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John Hollenhorst, Deseret News
Minnesota Medical Solutions CEO Dr. Jay Westwater talks about the process of growing marijuana in Minneapolis in late September 2018. The company is one of only two in the state that is legally permitted to grow marijuana.

MINNEAPOLIS — To some it's a threat, to others a godsend.

Hundreds of marijuana plants are now growing legally in Minnesota inside a highly secure private facility on the fringes of the Twin Cities metropolitan area.

"We're on camera now, probably from every angle," said Dr. Jay Westwater as he strolled through an indoor jungle of greenery watched over by banks of security cameras. Westwater is CEO of Minnesota Medical Solutions, one of only two companies in the state that are legally permitted to grow marijuana.

John Hollenhorst, Deseret News
Hundreds of marijuana plants are now growing legally in Minnesota inside a highly secure private facility on the fringes of the Twin Cities metropolitan area in late September 2018.

In Minnesota, the two companies that grow marijuana also process the greenery into ordinary-looking pills, rubs, oils and vapors. Each company runs "clinics" or dispensaries where the drugs are legally sold to certified users.

The plant has roiled Utah's political waters this year, and now the Utah Legislature is expected to meet in a special session in December to grapple with it. Nearly two-thirds of the states have already legalized medical marijuana. Their experiences provide some clues about what Utah can expect now that voters have approved, according to unofficial election results, Proposition 2.

'Meant the world'

When the first cannabis-derived medicines went on sale in 2015, Kim Kelsey was waiting in line at midnight, the first customer in Minnesota for legal medical marijuana.

"I won't fail to stop smiling," Kelsey said in a recent interview. "It has meant the world."

She buys the medicine for her son, Alec. Encephalitis at age 5 left him with brain damage and an IQ below 75, according to his mother. She said he's suffered epileptic seizures almost daily for 22 years — severe seizures.

"Yeah, life-threatening, every single one that he has," she said on a recent visit to the clinic where she buys Alec's marijuana medicine.

The cannabis has dramatically reduced the seizures and at age 27, he's "500 percent better," she said. "In the three-plus years that he's been on it, he has amazed us all, cognitively."

In a suburb of Minneapolis on a recent autumn evening, 12-year-old Tyler Kennedy threw an angry tantrum in the driveway of his family's home. He was upset because his father closed the garage door. Tyler's fuss over such a small issue dramatically illustrated his medical difficulty — he suffers from severe autism and Tourette's syndrome. And yet, since he began taking medical marijuana, his mother said his behavior has greatly improved.

"It is dramatically better than it used to be," Katie Kennedy said as she watched Tyler's driveway tantrum die down. "I don't think we've seen a healthier Ty in 12 years. I really don't."

John Hollenhorst, Deseret News
Tyler Kennedy, 12, who has severe autism and Tourette syndrome, is pictured in a suburb of Minneapolis in late September 2018. Tyler's mother, Katie Kennedy, said since has started taking medical marijuana, his behavior has greatly improved.

'An experiment'

The Minnesota Legislature approved medical marijuana in 2014 after fierce debate much like in Utah today.

"It's an experiment, really," said Dr. Tom Arneson of the Minnesota Department of Health's Office of Medical Cannabis. "We make clear in our warning materials that there's not a lot known about these products."

Surveys by Arneson's department show that most users are happy with the results. Sixty-one percent of surveyed users report getting "a great deal of benefit." Only 10 percent say they derive "little or no benefit" from the cannabis drugs.

Participating health care providers are somewhat less enthusiastic: 43 percent report "a great deal of benefit" for their patients; 24 percent say their patients receive "little or no benefit."

The surveys fall a bit short of true scientific evidence.

"People say it's doing them some good," Arneson said. "We don't have a control (group) here, so we aren't making statements about effectiveness."

When growing marijuana, Minnesota Medical Solutions uses no pesticides. Tiny orange ladybugs patrol the marijuana leaves to gobble up pests.

During the marijuana plants' 16-week growth period, each one is labeled with grocery-store style bar codes to keep any from getting diverted onto the streets.

