Staff Columnist

Proposed medical cannabis expansion is good, not great

Iowa Legislature reconsidering cap on THC levels

Gov. Kim Reynolds speaks during the Condition of the State address in the House Chamber at the Iowa State Capitol in Des Moines on Tuesday, Jan. 15, 2019. (Stephen Mally/The Gazette)
Gov. Kim Reynolds speaks during the Condition of the State address in the House Chamber at the Iowa State Capitol in Des Moines on Tuesday, Jan. 15, 2019. (Stephen Mally/The Gazette)

Iowans are finally getting a glimpse of what a real medical cannabis program might look like.

A bill advancing through the Iowa Legislature would expand access to cannabis therapy in several important ways. The industry would still be absurdly restricted, but it would at least start to resemble a workable system, unlike our current law.

House File 732 was approved by the Iowa House last month by an overwhelming 96-3 margin, and the Senate Judiciary Committee advanced an amended version on Thursday.

A law passed in 2017 authorized tightly controlled production and distribution of medical cannabis products for a small subset of Iowa patients. The law is so weak that some policy trackers still do not classify Iowa as a medical cannabis state.

Among several major problems with the law is a 3 percent limit on tetrahydrocannabinol, or THC. Some advocates worry the limit encourages patients to consume huge volumes of product to get the THC they need to effectively treat their conditions.

One of the most significant changes in this year’s bill is a provision to alter the THC restriction. The House version would replace the existing 3 percent cap with a new limit of 25 grams per 90-day supply. That limit still is arbitrary, but may be better for some patients than the percentage cap.

“We don’t want to make perfect the enemy of good,” Rep. Jarad Klein, R-Keota, said last month on the House floor.

The proposal also would authorize physician assistants and nurse practitioners to recommend patients to receive a medical cannabis card. That’s a crucial development for people in rural communities with a shortage of physicians, and for patients whose doctors aren’t willing to sign off on cannabis treatment.

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“Many times in my pharmacy I have patients who come to me and say their physician just doesn’t feel comfortable in some cases recommending this product,” said Rep. John Forbes, D-Urbandale, who is a pharmacist.

Finally, the Legislature would direct the Board of Medicine to adopt a system of waivers to the THC cap for patients with a life expectancy of less than one year. Any compassionate person can clearly see the value of such a policy.

So it’s a good bill, but not as good as it could be.

Rep. Jeff Shipley, R-Fairfield, offered an amendment to the bill to include whole-plant treatment and expand the list of covered conditions. Ship-ley ultimately withdrew the amendment to not endanger the bill’s passage, but he aptly noted during floor debate that marijuana is demonstrably safer than some widely accepted medical treatments.

“How many people have died from marijuana overdose? I’ve never seen a statistic on that. I know a lot of people are dying of opioids. The Department of Public Health gives itself a pat on the back because less people are dying of opioids,” Shipley said.

If you read my column even occasionally, you know I frequently lament the state’s old-timey prohibition laws. Those columns are consistently my most widely read and discussed contributions, but truth be told, I’d be much happier if we had sensible laws and I never had to write another marijuana column.

HF 732 would bring Iowa one step closer to that reality.

• Comments: (319) 339-3156; adam.sullivan@thegazette.com

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