Minnesotans with obsessive-compulsive disorder or irritable bowel syndrome will be able to manage their conditions with medical cannabis starting in August.

The expansion of Minnesota’s medical cannabis program, announced Wednesday, means 19 conditions will qualify for enrollment next year. Patients self-medicating for other conditions gained access this year in Minnesota to recreational gummies and other products containing THC — the psychoactive ingredient in marijuana — but the medical program remains tightly controlled.

“We are adding the new qualifying conditions to allow patients more therapy options for conditions that can be debilitating,” said Jan Malcolm, commissioner of the Minnesota Department of Health, in a written statement.

Participation in the program hasn’t slowed, despite this summer’s legislative decision to expand recreational THC options.

More than 39,000 Minnesotans are actively enrolled, which is up from 29,000 in 2021. Almost all participants qualified because of intractable or chronic pain, and about a third reported post-traumatic stress disorder. Muscle spasms, cancer and sleep apnea also were commonly reported as qualifying conditions.

Gastroparesis and opioid use disorder were not added to the list of qualifying conditions, with mental health providers advising against the latter as an option for people with addictions or dependencies to pain pills or illicit drugs. In public comments, one provider cited a study in which opioid-overdose deaths increased 23% in states allowing medical cannabis use.

The decision came in the face of a growing opioid overdose problem, and despite commenters stating that illicit or recreational cannabis had already helped them.

“After having gone (through) 9 years of painkiller use under medical prescription for pain, I know that the use of cannabis would help ease the withdrawal side of it,” said one commenter, only identified publicly by the initials TB. “I only use cannabis now.”

The new qualifying conditions offer a modest expansion — with an estimated 10% of adults having irritable bowel syndrome and 1% meeting the diagnostic criteria for OCD.

“My daily life consists of constant fear and stress,” said a man with OCD, who was identified by the initials RH and described himself as a working professional with a wife and two daughters. “Practically the only time I am free of the symptoms is when I am sleeping. Otherwise, for about 18 hours a day, I am constantly working to overcome the symptoms that I deal with day to day. It is exhausting.”

A state medical brief highlighted research supporting management of OCD with cannabis, but also noted opposition by Minneapolis-based Allina Health and some studies showing increased risk of addiction. A similar brief also highlighted the limited medication and treatment alternatives for IBS, indicating that medical cannabis could serve an unmet need.

Minnesota is among 38 states permitting medical cannabis, despite federal laws regulating marijuana as a drug with a high potential for abuse and prohibiting prescriptions by doctors outside of research. The state considers its program to be a grand experiment of medical cannabis, producing studies on its usage patterns and effectiveness against PTSD and pain.

Participants in the state program must first be certified by doctors as having qualifying conditions and then pay up to $200 in enrollment fees.

Growth over the past year was fueled by Minnesota’s expansion to allow smokable flower forms of medical cannabis — something that isn’t available in the state’s growing recreational market.

Medical gummies are available in stronger THC concentrations as well, though people preferring cheaper recreational options can double what they take to gain equivalent amounts. Leaders of Minnesota’s two medical cannabis manufacturers and dispensaries said their products come with more rigorous oversight and guarantees of quality and dosage.

No petitions were submitted this year to study the addition of anxiety — a common condition that could greatly expand medical cannabis usage — after it was rejected by the state in 2020 and 2021.

Correction: This story has been updated to note Minnesota’s medical cannabis program covers 19 conditions.