"We have inventory controls and we can track" the plants, Westwater said. "We know when something might be missing. Opportunities for diversion are really minimal."

Minnesota law allows no marijuana plant material to be sold. No smoking is permitted. No gummies or brownies are sold. Only eight cannabis clinics are authorized in a state that is slightly larger than Utah. A licensed pharmacist advises each recipient.

Patients suffering from one of several legally specified ailments must be certified to use cannabis by a participating health care provider. The list of approved uses has grown over the last three years as officials added other medical conditions. Currently approved medical conditions include cancer with severe pain or nausea, glaucoma, HIV/AIDS, Tourette's syndrome, ALS, seizures/epilepsy, severe spasms, Crohn's disease, PTSD, intractable pain and terminal illness.

Medical practitioners must enroll in the program in order to certify patients for cannabis use. The Mayo Clinic at its home base in Rochester, Minnesota, allows its doctors to voluntarily participate. Maren Schroeder uses it to treat her PTSD.

"My physician at Mayo is my certifying provider," Schroeder said. She is co-founder of a pro-marijuana group called Sensible Minnesota. "What we learned in Minnesota, when we legalized medical in Minnesota, the sky didn't fall."

As in Utah, law enforcement agencies initially fought legalization in Minnesota. But they ultimately accepted a very strict compromise bill, according to Faribault Police Chief Andy Bohlen, who also chairs Minnesota's Violent Crime Coordinating Council.

"So if that can help treat certain kinds of pain, certain types of terminal illnesses," Bohlen said, "law enforcement isn't going to stand in the way of that. And we haven't seen really any problems at all since that's been adopted by this state."

But there are major worries, including criticism about astronomical costs, very low participation, and serious concern about whether a political door has been opened.

"We continue to get the pressure in the state of Minnesota to just legalize marijuana: 'Why don't you just legalize it?'" Bohlen said.

Cost factors

An immediate concern of many users of medical marijuana in Minnesota is the cost.

Kelsey said her son's condition now is "500 percent better than it was," but his vials of CBD oil cost plenty. "Per month, it's $707," she said.

"The cost is absolutely a problem," Arneson said. "Insurance doesn't pay for this, and it costs people usually at least $100, maybe up to $1,000 per month."

The high cost may be part of the reason the use of medical marijuana seems relatively low. Out of 5 million Minnesotans, less than 12,000 patients regularly use it.

"Yeah, I think the cost is definitely a big factor in keeping the use down," Schroeder said. She blames the details of Minnesota's medical marijuana law — widely considered the strictest in the nation. She says the law makes the medicine hard to get because only eight dispensaries are allowed.

There are competing theories about what pushed costs so high. Schroeder believes it's because only two companies are allowed to grow, process and sell marijuana medicines so there isn't enough competition. But a spokesman for Minnesota Medical Solutions says the company hasn't even turned a profit yet.

"There are high processing costs for us," Westwater said.

The two marijuana companies are required to refine the weed into oils, liquids and pills, with careful testing. No plant material can be sold or smoked. It's a delicate political compromise to satisfy those who worried marijuana would be abused and find its way to the streets.

Bohlen thinks those restrictions are appropriate.

"I don't think the real experts would say that there's actually a health benefit to smoking the vegetative marijuana," he said.

Another problem is that a minority of medical users report dizziness, nausea and other unpleasant side effects.

"They're usually pretty mild to moderate severity," Arneson said. "But sometimes they're bad enough that people discontinue because of the side effects."

In state surveys of certified users, a few patients do report feeling "high" or "stoned," but that doesn't seem to be the case for Alec Kelsey.

"He's not high," said his mother, who believes medical cannabis is worth every penny. "You can't get high on the product that he's on. It's healing his brain. It's giving him quality of life."

Culture change

In Minnesota, opponents of medical marijuana have generally gone quiet since the law permitting the drug was passed four years ago.

"I think that a lot of the fears have been dissipated," Westwater said.

John Hollenhorst, Deseret News
Hundreds of marijuana plants are now growing legally in Minnesota inside a highly secure private facility on the fringes of the Twin Cities metropolitan area in late September 2018.

