Today, Sensible Minnesota has received information from the Office of Medical Cannabis indicating 164 patients have received letters asking why they stopped purchasing medical cannabis from approved manufacturers. A mere two months ago, this number was 92 letters sent, meaning that patients continue to leave the program at a steady rate.

Minnesota’s program has faltered since the beginning, struggling with low enrollment — only 844 patients have been certified to date — and high costs that have forced some patients back to the black market. It has been noted that one in five registered patients are leaving and receiving notices from the Office of Medical Cannabis, and the updated numbers would indicate this trend will continue for the foreseeable future. Patrick McClellan is not alone when he noticed that this is “an expensive designer drug that only the rich can afford right now” in a Guardian article about the program’s high costs. Bureaucratic rules forced a plant that can be grown cheaply in a variety of climates and conditions to be extracted, reformulated, and standardized. Now, the inevitable result is patients — very, very sick patients with serious chronic or terminal illnesses — are forced to choose between purchasing legal cannabis products if they are lucky enough to have the resources, paying bills, or going back to the black market. Some other patients will choose to simply do without medical cannabis and that should be embarrassing to both Governor Dayton and the legislators who didn’t stand up to him. Still, others will move away from family, friends, and their support networks to other more compassionate and sensible states.

With the addition of intractable pain as a qualifying condition starting this summer, many hope an influx of patients will resurrect this program which is currently on life support. Dr. Kyle Kingsley of Minnesota Medical Solutions has said that his hope is a two- to threefold increase in enrollment” will result from the addition of intractable pain. However, while we applaud Dr. Ed Ehlinger and the Minnesota Department of Health for making the compassionate choice in allowing intractable pain patients in the program, it remains an unknown if the addition of pain will actually result in lowered costs for all patients.

The pain patients who enter the program will have to pay the same costs. At least at first. And therein lies a huge bottleneck: will there be enough pain patients who can purchase at the current prices at rates to increase supply enough to lower costs across the board?

If not, we will continue to see patients drop out of the program at similar rates. Patients cease purchasing from the approved manufacturers for a variety of reasons, but there is no doubt that the high costs is one of the major reasons. If the high costs are not resolved for Minnesota’s sickest, this program will sink completely.