Medical marijuana products at Minnesota Medical Solutions in Otsego, Minn. Jennifer Simonson | MPR News file

The Minnesota Health Department says it will expand the legal use of medical marijuana to cover people with intractable pain.

The department's top leaders announced their decision Wednesday after several meetings around the state to gather public input.

"The relative scarcity of firm evidence made this a difficult decision," Minnesota Health Commissioner Dr. Ed Ehlinger said in a statement.

"However, given the strong medical focus of Minnesota's medical cannabis program and the compelling testimony of hundreds of Minnesotans, it became clear that the right and compassionate choice was to add intractable pain to the program's list of qualifying conditions," Ehlinger added. "This gives new options for clinicians and new hope for suffering patients."

Lawmakers restricted medical marijuana's use to a handful of conditions when they approved it, a circumstance supporters of the drug say has held down the program's enrollment and led to higher costs for those using it.

A decision on whether to add chronic pain had been legally required by Jan. 1.

In November, an advisory panel said it could not recommend medical cannabis for pain because there wasn't enough evidence to justify use of the drug.

State health officials say they heard from nearly 500 Minnesotans on the issue and more than 90 percent supported adding intractable pain as a qualifying condition.

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The 2014 law defines intractable pain as a condition "in which the cause of the pain cannot be removed or otherwise treated with the consent of the patient and in 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."

Patients certified as having intractable pain will be eligible to receive medical cannabis from the state's two medical cannabis manufacturers starting in August, the department said.

Officials will ask doctors to share information every six months regarding the positive and negative impacts of medical cannabis on intractable pain patients and intends to share the reports with the public.

But Hibbing pharmacist Neal Walker points out that intractable pain is complex, and requires treatment from physical therapists, counselors and others.

"The fear is that some patients might just use the medical marijuana, and that's their 'magic bullet and that's all they need, and now I feel good,' that's not going to be the answer," he said.

Walker said cannabis could be part of the answer for some patients suffering severe pain, but there's not enough research yet to know.

Minnesota will be the 19th state where medical marijuana is legal to extend the drug to people with intractable pain.

Lawmakers could vote to reverse the commissioner's decision this spring but both the Republican-controlled House and DFL-held Senate would have to vote the addition down. A bipartisan group of lawmakers Wednesday praised the Health Department's decision.

However, State Rep. Matt Dean, R-Dellwood, slammed Wednesday's move expanding medical marijuana to intractable pain as an overreach by the Dayton administration and an "on ramp" on the road to fully legalizing marijuana use in Minnesota.

He noted that a Health Department advisory panel had recommended the state not allow patients in pain to buy medical marijuana next year.

Gov. Mark Dayton, however, agreed with his health commissioner that it was also a matter of compassion.

"People who are experiencing intractable pain, and believe this is going to be helpful to them, deserve a chance to find out through the use of cannabis whether it's going to be successful or not," he said.

Dayton added that he's comfortable with the decision, given the state law's other restrictions, including its prohibition on smoking medical cannabis in leaf form.

There were indications that the change could bring down prices for patients already enrolled in the medical marijuana program.

Kyle Kingsley, CEO of Minnesota Medical Solutions, one of the state's two cannabis manufacturers, said the small client base has made it difficult to control costs. He said selling the company's product to customers seeking to ease pain will help the company financially.

"We're excited about the increased volume," Kingsley said. "It's going to help us to lower prices and increase accessibility for more folks."

The average Medical Solutions client pays between $200 and $450 a month for medical marijuana. But Kingsley said some people pay upwards of $1,000 a month. He said he wants to bring down those prices, but doing so will depend on how many more patients the company enrolls.

The number could be large.

Manny Munson-Regala, CEO of LeafLine Labs, based in Cottage Grove, said pain patients in other medical marijuana states range from two to 10 times the number of those with all other qualifying conditions. In Minnesota, the new ruling likely means huge growth in the number of eligible patients.

"On the low end we could be looking at a total patient number of around 10,000, or you could be looking around, on the high end, somewhere around 100,000," Munson-Regala said.

But Kurtis Hanna, one of the founders of Sensible Minnesota, which supports medical marijuana, said he doesn't think this decision will result in many more cannabis prescriptions.

"There obviously are individuals that qualify, and I'm extremely happy for them that they now will be able to qualify and apply to the program," he said. "However, I don't think the number will be nearly enough to sustain the program."

Patients with intractable pain will need to be certified by a Minnesota provider. So far, about only about 400 providers have agreed to offer those certifications.

Pain patients who are certified will be eligible to receive medical cannabis on Aug. 1.

MPR News reporters Tim Pugmire, Lorna Benson, Dan Kraker and the Associated Press contributed to this report.