Just two months after Minnesota launched its medical marijuana program, some patients turned off by high costs say they are back to buying the drug illegally because it's the only way they can afford it.
State officials and the companies hired to make marijuana products trumpeted the program's medical approach - pills and oils, no leaf products - when it launched in July. But some patients say the highly restricted and regulated system is costing them hundreds or even thousands of dollars a month- none of it covered by insurance.
Company executives defend their prices - a small vial of marijuana extract can run nearly $130 in Minnesota, more than double the cost of a similar product in Colorado, where recreational marijuana is legal and they've sold it medically for more than a decade - and say costs will fall over time. But they're also taking steps to help some buyers, including raising money to cut the price for lower-income patients.
According to state data, nearly one in five of the 491 registered patients hadn't returned to buy more medication in the last month, though state officials stress there are many possible explanations.
Patrick McClellan, who suffers crippling muscle spasms from muscular dystrophy, told The Associated Press that his monthly tab for oil for vaporizer pens - one of the legal state-sanctioned treatments - runs $264. He can get a month's worth of marijuana buds on the street for $80, and mixes it in with as much of the state-approved medicine he can afford.
"That's a car payment," he said of his state bill. "What we're talking about is an expensive designer drug that only the rich can afford right now."
He's not alone. Faced with an estimated $2,000 bill, Jonathan Holmgren is back to using the raw plant that the state still deems illegal to treat his Crohn's disease. Darrell Paulsen can't afford to pay up to $700 a month for a legal supply - he, too, is relying on the black market to make the muscle spasms from cerebral palsy bearable.
Two other patients registered with the state told the AP they've reverted to buying marijuana on the streets because of cost, but asked that their names not be used due to fear of arrest.
There's no shortage of success stories in the program's first two months - from parents saying they've watched their children's epileptic seizures abate to patients talking about lives restored, free of pain.
But the return to illegal sources underscores some broader problems for Minnesota's program.
Faced by stout opposition from law enforcement, state leaders approved one of the nation's most restrictive guidelines: Leaf products aren't allowed and the range of qualifying conditions is narrow. Oils and pills cost more to make, and the customer base is small. One manufacturer has already announced delays in opening some of the distribution centers outside the Minneapolis metro area and raised its prices.
State officials are weighing whether to allow people in chronic pain to register for medical cards next year - a move that could trigger a massive wave of new patients and allow manufacturers to mass produce more cheaply.
Part of the price discrepancy with other states' offerings is due to simple competition: Just two companies are allowed in Minnesota; Colorado has no such limit.
Dr. Kyle Kingsley, chief executive at manufacturer Minnesota Medical Solutions, acknowledged Minnesota's prices are higher than some other states and said he sympathizes with the "small minority" of patients who have reverted to the black market.
"It breaks my heart that there are folks that are not able to access the program financially," Kingsley said. "We're busting our hump to make that right. It will improve over time."
Both companies are setting up charitable arms to buy down patients' medication, and already offer discounts to low-income patients.
But the prospect of future price cuts hasn't come fast enough for Holmgren. After weeks working with Minnesota Medical Solutions to find the right treatment, the 33-year-old was left with a vial of oil that didn't work as well as his illegal $400-a-month source - and would have cost him $2,000 each month.
Holmgren said he'd much rather use the state-approved medicine than risk arrest, but the costs have to come down.
"It wouldn't be as much distress in my life or other's people lives. We could be legal," he said.
The federal government might someday relax its stance on marijuana, meaning insurers could decide to cover it as medicine, but patients don't expect that any time soon. And Sen. Scott Dibble, a sponsor of the law, said there's likely no appetite in the Minnesota Legislature to reverse the law's prohibition on allowing raw leaf.