But there are echoes in Minnesota of concerns raised in Utah: Does approval of marijuana create political momentum that could push a state toward legalization of recreational marijuana?

Surprisingly, Kim Bemis, who's organizing to lobby against recreational marijuana, actually believes Minnesota's law allowing medical marijuana is a good thing.

"I wouldn't undo it, no, because I think we have done a good job of writing a very strong law," said Bemis, who chairs a group called Smart Approaches to Marijuana in Minnesota. What he does worry about is the growth of marijuana as a big industry, and he believes approval of medical marijuana may have nudged Minnesota more in that direction.

Pro-marijuana activist Schroeder views that nudge approvingly.

"I think when people start to see that the sky doesn't fall under medical, then it's OK to start having that discussion about adult use and kind of limiting the criminalization, and putting people in jail over marijuana," Schroeder said.

Several statewide political candidates in Minnesota endorsed recreational marijuana this year. Bemis worries about where that could lead.

"I don't care if someone smokes a joint in their home," Bemis said. "We just don't really want to have commercial marijuana available in the state of Minnesota."

That view was echoed by Bohlen who said "Big Marijuana" is growing into a replay of "Big Tobacco."

"We've fought this battle for many years against companies that target kids for smoking tobacco," Bohlen said. "You still see the ads on TV. Are we going to see the same fight 10 years down the road with marijuana?

Bohlen and other critics point to Colorado, which legalized medical marijuana in 2000. Did that decision create a political climate of acceptance for marijuana that eventually led to approval of recreational marijuana?

"I think it definitely changes the culture around marijuana in a state," said Mike Van Dyke of the Colorado Department of Public Health and Environment. "I think as you legalize medical marijuana, it becomes more accepted."

Door to recreation?

When Colorado legalized recreational marijuana in 2012, many critics worried it would lead to much higher rates of marijuana use by teenagers.

"I think that has not been what we've seen in Colorado," Van Dyke said. "What we've seen in Colorado is really … adolescent marijuana use has been pretty flat since 2005."

Still, other data from Colorado seems to strengthen the hand of marijuana critics.

A recent report on Colorado's marijuana situation by the federal Drug Enforcement Administration has been circulated by critics in Minnesota. According to the DEA, overall marijuana use in Colorado went up 45 percent since recreational pot was legalized in 2012. Marijuana-related emergency room visits went up 52 percent. Traffic deaths involving drivers who tested positive for marijuana more than doubled to 138 killed in 2017.

However, marijuana is not the biggest killer on Colorado highways.

"Our data shows that alcohol remains the No. 1 substance detected in fatal car accidents, with marijuana as a distant second," said Dominique Mendiola, director of marijuana coordination for the Colorado Governor's Office. But there are other worrisome statistics in Colorado.

"We have seen impacts," Van Dyke said. "We've seen increases in hospitalizations (that are marijuana-related). We've seen increases in child poisonings. Also, we've seen in Colorado that we have a higher number of pregnant women using marijuana than in other states where there's not this access to marijuana. So I definitely think there's a public health risk, and something to think about for Utah."

Of course, there's no certainty that Minnesota — or Utah — will ever follow Colorado's lead. Medical marijuana may, or may not, be a step in the direction of legalized pot-smoking.

"I don't think that's a good argument for restricting patient access to a potentially life-changing and life-saving medication," Schroeder said.

Nevertheless, Bohlen is concerned that pressure is building.

"Once you open the door and allow some part of it," the police chief said, "so even if we allow the liquids, the oils and the pills, there's always a lobbyist push to allow smoking the vegetative marijuana."

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Bohlen admits, though, it's a national trend. Regardless of what Minnesota or Utah does, polls show momentum across the country shifting more and more in favor of marijuana. Bohlen believes it's a dangerous political drift that's being pushed by a marijuana industry whose product is markedly different from the days of love-ins and pot parties in the hippie era.

"I think the new stuff that's being produced, the THC levels are much higher," Bohlen said. "So the effects of the marijuana are being felt a lot stronger than they would've been 30 years ago."