Duluth Hospitals Restrictive On Certifying Patients For Cannabis

No Doctors in Lake, Cook, Aitkin County Giving Any Patients Access to Medical Cannabis

Opioid overdoses have consistently been a problem for St. Louis County, the most recent data says the number of people who die from opioids in the area is double the statewide average, and highest in the state per capita.

Some people say they’ve found a cure for the opioid crisis in medical cannabis, using marijuana as an alternative treatment instead of potentially deadly prescription painkillers.

It’s the most common use for medical cannabis in the state. The only problem is if you’re a pain patient, chances are slim you’ll be able to find a doctor in this area willing to certify you.

Rallista Lendacky, a young wife and mother on the Iron Range was just last year was hooked on opioids after being prescribed them for her chronic pain for a brain and nerve condition.  She says medical cannabis saved her life and she no longer uses or is dependent on prescription painkillers.

“If I was still on opioids I would be on something a lot worse, because my brain was telling me I needed more,” said Lendacky. “I felt like I couldn’t control myself anymore.”

The medicine that freed her from addiction didn’t come from a Northland-based doctor. In fact she says her provider at Essentia health who was supposed to be helping her reduce her dependency on opioids told her medical cannabis wouldn’t help her.

“The minute I brought it up it was looked down upon,” said Lendacky. “It was basically shot down right away.”

The Minnesota Department of Health has a policy “not” to release the names of doctors who will give patients access to cannabis. That means patients like Rallista are on their own to find a doctor if their current one refuses.

Fox 21 is the first to get data from the state that shows just how big of a flaw there is in the Minnesota Medical Cannabis System,  a glaring disparity in the amount of doctors who will help legally qualified patients get access to medical cannabis in northern Minnesota.

With just over 1,200 practitioners currently enrolled in the state’s program to certify patients, only 24 are in St. Louis county. In Lake, Cook and Aitkin county, there are zero providers.

While more than sixty percent of cannabis-friendly doctors are in the Minneapolis and St. Paul region, even some smaller Minnesota cities have significantly more doctors certifying patients then in Duluth. The Rochester area has 172, and there are 37 providers near St. Cloud.

St. Louis county’s  two major hospital systems, Essentia health St. Mary’s, and St. Lukes have never certified a patient suffering from chronic pain for medical cannabis, unless they also have a terminal illness.

“Our policy is we’re still not using medical cannabis to treat chronic pain alone,” said Dr. Jeffrey Lyon, M.D. “We try to exhaust evidence-based treatments first.”

Essentia health St. Mary’s has something called a “Medical Marijuana Oversight Committee,” and Dr. Jeffery Lyon is the chair.

If an Essentia doctor thinks a patient could be helped by medical cannabis, a group of eight doctors, one nurse practitioner and a pharmacist meet. It’s up to the 10 of them to decide if that patient should be able to use medical cannabis.

“Really only after those treatments are exhausted, and not working do we then go onto think about using cannabis on that patient,” said Dr. Lyon.

Dr. Lyon says about 50 patients total since 2015 have been approved by the committee for cannabis for various conditions, primarily terminal illnesses like cancer. He says the committee has not met at all to consider a patients case in 2018.

The committee is a one-of-its kind group, there is no other such process for any other drug prescribed at the hospital including opioids like fentanyl.

A recent study by the Minnesota Department of Health of more than 2,000 Minnesota patients with intractable pain found in the first year that 60 percent of those patients reported significant pain reduction, and 60 percent were able to reduce or eliminate opioid use.  Only 10 percent reported no significant benefits from cannabis.

Dr. Lyon maintains that the effects are not known, and it’s not certain if cannabis could help someone who is struggling with addiction.

“It is an intoxicating drug, worst case scenario is they get behind the wheel of a car, or they do something that’s not what they wouldn’t do under the influence and hurt someone,” said Dr. Lyon.

Side effects of many commonly prescribed opioid pain killers also include drowsiness, impaired thinking and slowed reaction times. On it’s website, OxyContin advises “patients not to drive or operate heavy machinery until the effects of concomitant use of the drug have been determined.”

At St. Luke’s the decision to certify a patient for medical cannabis is left up to the individual doctors themselves

“The only physicians who decided to register with the state of Minnesota are our oncologists and that was for their patients that were already established in their practice and had some form of cancer,” said Chief Medical Officer Greg Peterson.

That is four doctors, out of a staff of  465 according to the hospitals website.

“We don’t know what the long-term effects are, we don’t know long-term 10, 20, 30 plus years,” said Dr. Petersen. “There are over 100 active ingredients in cannabis and we don’t know what each of those components do, what doses are appropriate.”

Dr. Peterson says, the hesitation is all about the unknown.

“Many physicians feel there isn’t enough hard evidence now,” said Dr. Peterson. “There’s been research done, but it isn’t what we would consider real good research, in other words it’s not controlled. It hasn’t been placebo-blinded, and the numbers have been small.”

The total number of opioids prescribed by the hospitals in the last year is not public information, representatives from the Minnesota Prescription Monitoring Program say that “providing data at anything lower than the county level could inadvertently identify a specific prescriber, dispenser, or patient.”

We do know that overall prescriptions for opioids in St. Louis County fell from 149,512 in 2016 to 123,387 in 2017, that’s a 12 percent decrease.

St. Luke’s tells us they can’t tell us their specific numbers on opioid prescriptions because pharmacy staff “couldn’t easily get access” to it.

Essentia did tell us that they’re prescribing patients the lowest effective dose of opioids to treat pain, they have reduced dosages prescribed by 16 percent in 2017 compared to 2016.

Both hospitals say they’re also simply prescribing some patients ibuprofen and, or physical therapy.

There is at least one doctor with a satellite office in Duluth certifying new patients for cannabis. Dr. Adam Locketz has his own private practice called Timewise Medical.

He says he’s confident in his decision to give hundreds of chronic pain patient’s access to medical cannabis. He believes he is saving lives.

“We’ve had good research for many, many years,” said Dr. Locketz. “These are political and other issues that are at play. Anyone who looks at this and says there’s no evidence has not looked. It’s just easy, simple.”

However, cost remains a major issue for many patients.

“This program was not designed for everyone; it was designed for the people who could afford the structure of the way it was set up.”

A consultation with Dr. Locketz will cost you $250 dollars, that fee will cover a year of care. The state charges $200 dollars to be certified for the program, or $50 if you qualify for assistance. Two of the patients FOX 21 talked to say their cannabis costs them 400 a month. None of this is covered by insurance.

Dr. Locketz says until marijuana is no longer federally illegal for medical purposes, that cost is unlikely to change.

“It makes me feel like we’re creating a concierge program, that we can’t help folks that need it as much.

Go inside Leafline Labs growing operation and Hibbing Dispensary in Part One. Hear from Minnesotan’s who say cannabis has freed them from opioid addiction and dependency in Part Two.