Passage of SF 1179 would mean Minnesota would no longer be the only state with a medical marijuana program that bans smoking of the drug.
Passage of SF 1179 would mean Minnesota would no longer be the only state with a medical marijuana program that bans smoking of the drug. Credit: Photo by Kimzy Nanney on Unsplash

The aggressive push to legalize recreational marijuana in Minnesota has lit a fire under the ongoing effort to update the state’s five-year-old medical cannabis program, including ending the state’s unique ban on smoking dried leaf and bud.

Patients and practitioners have complained almost from the start of the program that Minnesota’s law was overly restrictive, with strict limits on the number of producers, the number of dispensaries and the number of conditions that could be treated. All that was due to the compromises made in 2014 to get the law approved by reluctant lawmakers and a doubtful Gov. Mark Dayton.

State Sen. Michelle Benson
[image_caption]State Sen. Michelle Benson[/image_caption]
But with a reference to the “intensifying” legalization conversation — a bill in the Minnesota House would legalize and regulate marijuana for recreational use — Sen. Michelle Benson on Monday quickly moved a medical cannabis reform bill through her Senate Health and Human Services Finance and Policy Committee before sending it to the Senate floor.

“There’s some angst around updating our medical cannabis program and much of it is related to what we don’t know about medical cannabis and its place in the world of medicine,” Benson said. “But more of it is about a legalization conversation, which I know is intensifying. This is a sincere step to update our medical cannabis program. It is not a path to legalization.”

One of the most restrictive medical marijuana programs in the country

In the committee on Monday were a trio of bills aimed at modernizing the five-year-old medical marijuana program. All were ultimately combined under a bill, SF 1179, and passed. The bill now includes provisions to continue pandemic-related provisions such as curbside delivery; to add opioid addiction as one of the medical conditions for which marijuana can be authorized; and to allow producers to make and sell marijuana in dried flower form. The last provision would mean that Minnesota would no longer be the only state with a medical marijuana program that bans smoking of the drug.

That has been one of the biggest complaints about the state’s current program. Only oils and tinctures containing THC can currently be used in Minnesota — products that cost more to produce and purchase. That has left patients either to pay more out of pocket or to abandon the legal system and seek out illegal sales, and supporters of a bill in the Minnesota House to legalize recreational marijuana have used dissatisfaction with the medical cannabis program as one of the reasons to back their broader efforts. The House bill, HF 600, which has been moving through committees there on party-line votes, would benefit medical marijuana patients by making the drug cheaper for all users; it would also make those with medical authorizations exempt from any taxes imposed under the proposed recreational law.

Total number of patient visits to a Cannabis Patient Center that resulted in purchase of medical cannabis products, by month.
[image_credit]Minnesota Department of Health[/image_credit][image_caption]Total number of patient visits to a Cannabis Patient Center that resulted in purchase of medical cannabis products, by month.[/image_caption]
The ban on smoking in the medical cannabis program was just one of the compromises made in 2014, and Minnesota’s statute is considered one of the more conservative programs in the country. According to the state Department of Health, there are only two producers and 11 distribution clinics around the state for around 30,000 patients with nine health conditions who have received authorization from health providers. But that’s more than initially planned. As passed in 2014, the law allowed only eight distribution centers, and the health conditions covered would have meant only about 5,000 patients would have benefited.

Since the law was passed, the state health commissioner has added six more conditions covered by the program and will add two more this year: sickle cell anemia and chronic vocal or motor tic disorder. Despite petitions from patients to add anxiety to the list, the health commissioner did not do so this year.

State Sen. Mark Koran
[image_caption]State Sen. Mark Koran[/image_caption]
Sen. Mark Koran, R-North Branch, said his motivation for work on the bills was to make the program work better for patients and to answer one of the biggest complaints — that the cost that isn’t covered by insurance is too high. That causes patients to either forgo the drug or go to the illegal market. The illegal market is also sought out by patients who prefer to smoke the drug rather than use more expensive oils and tinctures.

“The goal is to lower cost, increase accessibility to qualifying patents,” Koran said.

Kim Kelsey, a medical cannabis advocate, said her family has paid more than $65,000 over five years for CBD oil for her adult son Alec, who suffers from seizures and cognitive challenges resulting from a  case of encephalitis as a child. None of it is covered by insurance.

