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MEDICAL CANNABIS Six Years In, Minnesota's Program Is Growing

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MEDICAL CANNABIS Six Years In, Minnesota's Program Is Growing MEDICAL CANNABIS IN MINNESOTA MEDICAL CANNABIS Six years in, Minnesota’s program is growing and changing BY LINDA PICONE innesota’s medical cannabis pro- Upcoming changes in Minnesota’s product is stable and consistent in dosage, gram started just a little more than medical cannabis program as are the non-smokable products. Msix years ago and has grown, as ex- Although the Minnesota Legislature did Recreational cannabis would be “a pected, in the number of qualifying medi- not legalize recreational marijuana in the whole different ballgame,” Tholkes says. cal conditions covered, the number of pa- 2021 session (the House passed a bill, but “Most other states have seen a decline in tients registered, the number of healthcare it was not taken up by the Senate), it did the medical side when they go to recre- providers participating and the number of make several significant changes to the ational, but lots of folks, I think, would medical cannabis units sold and product medical cannabis program. continue in the medical program. People sales made by the state’s two authorized The biggest change allows medical can- really value that conversation with phar- manufacturers. nabis patients who are 21 or older to access macists and there is some comfort in It also has grown in terms of the knowl- medical cannabis flower—which means knowing how it is processed.” edge base about medical cannabis. smokable cannabis. Currently, Minnesota Other 2021 legislative changes to the “We continue to be one of the only is one of only a few states with medi- medical cannabis program: states in the nation collecting patient ex- cal cannabis access that prohibits use of • Allow curbside pickup of medical can- perience data,” says Chris Tholkes, MA, flower products. Medical cannabis flower nabis products. director of the Office of Medical Cannabis. products will be allowed once policy is • Allow a single designated caregiver to “What we’re learning from the data is that developed by the Minnesota Department pick up medical cannabis products for patients are seeing tremendous benefit of Health’s Office of Medical Cannabis, no up to six registered patients (it has been from participating in the program. We later than March 1, 2022. restricted to one). hear story after story about not just a re- With smokable products, Tholkes says, • Make it possible for the Commissioner duction in symptoms but being able to get there likely will be a reduction in cost to of MDH to remove a health condition off other medications.” the patient—and cost of the current prod- from the list of those qualified for medi- The Office of Medical Cannabis has ucts is a complaint of many in the program cal cannabis, after receiving a petition commissioned and performed several and likely keeps others who could benefit from the public or a task force. Until studies on use of medical cannabis for out of the program. now, the Commissioner has only been specific conditions—and will do more “Other states have seen a reduction in able to add or modify conditions. in the future. “There have been so many costs with smokable cannabis,” Tholkes • Allow pharmacist-patient consultations restrictions on cannabis research (because says. “The biggest cost now is that the by phone or other remote means, in ad- marijuana/cannabis is still a Schedule I il- manufacturers have to extract the oil, so dition to videoconference. legal drug under federal law). I really have smokable should in theory be less expen- • Remove the requirement for a pharma- a great love for what we can contribute to sive.” cist-patient consultation when there is research,” says Tholkes. The regulations for smokable cannabis no change in dosage or product. will be designed to make sure that the • Remove the requirement that a health- care practitioner determine whether a 18 | MINNESOTA MEDICINE | SEPTEMBER/OCTOBER 2021 MEDICAL CANNABIS IN MINNESOTA patient is disabled and needs caregiver • 1,130 patient caregivers who have re- 113,832 in the fourth quarter of 2019, with assistance with medical cannabis be- ceived background checks and are ap- net sales of $1.6 million in the last quarter cause of that disability. proved. of 2016 to $7.2 million in the last quarter The curbside visit and telephone con- of 2019—an increase of $5.6 million or sultation came about through executive The price of medical cannabis 350 percent. order during the pandemic shut-down, Prices of most medical cannabis products By the end of 2019, Minnesota’s autho- says Tholkes dropped by 20–24 percent from 2016 to rized medical cannabis dispensary compa- 2019. For example: 120 ml Heather