Many doctors remain leery of Minnesota's expanding medical marijuana program.

When Dr. Charles Reznikoff, a member of the state's Task Force on Medical Cannabis Therapeutic Research, sent out an informal survey on the program to hundreds of fellow physicians around the state, the responses were overwhelmingly negative.

By a wide margin, the 262 physicians who responded said they did not know enough about medical marijuana to discuss the risks and benefits with a patient; the majority opposed the idea of expanding Minnesota's program to pain patients; and most thought the program just meant more hassle and paperwork for them.

"[Medical cannabis] does not occupy a central role in medicine," Reznikoff, an addiction specialist, told fellow task force members gathered for a meeting Tuesday with legislators in St. Paul. "This isn't aspirin for heart attacks. This is kind of a novel, unconventional thing we're doing in this state."

The survey wasn't meant to be scientific, he said, just a "conversation-starter" about physicians' lingering concerns about the program. Last June — one month before medical marijuana was legalized — the Minnesota Medical Association found that two-thirds of the doctors it surveyed were reluctant to certify patients to enroll in the program.

In the months since, the Office of Medical Cannabis has enrolled 844 patients and registered 479 health care practitioners who wanted to certify patients. In December, Health Commissioner Ed Ehlinger ruled that the tightly restricted program would open to include pain patients this year. Intractable pain will join the list of nine serious conditions allowed into the program this August.

So far, Ehlinger told the task force, Minnesota has "a very well-controlled medical cannabis program," but he acknowledged that physicians still have concerns — particularly about the effect cannabis could have on the developing brains of children and teens, and on people with serious mental illness. To guard against potential abuse, the Health Department hopes to add cannabis to the state's prescription drug monitoring program.

Minnesota's program has struggled in its early months to enroll enough patients to stay viable, and the low enrollment numbers have driven up prices. Adding to patient frustrations has been the struggle to find a doctor or clinic willing to confirm to the Health Department that they had cancer, epilepsy or one of the other qualifying conditions.

In Minnesota, doctors simply certify patients. Pharmacists at a handful of cannabis clinics deal with patients and dispense the medication.

A matter of education?

Task force member Jeremy Pauling, whose 8-year-old daughter, Katelyn, died from a seizure disorder months before the program launched, said his family had to "educate" the doctors in their small southwest Minnesota community. At one point, the town of Montevideo voted to invite a medical cannabis dispensary to open in town so the family wouldn't have to drive for hours to fill Katelyn's prescription.

"I educated our hometown doctors. They were not on our page to start with," Pauling said. "I educated them personally and now, in my community — which is a small community — everybody's embraced it. What are we doing, going forward, to educate these physicians that [cannabis] is not as bad or taboo as everybody always said it has been?"

When a new drug hits the market, Reznikoff said, doctors usually get the word from medical journals or pharmaceutical representatives. Since marijuana remains banned at the federal level, which makes studies scarce in this country, he said it may be up to patients, the state's two cannabis manufacturers and the state itself to push physicians to learn more, he said, "and that's what's going to change them and their attitudes."

The task force will submit its report on the fledgling medical cannabis program to the Minnesota Legislature when it returns to work later this winter.

Jennifer Brooks • 612-673-4008