In May 2014, the Minnesota Senate and House overwhelmingly passed different medical marijuana bills.The Senate bill included more patients, including those with PTSD, severe nausea, wasting, and intractablepain, and more dispensaries while costing significantly less to administer. The House bill reflected severalunreasonable demands from law enforcement and Gov. Mark Dayton, including prohibiting patients from using cannabis flowers or leaves in their natural form, having a monopoly manufacturer, and including an onerous observationalstudy. On May 15, 2014, a committee agreed to a compromise, which the House and Senate signed off onthe following day. Gov. Mark Dayton signed the bill into law on May 29, 2014. The first dispensaryopened a little more than a year later, on July 1, 2015.

Since then, the Department of Health has added additional qualifying conditions, which were excluded from the initial law, most notably intractablepain and PTSD. Due to the onerous and very limited nature of the program, the state manufacturers have not been able to turn a profit as of spring 2018.

Here is an overview of Minnesota’s restrictive medical marijuana law:

Qualifying Conditions:

  • The qualifying conditions are cancer (if the patient has severe pain, nausea, or wasting), glaucoma,HIV/AIDS, Tourette’s, ALS, seizures, severe and persistent spasms, inflammatory bowel disease — including Crohn’s disease, terminal illness with less than one year to live (ifthe patient has severe pain, nausea, or wasting), intractable pain, and PTSD. Beginning on July 1, 2018, patients with autism or obstructive sleep apnea will be allowed to register.
  • The health commissioner may add other conditions and was required to report on whether he recommended addingintractable pain by January 2016. Each recommended addition is submitted to the legislature beforetaking effect, and the legislature may overrule the recommendation. Intractable pain and PTSD were added in this fashion.

Healthcare Practitioners:          

  • Doctors, nurse practitioners, and physicians assistants may sign a patient’s certification. To do so, thepractitioner must have responsibility for treating the patient’s qualifying condition.
  • Practitioners must submit reports on patient health records, which are typically not covered by insurance.
  • The commissioner has established a registry program in order to evaluate data on patient demographics,effective treatment options, clinical outcomes, and quality of life outcomes.

Patient Certification:

  • Patients may enroll in a health department-run medical cannabis patient registry if the practitioner treatingtheir qualifying condition submits a certification and participates in the reporting requirements.
  • Patients must submit a new certification once per year.
  • Patients must pay $200, or $50 if the patient is a recipient of Social Security disability,Supplemental Security Insurance payments, or is enrolled in MinnesotaCare or medical assistance.

Types of Cannabis Administration Allowed:

  • The law only allows administration via liquids, oils, and pills that are made of cannabis,including whole plant extracts and resins.
  • Patients may vaporize, but only using oils or liquids, which make it much harder to control dosage and aremore intoxicating.
  • The commissioner may add additional types of administration methods.
  • Smoking is not allowed.

Manufacturers:

  • The commissioner of health has selected and will continue to regulate two in-state manufacturers.
  • Each manufacturer may have up to four satellite distribution locations. They are not, however, required tohave any satellite locations, so there could be as few as two total distribution points in the state.
  • Each applicant for a manufacturer license paid $20,000 to apply, $19,000 of which was refunded tounsuccessful applicants.
  • The commissioner will collect fees for regulating and inspecting the manufacturer each year.
  • Manufacturers were selected based on factors including their long-term financial viability and experiencecultivating and preparing medical cannabis. They were required to implement security requirements,including a fully functional alarm and perimeter identification system.
  • Manufacturers are not to be located within 1,000 feet of a pre-existing school.
  • Manufacturers may not employ someone under 21 years old or someone who has a disqualifying felonyconviction.
  • Only pharmacists are allowed to dispense cannabis.
  • Manufacturers must label cannabis, including with the patient’s number and the chemical composition.

Testing Laboratories:

  • Manufacturers must select and contract with a lab to test cannabis.

Caregivers:

  • Patients may only have a caregiver assist them with administering their medicine or picking up cannabisif the patient’s medical provider certifies he or she is so physically or developmentally disabled that theperson cannot administer his or her own medication. If a patient is too ill to travel or drive, but not sodisabled that he or she cannot administer their medical cannabis, he or she cannot have someone pick up their medicine for them.

Dosage and Possession Limits:

  • The commissioner must investigate and post information on chemical composition and ranges of doses,but this does not appear to be determinative. Patients may obtain a 30-day supply and a pharmacist workingfor the manufacturer appears to be responsible for ultimately determining dosage.

Timeline:

  • The health commissioner selected the two manufacturers on December 1, 2014. The manufacturers wereallowed to begin distributing cannabis on July 1, 2015. 

Patient Protections:

  • In addition to patient protections from criminal and civil penalties, there are protections fromdiscrimination in employment, child custody disputes, organ transplants, and other medical care.
  • There are no provisions to protect patients from the other medical cannabis states or D.C. while theyare traveling to Minnesota.

Penalties:

  • There are several new crimes for violating the act, such as intentional diversion by patients ormanufacturers and false statements on an application.

Task Force:

  • A 23-member task force was established, composed of four legislators, four patients, four health careprofessionals, four members of law enforcement, four substance abuse treatment providers, and threecommissioners. The task force is directed to issue a biennial impact assessment, including of the program design andimplementation, patients’ access and quality of cannabis, impact on law enforcement, and the impact onsubstance abuse rates.