The Iowa Board of Pharmacy voted unanimously in 2010 to recommend medical marijuana legalization for the state of Iowa. That same year, a Des Moines Register Iowa Poll indicated that 64 percent of Iowans support medical marijuana legalization with 33 percent in opposition.
In the three year since, support for medical cannabis has slipped by six percentage points according to a February 2013 Iowa Poll, and the Iowa legislature has yet to move forward on a bill. Governor Terry Branstad’s Office of Drug Control Policy has been levying its own rhetoric, meanwhile, defending marijuana’s classification as a Schedule I substance (i.e., a substance with no medical value and a high potential for abuse).
Enter Doctor Steven Jenison, co-creator of New Mexico’s medical cannabis program and, subsequently, the program’s first Medical Director and Medical Advisory Board Chair. It was Jenison’s New Mexico medical marijuana program that the Iowa Board of Pharmacy modeled when making its unanimous 2010 recommendation. Needless to say, Jenison has a bone to pick with Iowa’s inaction on the medical marijuana front.
“Whether people are positively inclined or negatively inclined toward medical cannabis, I believe that there is a certain inevitability to it,” Jenison said. “If Iowa is ultimately going to have a medical cannabis program, which I believe it will someday, then it is entirely appropriate and helpful that there be open and civil discussions about it. There shouldn’t be any character assassination or impugning peoples’ motives behind having discussions about having a medical cannabis program.”
Having received his B.S. degree from Iowa State University and his medical degree at the University of Iowa, Jenison is back in Iowa City until early December to study emergency medical care at the UI College of Medicine. While visiting, Jenison has partnered with State Senator Joe Bolkcom of Iowa City to advocate the implementation of a medical marijuana program on Iowa’s behalf. Jenison is giving a talk, titled “A Conversation about Medical Marijuana in Iowa,” on November 19 at the Iowa City Public Library (Meeting Room A) at 7 p.m.
“It’s worthwhile having discussions early about it so that, if it comes, which it may well, then you have had a good discussion that makes it so that that program accomplishes what you’re setting out to do, which is to benefit people truly in need without having any undue impact upon other things like the fabric of society or diversion to the illicit market.”
Jenison says that rhetoric warning of the alleged social ills of medical marijuana is well worth addressing, but such issues have not manifested in New Mexico.
“There are certainly a tendency in issues like this to resort to demagoguery and to say, ‘oh it’s all about protecting the youth.’ Well, if that is a real problem then it’s certainly one that needs to be addressed. We’ve had our program implemented since 2007 and to the best of my knowledge, that just hasn’t been raised as a real issue in regard to the implementation of our program.”
Getting others to see things his way has been difficult, Jenison says, not only because of a lack of research, but because of active attempts by the federal government — and other non-federal entities — to stifle medical marijuana research. It creates a catch-22 of sorts where those who are skeptical want more data, while the data itself is difficult to come by due to obstruction by those same skeptics. While there are many factors at play according to Jenison, he says, “I think it’s mostly a status quo thing.”
“Donald Abrams, who’s one of the only people who has managed to do any successful research — he was able to do it because the state of California decided that there was obstruction to research funding at the federal level so they established their own research foundation for medical cannabis using state money,” Jenison said.
Governor support is paramount when it comes to both medical marijuana research and medical marijuana implementation, Jenison notes, and despite Governor Branstad’s lack of support for such such a policy, he feels that Iowa shouldn’t necessarily discount Branstad’s ability to be swayed. He saw a similar change of heart occur in New Mexico under former Governor Bill Richardson, in fact.
“I think it’s entirely possible for people to move [Branstad] in the direction of being more supportive of [medical cannabis],” Jenison said. “At the talk at Iowa State [on November 10], there were three patients who gave very compelling testimony that is consistent with my understanding of what a medical cannabis program is all about.”
So, what is a medical marijuana program “all about?”
“People suffering terribly who have found relief from the use of medical cannabis or are seeking relief through the use of medical cannabis where really nothing else has been of benefit,” he said. “Really, all that a medical cannabis law does is protect those individuals from criminal liability.”
Jenison says that the benefit to risk ratio for medical cannabis is “a lot better than a lot of prescription pharmaceutical agents we use.” He added, “At the very least, we ought to respect the experience of those individuals [who benefit] to the point that we protect them from criminal liability — to protect them from being arrested and prosecuted as felons. I just don’t think that’s right.”
Jenison makes it clear that he doesn’t view medical marijuana as the “best thing since sliced bread.” He says that we should respect the experience of the people who benefit from medical marijuana to the point that, given the risk to benefit ratio of cannabis compared to other powerful pharmaceutical agents, those who find relief from medical cannabis ought to be protected, not prosecuted.
“You know? That’s really all these programs say. And if that’s considered to be controversial, so be it, but I think in states that have medical cannabis programs, and I think the ones where they’re administered well, it just isn’t a big deal anymore.”
He acknowledges that marijuana comes with certain illicit associations, but points out that there are social ills associated with many things from which people benefit in a medical context.
“We make a space available for people to use opiates. We make a space available for people to use benzodiazepines, because people benefit from them medically. I understand there are differences of opinion on this, but I believe we should make a space available for people to use medical cannabis who benefit from it, and that’s all that a program does … if we cant even have a civil discussion about setting up a safe zone for them not to be arrested and prosecuted then I despair at the possibility of us having any reasonable discussions about some of the larger issues.”
Jenison stresses that his advocacy is the result of some “fire burning in [his] belly,” but rather, the result of medical pragmatism. He notes that while he has no strong opinion on recreational use, “It does complicate the message a bit.”
As far as whether or not Jenison agrees with the 2010 Iowa Pharmaceutical Board in its assertion that New Mexico’s model is a good fit for Iowa, the doctor is ambivalent.
“I think that there are elements of our program that are worthy of emulating,” he said.
New Mexico uses a patient registry system in which an individual must first have a qualified condition, after which, that individual must visit a clinician to verify the condition and provide medical documentation. This application then gets submitted to the New Mexico Department of Public Health, which reviews the clinician’s assessment and ensures that the application is such that it fits with the letter and intent of the law. Unlike other medical marijuana states, New Mexico has not seen any federal intervention in its medical cannabis program. He attributes part of that to the legislative process New Mexico employed in implementing its program.
“Even though passing a medical cannabis law through the legislative process rather than through a citizens’ initiative can be a protracted and painful process, it certainly has its benefits in that you’re able, within the legislature, to discuss all of the alternatives about what a program would look like and to pass a law that gives a lot of structure to the program,” Jenison said. “We went through that process in New Mexico and I think as a result we have a pretty highly regulated program. For example, we don’t have storefronts, dispensaries that have neon images of a marijuana leaf in the window.”
Iowa State Senator Joe Bolkcom is hopeful about Iowa’s own implementation, but expects that such a move would be a multi-year effort. “I’m very, very disappointed that Iowans with serious health problems will be denied help for at least several more years,” Bolkcom said in a statement issued on November 8. “I’m still hoping Iowa won’t be the last state to act responsibly and with compassion when it comes to medical marijuana.”
