Minnesota Adds New Qualifying Conditions to Medical Cannabis Program

The Minnesota Department of Health announced on Wednesday that the agency will add irritable bowel syndrome and obsessive-compulsive disorder to the list of qualifying medical conditions for participation in the state’s medical cannabis program. Under state law, the addition of the new qualifying conditions will become effective beginning on August 1, 2023, according to state officials.

“We are adding the new qualifying conditions to allow patients more therapy options for conditions that can be debilitating,” Minnesota Commissioner of Health Jan Malcolm said in a statement from the health department.

Irritable bowel syndrome (IBS) is a disorder characterized by abdominal pain or discomfort, as well as irregular bowel movements that can result in diarrhea, constipation, both diarrhea and constipation, or bloating. Obsessive-compulsive disorder (OCD) is characterized by recurring, intrusive thoughts that often cause significant emotional distress and anxiety in those living with the disorder. This can lead to repetitive actions or other behaviors that those affected by the condition feel compelled to perform to reduce that distress.

“Research has shown that people who suffer from these conditions can see benefits from using medical cannabis to treat their symptoms,” the health department wrote. 

The new qualifying conditions offer a modest expansion to the state’s medical cannabis program, with an estimated 10% of adults having IBS and 1% meeting the diagnostic criteria for OCD, according to media reports. 

Minnesota Patients Support Adding New Conditions

In public comments on the petitions to add IBS and obsessive-compulsive disorder to Minnesota’s medical marijuana program, a man identified by the initials RH described himself as a working professional with a wife and two daughters.

“My daily life consists of constant fear and stress,” said RH, who noted he has OCD. “Practically the only time I am free of the symptoms is when I am sleeping.”

Under state rules, patients certified for the newly approved qualifying medical conditions will become eligible to enroll in the state’s medical cannabis program on July 1, 2023. Patients will be able to receive medical cannabis from either of the state’s two medical cannabis manufacturers beginning on August 1, 2023. Patients who wish to use medical marijuana to treat any of the state’s qualifying conditions need advance certification from a participating Minnesota healthcare provider.

Opioid Use Disorder Not Approved

The health department declined to approve petitions to add opioid use disorder and gastroparesis, a condition that affects the normal spontaneous movement of the stomach muscles, to Minnesota’s list of conditions that qualify a patient to use medical marijuana. The petition not to add gastroparesis was not approved as a qualifying medical condition because research indicates that cannabis can make the condition worse.

Chris Tholkes, director of the Minnesota Department of Health’s Office of Medical Cannabis, said that the decision not to add opioid use disorder was a difficult one, noting that limited access to existing treatment options, such as methadone clinics, in some geographic areas was one factor that supported approval of the petition.

“We did struggle with this one,” Tholkes told the Star Tribune, adding that medical providers were concerned that “introducing another type of drug could lead to relapse. And in the case of opioid use, relapse can be fatal.”

The decision not to approve opioid use disorder comes as Minnesota and the nation remain in the grips of an opioid overdose death epidemic. Many public comments revealed success in substituting marijuana for opioids.

“After having gone (through) nine years of painkiller use under medical prescription for pain, I know that the use of cannabis would help ease the withdrawal side of it,” said a commenter, identified publicly by the initials TB. “I only use cannabis now.”

When Minnesota lawmakers passed legislation creating the state’s medical cannabis program in 2014, the law included nine conditions that qualified a patient to receive medical cannabis. With the new additions, the list of qualifying conditions will be 19. Current qualifying conditions include chronic pain, post-traumatic stress disorder (PTSD), cancer in certain circumstances, glaucoma, and other serious medical conditions.

More than 39,000 Minnesotans are enrolled in the state’s medical marijuana program, up from 29,000 in 2021. Almost all registered participants are qualified because of intractable or chronic pain, and about a third for PTSD. Muscle spasms, cancer, and sleep apnea are also common qualifying conditions.

New Conditions Considered Annually

Each year, the health department conducts a formal petition process to solicit public input on potential qualifying medical conditions and delivery methods, followed by a public comment period and a review panel.

Under state rules, the commissioner of health is required to annually consider new petitions to add qualifying medical conditions and cannabis delivery methods. No petitions for new delivery methods were submitted this year.