Minnesota has 87 counties, but you'll only be able to buy medical marijuana in eight of them. With half the state's proposed clinics clustered around the Twin Cities, gaps in the cannabis coverage map will leave some families hours away from the nearest clinic.
Four marijuana distribution sites will open within 20 miles of the Twin Cities: Minneapolis, St. Paul, Eagan and Maple Grove. Four more will open outstate: St. Cloud, Hibbing, Moorhead and Rochester. The first clinics will open by July, when patients with serious, chronic or terminal illnesses can begin lining up to buy cannabis products legally.
None of them will open anywhere near the southwestern corner of Minnesota. Jeremy Pauling, of Montevideo, is facing a two-hour drive to St. Cloud to access the cannabis oil he hopes might bring some relief to his 7-year-old daughter, Katelyn, who's battling a debilitating seizure disorder.
"You forgot a quarter of the state of Minnesota," Pauling, who sits on the state's medical cannabis task force, told lawmakers and policymakers last week. Not that that will stop him. "Two hours for me to drive for my daughter — I'll do it," he said.
He worries, however, about frail patients who live even farther away from the planned clinics than he does. Luverne, in southwest Minnesota, is 200 miles from the nearest clinic. So is Roseau, to the north. It's a 3 ½ hour drive from Grand Marais to the clinic in Hibbing. Patients in the Twin Cities, meanwhile, will have their choice.
"We're very fortunate to live in the Twin Cities," said Angela Garin, who plans to enroll her son Paxton in the program.
Paxton, who turns 6 next month, suffers from a brain abnormality that can trigger hundreds of seizures a day. When he enrolled in an experimental cannabis therapy in Oregon, the oil — low in the chemical THC that gives marijuana its buzz but rich in other compounds — cut the seizures by 88 percent in a matter of weeks.
"He was able to walk better, he was feeding himself," Garin said. Now, she's waiting and worrying about whether the state's two new marijuana manufacturers will be able to reproduce the dosage that worked so well for her son in Oregon and whether her family, which is expecting a new baby this spring, will be able to afford the estimated $500 cost for the monthly prescription that insurance won't cover.
Using political maps
Eight clinics was a compromise number hammered out between lawmakers and law enforcement officials earlier this year. The state Senate favored a plan that would have allowed dozens of dispensaries around the state. The House countered with a bill that would have allowed just two.
Two companies, LeafLine Labs and Minnesota Medical Solutions, were selected earlier this month to grow and refine the state's entire medical marijuana crop and distribute it through those eight clinics.
Lawmakers wanted the clinic locations to be geographically balanced and sited where patients needed them most. That created a challenge for the Health Department, which had to approve clinic locations in December — half a year before the first patients will enroll in the program.
"We have no idea where the patients are," said Assistant Health Commissioner Manny Munson-Regala, who is spearheading the state's implementation of its medical cannabis program. "If you can tell me where the patients are, I'll tell you where the distribution centers should be. But we don't know where they are. We also don't know what the demand will be."
The Health Department gave manufacturers the broad guidelines to site a clinic in each of Minnesota's eight congressional districts. But district boundaries mirror the population — either clustered near the Twin Cities or far-flung across the state. The Seventh Congressional District, home to the planned clinic in Moorhead, runs almost the entire western length of the state. The Eighth District sprawls from the Arrowhead to the Iron Range to the northern suburbs of the Twin Cities.
"We just said, 'Look, let's just start with the premise that there is no good way to easily divide up the state in a way that's cognizant of population and patient needs, because we don't know the latter,'" Munson-Regala said. "So we let the manufacturers do their own due diligence and think through where they want to be located, and we used the congressional districts to surrogate for population distributions."
'Rolling it out slowly'
Minnesota passed one of the most tightly regulated and restrictive medical marijuana bills in the country. Not only does the state limit where patients can buy the drug, but it will only allow its sale in pills or liquids, and only to patients with certain medical conditions.
"We want to make sure we're doing it right, so we're rolling it out slowly," said state Rep. Carly Melin, DFL-Hibbing, who pushed medical marijuana legalization through the state House.
Some of her constituents were happy to learn the Eighth District's cannabis distribution center would be in Hibbing, she said. But Melin, who commutes three hours to St. Paul when the Legislature is in session, empathizes with patients who won't have a dispensary nearby.
State law will allow patients to designate a caregiver to pick up a 30-day supply of cannabis for them. And the Health Department is looking into the possibility of setting up mobile cannabis clinics that could travel to far-flung corners of the state like a high-security bloodmobile. Melin said she hopes the Legislature will take a look at increasing or rearranging the distribution sites in the future.
"I don't think relief can come fast enough for a lot of these families," she said. "I think a lot of people are anxious for these dispensaries to get up and running."
That includes officials in Hibbing, who are eager for the jobs and traffic the new clinic could draw to town. The city met with representatives of both LeafLine and Minnesota Medical about setting up shop in town, said Hibbing City Administrator Tom Dicklich.
"We thought it was a good fit for us. It's going to draw people into our town," he said. "We're not as big as Duluth, but we draw from a large area, and people coming from west of here might not want to drive all the way down to Duluth."
The dispensary will open by July 2016 at the latest, he said.
The gaps in the marijuana coverage map may not always be there, Munson-Regala said.
"Just because this is the way things are now, don't assume that that's the way things are always going to be," he said. But, "when you're making some pretty dramatic changes to culture, slow is not a bad thing."