oral nies, LeafLine and Green Goods, had sold: Medical cannabis numbers suspension, cherry vanilla flavor, sold by • 503,980 vape oil units at a total of $37.8 The Office of Medical Cannabis posts up- LeafLine, cost $207 in October 2016 and million. dated registration data on its site https:// $158.28 in December 2019 (and today). • 174,981 oral suspension units at a total www.health.state.mn.us/people/cannabis/ The average 30-day “spend” for a pa- of $16.8 million. about/medicalcannabisstats.html on Fri- tient with one qualifying condition was • 177,978 capsule units at a total of $8.2 days. $355 in 2016 and $311 in 2019. In 2019, million. The cumulative statistics from the be- the average ranged from $189 for a person • 26,376 topical units at a total of $1.2 ginning of the program on June 1, 2015 with terminal illness to $364 for someone million. through August 5, 2021 are: with seizures. Report on Medical Cannabis Price Study May 2020 • 1,946 healthcare practitioners registered In 2019, 10,755 patients with intractable by BerryDunn of Portland, Maine, for Minnesota and authorized to certify patients for pain spent an average of $314 every 30 days Department of Health, Office of Medical Cannabis medical cannabis. on medical cannabis products. The next • 50,482 patients who were approved for largest group was 3,008 with PTSD, who Medical cannabis and PTSD medical cannabis (since the program spent an average of $320. Some 1,223 pa- Post-traumatic stress disorder (PTSD) was started). tients with cancer spent an average of $236. added to the list of qualifying conditions • 23,772 patients currently active in the The number of units sold by both medi- medical cannabis registry. cal cannabis manufacturers went from 17,691 in the fourth quarter of 2016 to (continued on next page) SEPTEMBER/OCTOBER 2021 | MINNESOTA MEDICINE | 19 MEDICAL CANNABIS IN MINNESOTA practitioners said medical cannabis was of MEDICAL CANNABIS little or no benefit (score of 1, 2 or 3). Six years in, Minnesota’s program is growing and changing The most-mentioned benefits included reduction in pain severity (64 percent) and (continued from previous page) improved sleep (27 percent). Patient com- for medical cannabis effective August 1, • “Better sleep, better appetite, I’m not so ments included: 2017. angry all the time. My memories don’t • “This program has opened up a world for In the first year after PTSD was added, seem to bother me like they used to. This me I thought I lost. I started on this just a 15,538 products were purchased by those has been a life changer for me!” few short months ago and am totally off who were certified because they had a • “Since starting medical cannabis it’s like my narco’s and nicatin. I also have had PTSD diagnosis as a qualifying condition. I’ve been given a fair chance to treat my less spasms and cramping throughout my Patients who responded to a survey PTSD symptoms I’ve struggled with over body. I even chanced getting on a motor- about their use of medical cannabis ranked a decade now. My family sees a night cycle and going for a short ride with a the benefit they felt they had received from and day difference and it’s easier to com- friend before it snowed. Thought never 1 (no benefit) to 7 (great deal of benefit); municate with them. I’ve since found a do that again. It has also helped me gain 76 percent of responding patients rated part-time job with flexible hours to work weight. And silence some demons in my benefit 6 or 7, 4 percent rated benefit 1, 2 around starting college in January, 2018. head from my PTSD. So, thank you. Now or 3. The only hope I have is that it becomes all I ask is make it affordable to stay on.” The most important benefits, patients more affordable as I’m barely able to af- • “At first, when I began using the medical said, were anxiety reduction (23 percent), ford it now.” cannabis for pain, I Definitely noticed a improved sleep (16 percent), improved About 25 percent of the patients who Drastic Relief in my pain levels - that was mood and/or emotional regulation (13 responded reported physical or mental So Wonderful - I was So Hopeful. Then, percent) and pain reduction (12 percent). side effects related to medical cannabis unfortunately, after the first week of using Comments from patients who re- use. The most common adverse side ef- the cannabis regularly, the efficacy for the sponded included: fects were dry mouth, increased appetite, pain relief I had been receiving began to • “Fewer periods of dissociation due to anxiety, drowsiness and fatigue. No serious steadily wane..., to the point of no notice- increased mindfulness, being able to toler- adverse events were reported during the able pain relief at all within a 6 to 8 week ate processing trauma in therapy without observation period.
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