Iowa’s medical community is reluctant to embrace state’s medical marijuana program

Cannibidiol (or CBD, here in oil form) has been shown to benefit patients with epilepsy, PTSD, ALS, MS, cancer and other conditions. — photo by Zak Neumann

A poll conducted in January found that 78 percent of Iowans approve of medical marijuana. But even that level of popular support is meaningless if doctors don’t participate in the state’s very limited medical cannabis program.

“Unfortunately, too many physicians, nurses — and really the medical community at large — too many of them have been unwilling to meet with us or really anyone tied with this industry. Unwilling to talk about it and learn more about it,” MedPharm Iowa spokesman Lucas Nelson told Radio Iowa.

Des Moines-based MedPharm Iowa is one of two companies licensed by the state to manufacture cannabidiol, the only cannabis-derived product available under Iowa’s medical marijuana program. The program also sharply limits who is eligible to receive a registration card from the Iowa Department of Public Health that will allow a patient to purchase cannabidiol. A doctor must certify a patient has one of the following “debilitating medical conditions”:

• Cancer (with severe or chronic pain, nausea or severe vomiting, cachexia or severe wasting);

• Multiple sclerosis with severe and persistent muscle spasms;

• Seizures;

• AIDS or HIV (as defined in Iowa Code, section 141A.1);

• Crohn’s disease;

• Amyotrophic lateral sclerosis (ALS);

• Any terminal illness, with a probable life expectancy of under one year (if the illness or its treatment produces one or more of the following: severe or chronic pain, nausea or severe vomiting; cachexia or severe wasting);

• Parkinson’s disease; and

• Untreatable pain

“One of the things we’ve noticed is that not enough people across the state are really aware of this program and have the education about it that we think needed to be out there,” Nelson said.

MedPharm has been hosting informational forums around the state about the cannabidiol program, including one in Iowa City last month.

“We’ve heard from a couple of medical community members that this is illegal for them to do and there is no protection,” Nelson said. “That isn’t true, it’s built right into the code.”

But misinformed doctors may not be the only obstacle standing between patients and cannabidiol.

In February, Laura Belin of Bleeding Heartland reported, “Doctors affiliated with Mercy Cedar Rapids and The Iowa Clinic are refusing to sign paperwork their patients need to register for the Iowa Department of Public Health’s medical cannabis program.”

Mercy Cedar Rapids appears to have instructed its 503 physicians not to sign the IDPH paperwork, according to two sources with qualifying conditions, who receive health care at different facilities in that network. Most if not all of the 250-plus health care providers at The Iowa Clinic, a doctor-owned group in the Des Moines area, are also refusing to sign medical cannabis card applications.

A spokesperson for Mercy Cedar Rapids told Belin, “Mercy has not prohibited its physicians from signing the cards. We have recommended that they wait until further guidance is provided by the state and our physician-led Quality Committee has completed its review and outlined a formal policy and process that will be needed to appropriately address the new law and support our patients.”

According to Belin, “My source [a Mercy patient] characterized that explanation as a ‘shell game.’ His primary care provider and her nurse assured him that no one in Mercy’s local network would ‘sign a qualifying conditions form, and that there was no one in Cedar Rapids who would.’” Belin did report that she’d found “some Mercy Health Network primary care providers have signed the IDPH form certifying a qualifying medical condition.”

The Iowa Clinic also provided Bleeding Heartland with a statement:

At this time, The Iowa Clinic does not have a formal policy on the Healthcare Practitioner Certification required on the patient application for a Medical Cannabidiol (CBD) Registration Card. We are awaiting further guidance and development of the program by the State of Iowa. Therefore, most of our physicians are not comfortable proceeding. Once additional information has been received, we will begin the process of studying both CBD and THC (tetrahydrocannabinol) for use in medical therapy.

The spokesperson added, “The Iowa Clinic physicians and providers are allowed to use their independent medical judgement in the management of their patients.”

Information about the state’s cannabidiol program can be found the IDPH’s Office of Medical Cannabidiol site. The patients who receive registration cards from the program will be able to buy cannabidiol at the state’s five licensed dispensaries beginning Dec. 1.

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