Patrick McClellan uses a 32-pill regimen each day to ease the suffering from his rare form of muscular dystrophy, which can feel like a charley horse that violently spreads across the lower half of his body.
He could cut that prescription cocktail in half with a steady dosage of medicinal marijuana after he discovered a decade ago that it does wonders to treat the symptoms of his disease.
That is, if he could afford it.
He's hopeful he soon can under a new law that allows adults 21 and older in the medical marijuana program to purchase the raw flower form of cannabis and smoke it. The change puts Minnesota's program, previously one of the most restrictive and expensive in the nation, in line with what most other states are doing. The state estimates it will increase participation by three or four times, driving down costs.
"This is a huge win for the patients," said McClellan, who limits his participation in the program because of the high cost. "The price is going to drop substantially and it's also going to give people more options to choose what works best for them."
It's one of the most significant changes to Minnesota's program since it started seven years ago, but it could take until early next year before patients see flower products at dispensaries.
Adding the dried flower to the cannabis liquid, oil and pills already allowed in the program will require new labeling for products and lab tests. Minnesota's two medical marijuana manufacturers need time to prepare for the expected uptick in demand. The state has until March 2022 to get the program up and running, though officials and legislators hope it can start sooner.
"It's not as simple as grow some plants and we're ready to go," said Chris Tholkes, director of the Office of Medical Cannabis at the Minnesota Department of Health. "Our No. 1 concern is patient safety; that will always be our No. 1 concern. We want to make sure we have all the public health guardrails in place, from planting all the way through harvest and packaging, so that people can trust what they're getting."
Patients can enroll in the state's program if they have one of more than a dozen qualifying conditions approved by the Department of Health and clearance from a physician.
Roughly 34,000 residents — about 0.6% of the state's population — are now enrolled, and many have testified over the years that they've struggled with the costs of buying oil and liquid products, which are more expensive to extract.
The cost of participating in Minnesota's medical cannabis program is not covered by medical insurance. Thousands have opted to instead go through the black market for cannabis.
Former emergency room doctor and now CEO of Vireo Health, one of the state's two medical cannabis companies, Dr. Kyle Kingsley said allowing the raw flower would cut costs in half for patients and manufacturers.
"Longer term you'll get decreased costs for all the products, but Minnesota is very demand-limited right now. We're operating at a small fraction of our capacity," he said. "Both operators have lost a lot of money in the state since [the program's] inception."
Vireo operates in several other states, where the dried flower product is the most popular among patients, Kingsley said. But it will take time in Minnesota to get the product on shelves, for demand to increase and the benefits to trickle down to customers.
Unlike in some other states, Minnesota medical marijuana enrollees don't have a card to identify that they're in the program. Their information is included on the product label, just like with other prescriptions.
With the raw flower still illegal for recreational purposes in Minnesota, the state needs to come up with a clear way to identify the products being sold through the medical program, Tholkes said.
The state's medical cannabis office has been flooded with questions from people about whether they can grow their own at home, which some other states allow. Minnesota law only authorizes growth from the two approved medical marijuana manufacturers: Vireo Health and LeafLine Labs.
Concerns about the costs for patients converted Sen. Michelle Benson, R-Ham Lake, from a skeptic to a supporter this legislative session. She wants to make sure patients continue to be under a doctor's care, which doesn't happen if they're turning to the black market for cannabis.
"That way they can see if this is working for them, and if not, try another alternative," said Benson. "If they are not under a doctor's care they are not learning whether it's helping them."
Rep. Heather Edelson, DFL-Edina, was also an opponent when she first joined the Legislature in 2019. Now she's the lead sponsor of the expansion. She was moved by the stories of people who were in the program and spending too much money, and those who wanted to be part of the program but couldn't afford it.
Instead, they would turn to painkillers and opioids.
"Even people who are not on the program now are saying, 'Wow, instead of an opioid or instead of a prescription, maybe this could be an alternative for me,'" Edelson said.
It's not the end of the marijuana conversation at the Capitol, where the House cast a historic vote on the floor this year in favor of legalizing its recreational use for adults. The proposal didn't get a vote in the Senate. At least 17 states and the District of Columbia have already legalized recreational marijuana.
Advocates like McClellan, who has been pushing for medical marijuana and then the program's expansion for more than a decade, say whatever happens with the recreational debate, Minnesota still needs a robust medical program for people like him.
Once prices drop, McClellan expects to get enough medical cannabis in pill form to ease his pain every day, plus the dried marijuana for when he has an attack. It stops pain from his muscle spasms within minutes.
He's most excited to reduce the whopping 11,680 pills he takes every year.
"If I was not on the meds I'm taking I wouldn't be functional, but it's horrible," he said. "Patients shouldn't be treated like criminals for doing something that helps them."
