State health officials soon will allow the use of medical marijuana for people with sickle cell disease as well as those with chronic vocal or motor tic disorder.

Minnesota Department of Health (MDH) officials dismissed a petition to also include anxiety as a qualifying condition but said they will take a "deeper look" at it early next year.

"Anxiety is a broad term for a group of specific disorders," Health Commissioner Jan Malcolm said. "We want to dig into specific anxiety disorders more and move forward carefully. The large number of patient testimonials submitted during the petition process tells us there is something there."

However, Malcolm added, state officials "want to avoid unintended consequences — there is evidence that cannabis use can actually contribute to and make anxiety worse for some people."

Chris Tholkes, MDH's director of the Office of Medical Cannabis, said interest in adding anxiety as a qualifying condition isn't waning. The department was petitioned in 2017 to add the condition but rejected it then because of insufficient evidence. It has dismissed similar petitions the past three years.

But health officials likely will take a deeper look at the issue, consulting with a network of health providers and looking at other states that include anxiety. Research has been limited on the use of cannabis for anxiety but it's growing, Tholkes said.

"There's obviously interest and a need," she said.

Of the 20,000 people who are on Minnesota's registry for medical cannabis, more than 60% use it for intractable pain. It would be difficult to estimate how many people with anxiety might be added to the registry if the condition is approved, Tholkes said, but it would be more significant than those who use cannabis for Alzheimer's disease or Tourette syndrome.

Dr. Stephen Dahmer, chief medical officer for Vireo Health, the parent company of one of two cannabis manufacturers in Minnesota, said some patients with anxiety could use medical marijuana to augment their medications or replace them.

"The opportunity is to offer providers another tool in a medical program that is closely monitored," Dahmer said. "I've had patients who said they've tried everything under the sun and nothing has worked. [Medical cannabis] gave them a sense of calm that they never felt before."

Since the Legislature approved the medical cannabis program in 2014, the list of qualifying conditions has expanded.

Patients certified with sickle cell disease or a chronic motor or vocal tic disorder will become eligible to enroll in the medical cannabis program on July 1, 2021, and receive medical cannabis from either of the state's two medical cannabis manufacturers starting Aug. 1.

Sickle cell disease, an inherited red blood cell disorder, primarily affects people who are Black. They may suffer severe pain caused when sickle cells get stuck in small blood vessels and block the flow of blood and oxygen to organs in the body.

"Giving sickle cell patients a more direct pathway into the medical cannabis program will permit them a non-opioid option to manage their pain," Malcolm said.

Vocal or motor tic disorder was added after evidence showed medical marijuana can treat tics for those with Tourette syndrome, already added to Minnesota's medical cannabis program.

State health officials added the conditions to the list after a formal petitioning process to solicit public input.