The discussion surrounding the proposed medical cannabidiol (CBD) legislation evolved into a passionate sharing of ideas from both sides of the issue. Speaking from experience in my role as a prevention specialist at the Area Substance Abuse Council (ASAC), I am supportive of Gov. Kim Reynolds’ veto of the bill.
Preventing and treating substance abuse disorders is the primary mission of our organization. When the 25 Grams of THC (tetrahydrocannabinol) limit in 90 days was proposed by lawmakers, the prevention and treatment community became concerned.
This amount of THC — enough for about 28 doses of THC every single day (277 mg.) in medical CBD products manufactured and sold in Iowa — was over 5 times higher than was recommended by the Medical Cannabidiol Advisory Board. The Board was vital to bringing the medical community into the discussion, as stated by House leadership during the live debate, “Because we are not doctors, for the most part, in this room …” This Board is made up of mostly physicians and specialists in their medical fields.
In November, during the board’s last meeting before the legislative session began, the board voted unanimously to recommend that the legislature keep the 3 percent THC cap in place.
The board members noted that an existing capsule form contains 20 mg THC, is compliant with the 3 percent THC cap, and is available for distribution in Iowa’s licensed medical CBD dispensaries. This 20 mg dose is well into the range considered psychoactive; i.e., creating a “high” for most people. It also covers the majority of indications documented in the medical literature for which THC has been found to be beneficial. Twenty milligrams of THC is twice the amount of THC in the largest dose of dronabinol (Marinol), a synthetic THC preparation. Marinol, approved for nausea-related symptoms in 1987, is available through every US pharmacy.
After the bill passed and leadership realized 25 grams of THC was not a recommendation provided by the medical experts, the board reconvened and provided the Senate with a modification of their recommendation of 4.5 grams, enough for five 10 mg doses of THC every day for 90 days. An analysis of studies released by the Minnesota Department of Public Health showed that 25 mg daily was what was most tolerated and effective by a majority of patients for the conditions in Iowa’s Medical CBD Act. The 4.5 gram limit recommended by the CBD board is twice that. The board also recommended a 20:1 CBD: THC ratio for pediatric patients (those 17 and under) and even a limit on the maximum daily dose of CBD. Unfortunately nothing was changed in the Senate on the bill that had passed the House with misinformation, even though the Senate was given a timely and clear recommendation by the board.
In substance abuse prevention, we have also studied what is happening with other states with high THC products. Unfortunately, sometimes public policy intended to help some can result in unintended consequences that hurt many more. It is important at times to move cautiously so that our public policy does more good than harm. We are encouraged by the increasing amount of research regarding THC and CBD. At the same time, more studies are also showing the dangers of high potency THC products that affect all of society, including drugged driving, higher rates of addiction and psychosis.
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We look forward to working with all interested parties to come up with safe and sensible next steps for all Iowans.
• Jennifer Husmann is an advanced certified prevention specialist for the Area Substance Abuse Council.