By Jon Collins, Minnesota Public Radio News

Minnesota’s medical marijuana program was approved by the state Legislature in 2014 as one of the most restrictive programs in the country. Minnesota is one of 33 states with a law allowing medical marijuana, even though federal law still classifies marijuana as a Schedule I substance.

Since Minnesota’s program was launched in 2015, the state has expanded the number of conditions that qualify for a marijuana prescription. Just this week, regulators unveiled a plan to add chronic pain and an eye disease to that list.

The state has also allowed the medication to be delivered in more forms and the two companies that produce the state’s medical marijuana to open new distribution centers around the state.

More than four years in, the state’s program serves relatively few people and is considered to be too expensive by many patients. The exact form the program will take in the future is unclear, as some lawmakers push for Minnesota to join other states that allow the sale of recreational marijuana.

What conditions qualify for medical cannabis in Minnesota?

• Cancer associated with severe/chronic pain, nausea or severe vomiting, or cachexia or severe wasting
• Glaucoma
• HIV/AIDS
• Tourette syndrome
• Amyotrophic Lateral Sclerosis (ALS)
• Seizures, including those characteristic of epilepsy
• Severe and persistent muscle spasms, including those characteristic of multiple sclerosis
• Inflammatory bowel disease, including Crohn’s disease
• Terminal illness
• Intractable pain
• Post-traumatic stress disorder
• Autism
• Obstructive sleep apnea
• Alzheimer’s disease
• As of July 1, 2020, chronic pain and age-related macular degeneration will also qualify

How do patients enroll in the medical cannabis program?

• A prescriber who is certified for medical cannabis must diagnose the patient with one or more of the qualifying conditions.
• Patients must then register online with the Office of Medical Cannabis. Approval can take up to 30 days.
• The patient or a designated caregiver needs to visit one of the current eight cannabis patient centers in the state to receive the medications.
• Patients need to reenroll in the program annually.

Who uses medical marijuana?

• About 18,000 patients were enrolled in the state’s medical cannabis program as of October 2019.
• About 64 percent of patients were enrolled in the program for intractable pain conditions, which requires a higher threshold than chronic pain. Nineteen percent of patients were diagnosed with post-traumatic stress disorder and 12 percent were diagnosed with severe muscle spasms.
• The average medical marijuana patient is almost 50 years old. For patients diagnosed with conditions like autism, the average patient is about 18.

What forms of marijuana can be prescribed in Minnesota?

• Minnesota’s medical marijuana law doesn’t allow providers to prescribe marijuana plants or gummies to patients.
• Patients may not grow their own plants.
• Medical marijuana in Minnesota originally was only available in pill, vapor oil, topical or liquid forms.
• Starting in the summer of 2020, patients will also be able to get marijuana powders, lozenges, gums, mints and tablets.

How much does medical marijuana cost in Minnesota?

• Patients must pay a registration fee of $200 before they’re eligible to buy medical marijuana. Patients on some forms of medical assistance qualify for a reduced fee of $50.
• Medical marijuana is not covered by private insurance, and needs to typically be paid for out of pocket.
• A survey of medical marijuana patients in Minnesota conducted in the first year of the program found that more than half of them considered the cost of the medication to be prohibitive or very prohibitive.
• Prices for pills, vapor oils and other products sold charged by Minnesota Medical Solutions ranged from $23 to $236 depending on the strength and format of the medications.
• Prices charged by LeafLine Labs ranged from $28 to $228.
• Reporting from the St. Paul Pioneer Press earlier this year found that patients they spoke to paid between $200 and $700 a month on the medications.

How could Minnesota’s medical marijuana system change in the future?

• Patients and advocates can petition the state to allow marijuana to be prescribed for conditions not currently covered.
• The state is allowing eight more cannabis patient centers by December 2020, with possible centers in Blaine, Burnsville, Duluth, Golden Valley, Mankato, Rogers, Willmar and Woodbury.
• Some lawmakers plan to push for Minnesota to join 11 other states, including Illinois, that have approved marijuana for recreational use. Others states like Illinois have kept their medical marijuana programs, but liberalized the requirements to offer patients more benefits than buying recreational marijuana would.