By Pat Anson, Editor

After months of debate, Minnesota’s health commissioner has decided to include chronic pain in the list of conditions that allow residents to legally use medical marijuana. They just have to wait another nine months before they can buy it.

Commissioner Ed Ehlinger said it was “the right and compassionate choice” to allow pain patients into the program.  Only nine health conditions currently qualify for marijuana prescriptions in Minnesota – and chronic, intractable pain won’t be added until August 1, 2016. Health care providers can start certifying intractable pain patients on July 1 of next year.

Ehlinger, who is a physician, said “the existing tools are not working well” to manage pain, according to the Minneapolis Star Tribune.

“There are strong and conflicting opinions ... in both the professional community and in the general population. However, as a physician who is concerned about the treatment each individual patient receives and as the Minnesota Health Commissioner who is concerned about the overall health of everyone in this state, I believe that adding intractable pain to the list of qualifying conditions for our medical cannabis program is the correct decision,” said Ehlinger

Last month a state advisory panel recommended against the inclusion of chronic pain in Minnesota’s marijuana program, saying cannabis was not a “magic bullet” and there wasn’t enough evidence to support its use for pain.

“Panel members expressed concern that patients eligible to use medical cannabis for pain have expectations that it would provide total relief and that such a perception may leave patients to abandon other proven pain-management methods, such as physical therapy,” the recommendation said.

“Panel members cited the recent opioid crisis, where good medications were demonized because prescribers used it to treat pain without knowing its proper uses. Even after studying the information available on medical cannabis, panel members said providers do not feel prepared to certify patients for its use.”

Over a dozen public hearings on the issue were held across the state, and the vast majority of speakers favored including intractable pain in the list of health conditions marijuana can be used for.

Intractable pain is defined as “a pain state in which the cause of the pain cannot be removed or otherwise treated with the consent of the patient and which, in the generally accepted course of medical practice, no relief or cure of the cause of the pain is possible, or none has been found after reasonable efforts.”

The nine conditions that currently qualify for medical marijuana in Minnesota are cancer, glaucoma, HIV/AIDS, Tourette Syndrome, Amyotrophic Lateral Sclerosis (ALS), seizures, severe muscle spasms, Crohn’s Disease and terminal illness. In addition to strict limits on conditions it can be prescribed for, medical marijuana is not available in leaf form and cannot legally be smoked in Minnesota.  It is only legal in a pill, vapor or liquid form.

The limits are so restrictive, less than 800 patients have enrolled in the program so far. Enrollment is expected to increase dramatically once chronic pain is included.

"Congratulations to the State  of Minnesota for now becoming a true state of compassion," said Ellen Lenox Smith, a medical marijuana advocate and a columnist for Pain News Network.  "I do hope that in the near future, they will also consider to adjust their stand on cannabis being sold only in pill or liquid form — nothing smoke-able.  For those of us in Rhode Island, we can choose to vaporize, use topicals, smoke if that is your only way to make it work for you, along with tinctures, drinks and edibles. We all have to find the right way to make this medicine work for our conditions, so may they realize their limitations are very controlling and holding back pain relief for many."

Minnesota is one of 23 states and the District of Columbia where medical marijuana is legal.