Count (%) of Active Patients by Condition* as of Dec. 31, 2020
[image_credit]Minnesota Department of Health[/image_credit][image_caption]*Patients certified total more than 100% because 63.1% of the 28,522 patients are currently certified for
more than one condition; this table counts each certified condition.
**Refers to patients who are certified only for chronic pain (with no additional qualifying conditions).[/image_caption]
Dr. Kyle Kingsley, the CEO of Vireo Minnesota — one of two producers of medical cannabis in the state — said Minnesota’s law limits the number of people who can benefit from what he called “a real alternative to opioids and other pharmaceuticals in the setting of chronic pain and other serious medical conditions.”

While the state is sometimes considered a leader in health care policy, it is “trailing the country” in access and affordability of medical cannabis, he said. He called the sale of dried marijuana plant a “simple change” that would bring the state in line with all other states that allow it. “Minnesota is an extreme outlier by not allowing the use of cannabis flower in the program,” Kingsley said.

One-half of 1 percent of the state population is enrolled in the program but other states have 2 percent of their residents in the program. “It will also squeeze the illicit cannabis market, which is currently accessed by 10 percent of the Minnesota population,” he said.

A bipartisan effort

During the hearing before the Health and Human Services Finance and Policy Committee, the tone was so different from most committee debates — there were no motives questioned, no party-line votes — that several members of the Health and Human Services Finance and Policy Committee felt the need to comment upon it. “If the public had watched this discussion, they think we fight about things. Because here we are in a bipartisan way from people all across the state trying to solve people’s challenges,” said Sen. Jim Abeler, R-Anoka. “There are times when we should notice how well things work here and this is one of those times.”

State Sen. Chris Eaton
[image_caption]State Sen. Chris Eaton[/image_caption]
That it was all done around a controversial issue — at least in Minnesota — made it all the more interesting. One reason for the different tone was that some members have personal connections to the issue and others said the stories of patients changed their minds, from opposing the program to supporting it. “I’ve come from one end to the other on this,” said Sen. Chris Eaton, DFL-Brooklyn Center. “As a person in long-term recovery, I had some real qualms about supporting medical marijuana.”

But Eaton, who’s daughter Ariel died from an opioid overdose in 2007, said she now supports adding addiction to the conditions under the law. “This is certainly a safer alternative.”

Eaton’s amendment, however, did attract the only significant opposition, from Sen. Carla Nelson, R-Rochester, who said there isn’t enough scientific evidence of cannabis’ use in helping opioid addiction. “I know it is well-intended, but I just cannot in good conscience vote for something that is not evidence-based,” Nelson said. Also speaking against the Eaton amendment was Ken Winter, a psychology professor at the University of Minnesota and co-founder of the state chapter of Smart Approaches to Marijuana. 

photo of article author
[image_caption]State Sen. Matt Klein[/image_caption]
Sen. Matt Klein, DFL-Mendota Heights, said he is torn because there isn’t sufficient data but agreed that the “margin of toxicity of cannabis” is extremely low and the burden of opioid addiction is very high and very dangerous. “I think it’s a reasonable intervention at this time,” said Klein, an internal medicine-hospitalist physician. 

Benson said it was testimony from Kim Kelsey and her son that altered her thinking. “I had doubts and hesitations and then I started hearing these successes around seizures,” Benson said. “That’s kind of what flipped me on medical cannabis. So you did make a difference and you did move early action on this bill.”

 

Correction: This story was changed to show that Sen. Matt Klein is a hospitalist physician, not an emergency room physician.

Join the Conversation

13 Comments

  1. Sen. Carla Nelson, R-Rochester, who said there isn’t enough scientific evidence of cannabis’s use in helping opioid addiction. “I know it is well-intended, but I just cannot in good conscience vote for something that is not evidence-based,”

    These trumpanzees really crack me up, that is a very funny statement from a republican for sure. I wonder how that brainiac feels about masks, or distancing, or other scary science (we all know that answer, just putting it out for effect)

    1. One wonders is she has taken an evidence based approach to the most recent presidential election.

  2. Good to see Republicans support a reform. Preserving the status quo is often not a good thing.

  3. “there isn’t enough scientific evidence of cannabis’s”
    Yeah OK, following this line of thinking, we would still be without, seat belts, air bags, polio shots, small pox shots, Covid shots, fuel economy, etc. etc. etc. etc. To some of these folks there will never be enough. Suppose there isn’t enough “scientific evidence” that Biden won the last presidential election as well!

