qualify for using pills, vapors and oil made from the marijuana plant. Smoking it is not allowed under state law.

Those who favor Ehlinger's move say the marijuana products could result in less use of drugs such as hydrocodone, oxycodone and morphine. Those medicines, known as opioids, increasingly are being abused across the country.

Opioid addiction was one reason Ehlinger said he decided to allow those suffering from severe pain, which cannot be relieved by other means, to use marijuana extracts.

The only two companies allowed to grow marijuana in Minnesota said Ehlinger's decision will improve health.

"Opioid use kills more Minnesotans than homicide or car wrecks," LeafLine Labs CEO Manny Munson-Regala said. "States with medical cannabis laws have lower annual opioid overdose deaths than states without such laws."

Minnesota Medical Solutions CEO Kyle Kingsley said that his firm can provide an alternative to "opioids and other highly addictive and dangerous prescription pain medications."

Marijuana supporters say it is virtually impossible to overdose on products from the plant, while about 46 Americans a day die from opioid overdoses.

It was not an easy decision, Ehlinger said, because there is little scientific proof that marijuana products help, but they likely will cause no greater harm to a patient.

"Pain management is a difficult process and existing tools are not working well," he said.

Wednesday's decision could greatly increase the number of Minnesotans using medical marijuana, also known as cannabis. The director of the state medical cannabis program, Michelle Larson, said more than 700 patients receive the medicine under a law that began July 1.

Patients will be able to enroll for pain management marijuana on July 1 and pick it up a month later.

While Ehlinger had no estimate about how many Minnesotans would seek pain relief from marijuana, some supporters put the number in the thousands.

“We get to help a ton more Minnesotans and maybe even save a few lives,” Munson-Regala said, adding "pain either doubles patient count or multiplies it by 10.”

Patient growth is expected to be gradual at first, but could grow exponentially after the first few years, he said.

Kim Kelsey of Minnetonka said such an expansion in the young cannabis program would lower prices and help her afford the product for her 24-year-old son, Alec, who since starting the medicine in July has begun to experience far fewer seizures for the first time in 20 years.

While the cannabis costs up to $18 a day, Kelsey said, "I tell you what, I would sell my left leg to keep him in the medicine."

Not everyone agreed Ehlinger's decision was right.

"The Legislature voted to allow the narrowest legalization of marijuana in the country," Rep. Matt Dean, R-Dellwood, said. "Those supporting this bill could have included 'intractable' pain as a qualifying condition, but chose not to."

However, the law gave the health commissioner power to annually add conditions that can be treated with marijuana extracts.

Larson said her office will set up a process for adding more conditions for marijuana treatment.

Law enforcement issues

Ehlinger said that he has no enforcement powers if doctors and other health professionals abuse the law and recommend too many patients for marijuana use. "I trust providers to do what is right for patients and stay within the letter of the law."

However, he wants marijuana included in a database of Minnesotans' prescription medicines so doctors can see a full list of medicines their patients are taking.

Marijuana technically is not prescribed. Instead, doctors and others who can prescribe medicines may recommend that their patients be enrolled in the state cannabis program.

Larson said her department will get information to medical professionals about risks some people would face using marijuana products. Among those patients are infants, children, pregnant women, nursing mothers and people with psychosis or with a family history of it.

Minnesota legislators in 2014 approved using products of the marijuana plant for nine specific health conditions: glaucoma, AIDS-HIV, Crohn's Disease, seizures, cancer with severe pain, Tourette syndrome, amyotrophic lateral sclerosis, severe muscle spasms and terminal illnesses.

Twenty-three states allow marijuana use for some medical problems, and now just four of them do not allow it for pain.

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Forum News Service reporter Scott Wente contributed to this story.