Minnesota will open its medical marijuana program to pain patients, starting next summer.

The move, announced Wednesday by Health Commissioner Ed Ehlinger, could bring thousands of new patients into a program that has struggled with low enrollment and high prices. Ehlinger, however, said his decision was driven not solely by economic or scientific data but by compassion for pain-wracked Minnesotans who hope cannabis will give them some relief when every other pain treatment has failed.

"I knew the decision was not just about medicine and objective science," said Ehlinger, a physician. "It was also about people, people who had been suffering — many of them for many, many years without lasting relief from their severe, persistent, intractable pain."

The first pain patients will be able to legally use medical marijuana beginning Aug. 1. In the coming years, the Health Department will evaluate other medical conditions for possible inclusion in the program. Other state programs allow cannabis treatments for everything from post-traumatic stress to Alzheimer's disease.

Word of Ehlinger's decision spread quickly. In St. Paul, Gabriella McCann burst into tears as she read the Health Department's announcement. Her 3-year-old daughter, Elisa, suffers from a rare genetic condition that causes her skin to blister at the slightest contact. Drugs like morphine and oxycodone can do little to ease the little girl's daily agony, but cannabis oil might offer her some relief.

"It's a chance," McCann said. "It's beautiful. … My daughters asked, 'Mommy, are you crying?' I said, 'Yes, but I'm crying for happiness.' "

In Maplewood, Nikki Villavicencio, was caring for her own 3-year-old from her wheelchair, despite the pain of a rare joint disorder that limits her movements and arthritis that makes those limited motions even more painful. Her partner, Darrell Paulsen, is already enrolled in the medical cannabis program and she's looking forward to being able to buy cannabis legally in a safe, pleasant clinic environment, rather than on the black market. But Villavicencio didn't qualify for Minnesota's program — until now.

Visiting a cannabis care center, is "a night-and-day type experience," compared to buying cannabis illicitly, she said. "It's like going into a clinic or a salon. It's very clean, I feel comfortable taking my daughter there."

Bringing pain patients into Minnesota's medical marijuana program was a fraught decision for the state. Critics worried that expanding the program would open it up for potential abuse, and an eight-member panel of medical professionals recommended against the expansion. The Minnesota Medical Association has also balked at allowing patients to use a drug that is still illegal at the federal level and has had relatively little clinical testing in this country.

Ehlinger heard from almost 500 Minnesota citizens during the public comment period before he made his decision, and 90 percent of those comments were in favor of adding intractable pain to the shortlist of conditions that qualify Minnesotans to use medical cannabis. Right now, the program is one of the most restrictive in the nation — open to just nine conditions, including certain cancers and terminal illnesses, seizure disorders and severe muscle spasms.

Adding pain patients to the list, Ehlinger said, was the "right and compassionate" choice.

Gov. Mark Dayton said he backed Ehlinger's decision, and a bipartisan group of state lawmakers issued a joint statement, welcoming the news.

"I met with Commissioner Ehlinger earlier and told him I fully support that," the governor said. "From a social, compassionate standpoint, people who are experiencing intractable pain, if they believe this is going to be helpful to them, deserve the chance to find out through the use of cannabis, whether it's going to be successful or not."

In a statement, Minnesota Medical Association spokesman Dan Hauser said the group "remains concerned about the expanded use of medical cannabis, particularly for conditions such as intractable pain that are difficult to objectively certify." The group has called for more clinical trials to evaluate the drug's effectiveness.

As of Friday, the program had 760 enrolled participants, and opening enrollment to pain patients could bring in thousands more. Most states with legal medical marijuana programs include pain as a qualifying condition, and in most of those states, pain patients make up the bulk of the patients in the program.

The phones began ringing at Minnesota Medical Solutions' downtown Minneapolis clinic within minutes of the announcement — pain patients, eager to know how soon they could register. Kyle Kingsley, an emergency room physician and CEO of one of the two companies selected by the state to grow, refine and sell all of Minnesota's legal cannabis — said his company has already developed 10 strains of pills and liquids that could be used to treat pain symptoms. But enrollment for pain patients will not open until July 1, a month before they'll be able to buy the drug.

The program expansion is "great news," he said. Minnesota's pain program will be more narrowly focused than other states, but Kingsley said he still expects to see a "two- to threefold increase" in enrollment. Right now, he said, enrollment numbers are so low, his company could treat all its customers at a single clinic, although it is still pushing ahead with plans to open a total of four around the state by next spring.

Cannabis is sold only in pill or liquid form — nothing smokable — and can only be purchased at one of the clinics now open. MinnMed has clinics in Minneapolis and Rochester, and the state's other cannabis company, LeafLine Labs, has a clinic in Eagan. Others are set to open in St. Paul, St. Cloud, Moorhead, Hibbing and Eden Prairie by next summer.

The state will develop guidelines for doctors about cannabis use for pain patients who are children, pregnant or nursing women or have a history of schizophrenia. Ehlinger also hopes to add cannabis to the state's controlled substance database, which tracks patients' use of opioids. In many states with medical marijuana programs, deaths from narcotics overdoses have dropped by 25 percent or more.

For more information about the Office of Medical Cannabis, visit: www.health.state.mn.us/topics/cannabis/

Reporter Patrick Condon contributed to this report.

Jennifer Brooks • 612-673-4008