Guest Columnist

Gov. Reynolds should sign Iowa's medical cannabis expansion

MedPharm Iowa's Aliviar brand of medical cannabis capsule products at their Manufacturing Facility, Wednesday, Oct. 17, 2018, in Des Moines. (Matthew Putney/Freelance)
MedPharm Iowa's Aliviar brand of medical cannabis capsule products at their Manufacturing Facility, Wednesday, Oct. 17, 2018, in Des Moines. (Matthew Putney/Freelance)

As a surgeon and palliative care physician who has been caring for cancer patients for over 25 years, I urge Gov. Kim Reynolds to sign HF 732 in favor of expanding choice and access to medical cannabis in Iowa. I have taken the time to review the research literature on medical cannabis’ ability to reduce the toxic effects of cancer treatments and to assist in the management of chronic pain. As a consequence of that review, I am speaking out today to say HF 732 is a huge step forward in serving suffering Iowans.

Everyday Iowans consistently show high levels of support for medical cannabis. This view is mirrored to a great degree by their physicians. Citing the desire to reduce patient suffering, a 2013 national survey of more than 1,500 physicians found that 76 percent supported cannabis for medical purposes.

An important part of facing both cancer and its often-toxic therapies is to feel that one has control over the arduous journey. Access to medical cannabis, including modest levels of THC (tetrahydrocannabinol) that can provide relief, is part of that process in more than 33 states and the District of Columbia. As a physician, I believe in structuring programs around scientific data, but I also see that every patient is unique in the care they need for their condition. Thus, putting constraints that are too restrictive on patient’s dosages of the psychoactive THC component fails to actually provide compassionate care. It should be noted that potent prescription antidepressants, opioids and anti-anxiety agents are often provided to cancer patients to assist in managing the emotional and physical toll of having their tumors treated. Medical cannabis with a liberalized THC cap is no different from our use of those agents, and may in fact reduce cancer patients’ use of the opioids, whose problems are now well known to all Iowans.

This bill is unique in that it considers the needs and input of many varying parties, from physicians, to patients, to families, and to advocates. Beyond allowing a greater amount of THC to be offered, HF 732 opens up access for rural Iowans by adding categories of providers that can certify, appropriately clarifies the definition of qualifying pain, and provides for a THC cap that will decrease diversion. While the cap of 25 grams of THC over each 90-day supply would make Iowa the most restricted purchase cap in the country for programs like ours, it still constitutes a step in the right direction.

Opponents of HF 732 see the raising of the THC cap for medical cannabinoids as a “slippery slope” toward legalization of marijuana for recreational purposes. This is clearly not the purpose of this bill and is simply a straw man argument for those who have not moved on from the “Just Say No” message of the 1980s.

We do not yet have a perfect program, but not signing this bill would be a step backward for Iowans asking for new forms, more choice, and more access. Vetoing it would prolong suffering for those in need, including many others outside of the cancer realm. It would also make certification more difficult or even impossible for rural Iowans. As a physician who daily sees the devastation cancer can cause both patients and families, I urge Reynolds to sign HF 732 and give Iowans the opportunity to access a better medical cannabis program.

• Dr. Charles Goldman is an oncology surgeon from Iowa City.

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