State officials are weighing a question that could drastically expand Minnesota's medical marijuana program and offer hope of relief to thousands of residents: Should it allow people with intractable pain to buy the new drug?
With its program launched just this summer, the state is seeking public input on the expansion in a series of community meetings statewide starting in Rochester on Wednesday. The final decision is subject to some of the same political pressures and unease that shaped Minnesota's new law into one of the most restrictive programs in the U.S.
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Here are some of the considerations officials have to make as they decide whether patients in pain can buy medical marijuana starting next summer:
WHAT'S THE IMPACT?
The state doesn't have a firm grasp on how its patient base would increase if they expand the narrow list of qualifying conditions to include intractable pain. But there's no doubt it would be a massive change.
Manny Munson-Regala, chief executive of the medical marijuana manufacturer LeafLine Labs, said he thinks it could eventually triple or quadruple the 5,000 patients they currently expect to sign up. He said that's a conservative estimate, though Minnesota Medical Solution's Dr. Kyle Kingsley said he would expect a "more modest" bump.
Patients in chronic pain are eyeing the possible addition as both necessary and potentially life-changing.
After more than a decade of compounding back problems and countless surgeries and drugs that proved fruitless, Jeff Ross spends much of his time in bed coping with crippling pain. Support groups for his painful form of spinal arthritis have praised medical marijuana's effects.
"This is a possibility of having my life back, of going back to work, of being able to be a father and being able to be a husband instead of living this half-life that I have now," said Ross, a 55-year-old Maple Lake resident and father of four. "If there is a chance that I can have a normal life again, what is their right to be in my way?"
HOW IS THE DECISION MADE?
The decision ultimately lies with Department of Health Commissioner Ed Ehlinger, who assembled an advisory group of medical professionals to weigh the addition with the goal of forwarding him a recommendation by the end of the year. The patients being considered must have pain for which "no relief or cure of the cause of the pain is possible," though the state could expand — or tighten — those standards.
With Ehlinger's decision coming, medical marijuana could be available for pain patients in August 2016 at the earliest. The Legislature could also step in and make the expansion sooner or shoot down any decision to add it.
WILL IT HAPPEN?
The advisory panel tackling the issue is confronting some of the same doubts among the medical community that have made it difficult for patients to get a doctors' sign-off. Some doctors and clinics are still leery of sending their patients to buy medical marijuana.
"There's a ton of literature and data and opinions to comb through," said Nancy Jaworski, a pediatric pain specialist in Minneapolis and one of eight advisory panel members. "I feel like I have to be very, very, very careful. I have to look to the science."
The manufacturers themselves were once mum on the question, preferring to leave it to lawmakers and state officials.
But executives from both Minnesota Medical Solutions and LeafLine said this week they believe expanding the program to include intractable pain is the right route, especially as an alternative to opioid medication and the concerns of addiction and overdose that come with it.
"The medical case is building. We need to advocate for these patients," Kingsley said.
COULD THEY HANDLE THE NEW BUSINESS?
Just 361 patients were cleared to buy medical marijuana by the state as of Thursday. Though it's unclear just how much that may increase if intractable pain patients were added to the fold, the two manufacturers expressed confidence they could meet increased demand.
Both companies have expansion plans for their manufacturing facilities drawn up that could be retooled if pain is added as a qualifying condition.
"We have enough lead time to be prepared to whatever influx of patients could reasonably be expected," Munson-Regala said.