Minnesota expands forms of medical cannabis, but not what it treats

Minnesota will allow a new delivery method for medical cannabis, but won't expand the conditions it treats — despite legalization this summer of recreational marijuana for adults in sickness or in health.

On Thursday the state announced that it will allow nearly 43,000 Minnesotans the option to soothe chronic or critical illnesses by inhaling vapors from dry cannabis herbs. Pharmacists in Minnesota's decade-old medical cannabis program had requested the change.

"They were hearing so often from patients that it's a little bit physically safer to vaporize plant material than to smoke it as a joint," said Chris Tholkes, director of that program — Office of Medical Cannabis — which is part of the Minnesota Department of Health.

Thursday's announcement rejected six other proposed delivery methods and reaffirmed the state's decision earlier this year not to add anxiety, opioid-use disorder and Attention Deficit Hyperactivity Disorder as qualifying conditions. Most patients in Minnesota's program have intractable pain or posttraumatic stress disorder, but there are 19 qualifying conditions in all — including cancer, muscle spasms and sleep apnea.

Advocates petitioned for the third time since 2016 to add anxiety as a qualifying condition, hoping that it would receive more consideration this year because of legalization.

Tholkes said the requests were rejected without detailed review because no one offered new data that they helped these conditions, and some doctors feared they could actually make anxiety symptoms worse.

"People can't just petition every year in the hopes that they can kind of wear us down," Tholkes said. "There has to be new evidence."

The new delivery method becomes available in August 2024 and is added on top of existing smokable forms along with pills, oils and dissolvable films.

Minnesota's medical cannabis program still has a responsibility in the new recreational era to limit usage for therapeutic purposes and provide options for the more than 400 children ages 5 to 17 who are enrolled, Tholkes said. "We should not forget about our pediatric patients. The advocacy for this program was largely on behalf of those patients in 2014. It was parents who were in front of the Legislature saying, 'We need this for our kids!' And those kids can't participate in the adult-use market."

The first days of the adult recreational use market in Minnesota didn't dampen visits to the state's certified medical dispensaries. A record 49,512 visits in August were followed by more than 48,000 in September, the most recent month for which data is available.

The waiver of a $200 enrollment fee likely helped, but Tholkes said the medical cannabis program still has unique value because it allows qualified pharmacists to guide patients on choices and discuss possible drug interactions.

"On the adult market, you would be navigating that on your own," Tholkes said.

While it was the 22nd state to approve medical cannabis, Minnesota's program was uniquely designed to research its risks vs. benefits. Reports on its use for sleep apnea and autism are due soon.