Minnesota Medical Cannabis Program. October 24, 2017

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Minnesota Medical Cannabis Program October 24, 2017

Agenda: Overview of Minnesota Medical Cannabis Program Conditions, roles, products Laboratory Issues Program Evaluation * indicates a hyper-link to website source 2

2014: MN became 22 nd state with full medical cannabis program *Link to Minnesota Law Recreational and Medical (8+) Medical (21) Low THC/High CBD Products (16) 3

Minnesota s Program is Different From Most No smokeable or plant form marijuana (only liquids and oils in capsule, tincture, vaporized form, topicals including patches, lotions & balms) Only two vertically-integrated manufacturers (cultivation-productiondistribution supply chain) Commitment to learning from experience with program (reports and observational studies on effectiveness, side effects, etc.) Patients agree to provide access to medical data 4

Qualifying Medical Conditions: *Qualifying Conditions Cancer or its treatment, with severe or chronic pain, or severe nausea, or severe wasting Glaucoma HIV/AIDS Tourette s Syndrome Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig s Disease) Seizures, including those characteristic of epilepsy Severe and persistent Muscle Spasms, including those characteristic of multiple sclerosis Inflammatory Bowel Disease, including Crohn s Disease Terminal Illness with life-expectancy < 1 year with severe or chronic pain, or severe nausea, or severe wasting) Intractable Pain PTSD 5

Approved and Active Patients (as of Aug 31, 2017) Total = 6,606 (8,454 including non-active) By Qualifying Conditions: 67.6% Intractable pain 15.8% Severe and persistent muscle spasms 11.4% Cancer 6.0% Seizures 3.9% Inflammatory bowel disease 3.2% PTSD 1.4% Terminal illness 1.1% HIV/AIDS 1% each: Tourette syndrome; Glaucoma; ALS Note: 11.6% of patients >1 condition Age distribution: 0-4(<1%) 5-17 ( 2%) 18-24 ( 3%) 25-35 (14%) 36-49 (26%) 50-64(35%) 65+ (19%) Gender: M/F 49%/51% 6

Patients Active in Registry (as of 8/31/17) Number of Patients Active in Registry 7000 6000 5000 4000 3000 2000 1000 0 7

8

Manufacturers Products Manufacturers each determine their own product line Different medical cannabis products in MN are characterized by different ratios of THC:CBD and mode of delivery Products range from: high CBD/low THC 1:1 low CBD/high THC Current products are listed on manufacturers websites (links on OMC website) Insurance does not cover cost of medical cannabis 9

Independent Laboratory Testing Content Cannabinoid Profile Contamination: Laboratory must be approved by MDH Metals Pesticides Microbials Residual Solvents Consistency and Stability (3 month intervals) *MN Medical Cannabis Laboratory Rulemaking 10

Research & Analytics in OMC Sources of information: Enrollment Information: qualifying condition, age, race, etc. Symptom, side effect, and medication information collected at each transaction (purchase) Periodic surveys of patient and their certifying health care practitioner 11

Learning from Participants Experience June 2017: First Year Report of first year enrollees (July 1, 2015 June 30, 2016) Condition: muscle spasms (43%), cancer (28%), seizures (20%), each of the others <10% Age: 56% age 36-64, 11% <18, 11% 65 *First Year Report 12

Learning from Participants Experience: Examples of symptom improvement: Among seizure patients, 68% reported 30% reduction in seizure frequency and 49% both achieved that level of reduction and retained it, on average, for at least four months Among patients with severe, persistent muscle spasms, 48% reported 30% reduction in spasm frequency and 28% both achieved that level of reduction and retained it, on average, for at least four months Among patients with Tourette Syndrome, 61% reported 30% reduction in tic frequency and 46% both achieved that level of reduction and retained it, on average, for at least four months 13

Learning from Participants Experience: Their stories I am getting enough sleep for the first time since about 2011. My absence seizures have gone from 3-4 a day to almost 0. It also has lessened the severity of grand mal seizures. The recovery time after has gone from around 12 hours to around 4. Almost all muscle spasm and pain associated with spasms are gone. I used to have constant nerve triggered pain that is minimal now. Results were almost immediate. I am sleeping way better now also.? At first it helped a lot but my seizures have returned. 14

For Additional Information Website: Http://www.health.state.mn.us/topics/cannabis/ OR Http://mn.gov/medicalcannabis Phone: 651-201-5598 844-879-3381 Email: Health.cannabis@state.mn.us 15

Thank you! Michelle, PhD Director, Office of Medical Cannabis Minnesota Department of Health Michelle.@state.mn.us 16