Minnesota next summer will open its medical marijuana program to patients who experience chronic pain, state Department of Health Commissioner Ed Ehlinger said Wednesday, according to the Star Tribune. The decision could add thousands of patients to the state’s program, which has struggled with low enrollment and high prices since it was launched in July.

This change will make Minnesota the 19th state where people with intractable pain -- pain that cannot otherwise be cured or treated -- can legally use medical marijuana, the Associated Press reported. Of the states where medical marijuana is legal, just five do not include severe, chronic or intractable pain as a qualifying condition.

Ehlinger said in a statement that it was a “tough choice,” according to the AP. However, he said, “given the strong medical focus of Minnesota's medical cannabis program and the compelling testimony of hundreds of Minnesotans, it became clear that the right and compassionate choice was to add intractable pain to the program's list of qualifying conditions.”

Minnesota’s medical marijuana program, which had 760 people enrolled as of Sunday, is one of the most restrictive in the country. To be accepted, patients need a doctor or other caregiver to certify they have one of nine serious health conditions, such as cancer, epilepsy, muscular dystrophy or Crohn’s disease, the Star Tribune reported. The state sells cannabis only in liquid or pill form, according to the Star Tribune, and it must be purchased at one of eight dispensaries owned by two approved companies -- Leafline Labs and Minnesota Medical Solutions.

While pain patients make up the majority of medical marijuana users in other states, Minnesota residents were divided on the issue. In the leadup to the decision, many citizens lobbied the state's health department to expand the program, while an eight-member panel of health experts recommended against it, citing concerns about drug abuse and a lack of evidence for the efficacy of treating pain through medical marijuana.

The expansion is set to take effect Aug. 1, 2016, if lawmakers do not make changes to it this spring. However, both the Republican-controlled House and the Democratic-Farmer-Labor-led Senate would have to vote against the addition for it to fail.