  4. The cost of the medical marijuana program is far too high. I don’t see any justification for an annual fee of $200 just to be able to participate. On top of that the red tape for providers drives up the cost for patients and as was mentioned, the forms available are costly. Everything about the program encourages people to seek out illegal marijuana. Why not just legalize cannabis and do away with the medical cannabis program entirely? People won’t need to turn to illegal sources. There will be a wider variety of options, the price for patients will go down even if the state taxes the sale of marijuana. The state will benefit from the added revenue and those tax dollars won’t be flowing to states that have legalized recreational use and sell to Minnesotans. You would think it would be a no-brainer but I guess it is those legislators with no brains that are standing in the way.

    1. One major sticking point for proponents of recreational cannabis legalization in Washington State in 2012 was the fact that legalization entirely dismantled the then-existing medical cannabis program. Medical cannabis patients were able to purchase their prescribed cannabis tax-free, whereas the new recreational program was taxed at three levels. Patients, rightfully so in my mind, didn’t want to be taxed for purchasing something they were prescribed as medication.

      The compromise the State Legislature came up with was a registration scheme by which people with valid prescriptions would be exempt from the final one of those three levels of taxes applied to recreational cannabis. Patients didn’t like this either, and again, I can’t blame them: the registration scheme meant that their name was associated with cannabis within a government database, rather than privileged medical databases. Cannabis still being illegal at the Federal level, that caused patients some concern that they could be targeted for enforcement by the Feds.

      At the time I lived there and these conversations were ongoing, I was in support of a dual-track system. One for medical cannabis, one for recreational, even though that ultimately never panned out. I think I still am in support of a dual-track system. We should treat recreational consumers and medical consumers of cannabis in the exact same way.

      1. Any idea what the tax hit would be for medical marijuana users if the program was eliminated? They would not have to pay the 200 dollar annual fee and products would likely be cheaper pretax. It might be a wash, overall cheaper, or an insignificant increase. If they choose to smoke or can produce their own tinctures or edibles, home grown product would be a significant savings. Of course a dual system would give them the option of dropping out of the medical marijuana track if they find it to their advantage.

      2. Illinois seems to have the same shops for medical and recreational, with a medical card that gets you out of paying the extra tax. I get the idea you don’t want the government to know you have a pot prescription, but at some point the stigma will go away and it seems burdensome to have two kinds of shops for the same product.

  5. Oh good, someone from Smart Approaches to Marijuana. Do you know who funds their campaigns and lobbying efforts? Alcohol companies. Drug testing companies. Fentanyl manufacturers. Its just disgusting and offensive that they couch their lies as a “smart” approach.

  6. Pot enforcement is a big deal in rural MN. Recreational marijuana would result in a steep loss of funding for their war on drugs which is directed at their citizens.

  7. smoking weed is yesterday’s headline. what the Minnesota Legislature ought to do is usher in the commercialization of cannibis production so that the vast revenues get into the state coffers. Minnesota should be absolutely copying Colorado’s model for cannibis commerce! it’s a cash-only business! who can complain? piddling around on the edges like the Republican family-values folks love to do is not where Minnesota needs to be. overdosing on opiates doesn’t explain the underlying depression and mental health concerns that smart people talk about. could Minneapolis de-criminalize pot growing without the legislature’s over-arching consent?

  8. If you refuse to look at and evidence based on facts, how do you know there isn’t any? The other side of the statement that seems to continually be in conflict is, If you don’t take it off of schedule 1, you are limited in the research that can further the amount of fact-based evidence that you can collect. Once again, where do you get these oxymorons in government represenatatives? They are worried about ghosts.

  9. More studies are emerging from states that have legalized the non-medical use of cannabis. Each of them brings more understanding to the social issues involved. The education of youth continues to be limited by those who hold the strings of power. The problems of speaking the truth limit the ability to keep illegal use of cigarettes, alcohol, drugs of any kind, out of the hands of children. You can’t get solid data from people(children) who live in fear of science and the laws. Education is the only answer in this area. Youth have always employed curiosity and experimentation regardless of the law. According to this paper, legalization had very little effect on youth consumption. It comes down to how much education can change the average maturity level of adults and whether they abuse a substance of any kind. If the youth have lost confidence in the authority that is conveying the message, it is difficult to limit the use of substances by youths. History teaches this.

    https://www.npr.org/sections/money/2021/03/16/976265525/the-data-on-legalizing-weed?fbclid=IwAR1MrjOTgBjnp6la7FecVh96HIvMaFzI3KIzaGAyMuY9fs_CjMK3bMo4qRM

    https://www.ajpmonline.org/article/S0749-3797(20)30188-4/fulltext?utm_source=npr_newsletter&utm_medium=email&utm_content=20210311&utm_term=5237211&utm_campaign=money&utm_id=7043805&orgid=305&utm_att1=money

Leave a comment