FARGO — The number of patients in North Dakota who are registered to receive medical marijuana has grown steadily along with the establishment of eight regional dispensaries.

There are 1,944 active users of medical marijuana, according to figures from the North Dakota Department of Health’s Division of Medical Marijuana, which oversees the program.

That number could be much higher, but inflated costs resulting from high fees for dispensaries and growers and other restrictions have suppressed enrollment in the program, said Ray Morgan, a Fargo businessman who spearheaded the petition drive for a ballot measure legalizing medical marijuana approved by voters in 2016.

“There was pent-up demand for this,” said Morgan, adding that he expected there would be 5,000 registered patients by now.

The modest amount of patients who have access to medical marijuana threatens the financial viability of the program, he said.

“Two-thousand patients is not going to take care of eight dispensaries and two grow centers, no ifs, ands or buts about it,” he said.

The eight authorized dispensaries must pay two-year licensing fees to the state of $90,000, and the two authorized medical marijuana manufacturing centers must pay two-year licensing fees of $110,000.

“It’s going to be very hard for them to make money with the fees,” Morgan said.

Those high costs are passed along to patients, he said. A tincture, for example, costs $213 for 30 milliliters, or slightly more than one ounce, he said. Similarly, it costs $105 for 50 grams of lotion, or about 1¾ ounces.

“I find the prices are, like, out of this world,” Morgan said, adding that they’re not covered by health insurance. “The prices are just so outrageous that I can’t justify paying them.”

Medical marijuana prices are set by the manufacturers and dispensaries, but state regulators have the authority to examine financial records if they suspect prices are out of line, Wahl said.

“As the program continues to move forward we’ll continue to monitor pricing,” he said.

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Also, he said, each dispensary is required to have a program to help patients of limited financial means to afford their medications. Patients should contact their dispensary for details.

One of the state’s two medical marijuana manufacturers, Pure Dakota, located in Bismarck, told a legislative committee that they have invested $12 million in their facility, Wahl said. State registration fees are a relatively minor cost for manufacturers and dispensaries, he said.

Patients pay an annual registration fee of $50. Those fees are intended to pay for the state’s administration of the medical marijuana program, which is on pace to wean itself from state general fund support in its 2020 fiscal year with a projected budget of almost $1.4 million, Wahl said.

Information provided to North Dakota from other states that allow medical marijuana suggests it takes one to three years for dispensaries to become profitable, and five years for manufacturing centers to become profitable, Wahl said.

As the patient base grows, he said, there will be more business activity to sustain dispensaries and manufacturing centers.

Lawmakers have expanded the list of “debilitating medical conditions” that can be treated with medical marijuana, which is one reason for the growth in patients in the program, Wahl said.

The list of 26 eligible medical conditions includes AIDS, agitation of Alzheimer’s disease or related dementia, anorexia nervosa, anxiety disorder, autism spectrum disorder, brain injury, cancer, Crohn’s disease, epilepsy, fibromyalgia, glaucoma and interstitial cystitis, a form of severe bladder pain.

“I think we saw more significant growth as more dispensaries opened,” Wahl said. The eighth center opened Dec. 13 in Dickinson, the last designated region to get a dispensary.

There’s a good chance 2,000 patients will be registered by the end of the year, he said, although the holiday season could mean that mark isn’t reached until early in 2020. State officials projected they would reach 2,000 patients by June 2020.

As of June 30, the most recent figure available, 155 health care providers were registered to determine whether a patient has a medical condition that is eligible for treatment with medical marijuana. Providers can be a physician, physician assistant or advanced practice registered nurse.