Medical cannabis bill advances in Iowa senate

Photo by Jurassic Blueberries

A bill to expand access to medicinal cannabis in Iowa may be debated as soon as today. Senate File 506 has received bipartisan support and may pass in the senate. The ways and means committee, including Sen. Joe Bolkcom (D-Iowa City), voted 14 to 1 to move forward with the bill.

What would this bill do?

Schedule I drugs, which currently include cannabis, are considered to have high potential for abuse and no medical value. This bill would recognize cannabis as medicine by moving it to the schedule II category. Schedule II drugs (like opiates and cocaine) are also considered to have high abuse potential, but have accepted medical applications as well.

Cannabidiol (CBD) oil, which contains three percent THC, is one of 80 active cannabinoids in the cannabis plant, and has been legal for the treatment of epilepsy in Iowa since 2014. That law expires July 1. SF 506 would permit medicine to be made from the whole plant, and would allow cancer, HIV/AIDS, multiple sclerosis, Crohn’s disease and more to be treated with cannabis.

SF 506 would also establish a medical advisory board to recommend additional uses, and establish up to four manufacturers and 12 dispensaries in the state, changing current laws against manufacture and purchase. Smoking it would still be illegal.

The Medical Cannabis Bill ( SSB 1190 ) has made its way out of subcommittee AND full committee, now we need your help. #ialegis
Hear from myself, Senator Bill Dotzler & Senator Matt McCoy on what you can do.

Posted by Senator Joe Bolkcom on Wednesday, April 12, 2017

Benefits of SF 506 may outweigh risks

Bolkcom said there are significant barriers to abuse of the law by recreational users.

“It’s treated like other drugs, like what we get at the pharmacy. It requires that a doctor certify that you have a condition, and then it’s up to the patient to decide if they’re going to go to the dispensary,” he said. “Then you can apply to the state to get a medical cannabis card. The state will oversee the issuance of the cards to try to prevent doctor shopping.”

Bolkcom said legislators opposed to the bill are afraid higher levels of THC will cause people to get high when they take their medication.

“If the effect of THC is a euphoric feeling I’m not sure what’s wrong with a patient, who has a condition none of us would want, to have a euphoric feeling when they take their medicine,” Bolkcom said. “A number of the conditions in the bill actually require THC in more than 10 percent be available to people in their medicine in order to get a therapeutic effect.”

Bolkcom also noted that cannabis has far fewer side effects than other schedule II drugs for conditions which SF 506 would allow to be treated with cannabis, and that medical cannabis states have seen a 25% reduction in opiate overdoses.

SF 506 would also allow PTSD to be treated with medicinal cannabis, potentially bringing those who are currently self-medicating out of the shadows to access professional help. Shelly Servadio, RN, chair of the Iowa Democratic Party’s Veterans’ Caucus and Iowa’s only cannabis nurse, said many veterans don’t seek treatment for PTSD at the VA because they’re afraid they’ll test positive for THC and lose their benefits.

How is the CBD oil law working out?

A CNN Special with Dr. Sanjay Gupta helped open Iowa minds about CBD oil for epilepsy treatment, Bolkcom said.

However, he considers Iowa’s CBD oil law a failure because significant barriers to access have led to low levels of use. Only 39 patients have gotten medical cannabis cards in Iowa. Those who do have cards must leave the state to legally purchase medication.

“The [Iowa] law basically said we won’t prosecute you if you break the law in other states, you break federal law to bring this medicine to Iowa,” Bolkcom said.

Nearly every state that allows medical cannabis requires residency, in-state certification and an in-state doctor’s permission. The nearest state that doesn’t is Colorado. These roadblocks lead many patients to seek cannabis on the black market, Servadio said.

“[Legislators] are perpetuating illegal activity in our state instead of creating a safe harbor of legal activity,” she said.

This can be risky for patients with compromised immune systems, Servadio said — four of her patients, fighting brain tumors, traveled to Colorado recently seeking safe medication.

“We want purity standards, we want to make sure that there’s no contamination, no pesticides or mold,” Servadio said. “If you are growing it in Iowa under controlled standards where it’s regulated, they can get a safe product.”

Servadio said CBD used to be classified as a supplement by the FDA until GW Pharmaceuticals began research on an epilepsy medicine called epidiolex, which is CBD oil.

“Once [GW] paid the fee to do the research on their medicine, FDA just moves the compound to ‘under research,’” changing CBD’s classification from supplement to schedule I drug and therefore illegal under federal law, she said.

Servadio said since this decision, children who are prescribed CBD oil for epilepsy must leave school grounds to take their medication.

What happens next?

Bolkcom and Servadio both said they hope the senate will pass SF 506 early this week, that it may have the votes to pass in the house, but it’s doubtful speaker of the house Linda Upmeyer will introduce it in the first place.

Servadio and Bolkcom both said they hope the bill doesn’t get watered down if it does make it to the house floor, though Servadio would like to see a few changes, including the non-refundable $15,000 licensing fee for producers.

“That would make it really hard for small businesses and would invite outside interests from outside Iowa to come in and take things over,” she said.

Additionally, Servadio said, “we need to have a mechanism in place where we expand into the highly rural communities. We need to have ways to expand access to people who are not mobile, who are bed-bound, who are very poor … some kind of person or agency or element so patients’ rights are always respected … so the intent of the bill cannot be superseded every time we have a new election.”

What can ordinary Iowans do?

Bolkcom and Servadio encourage those concerned about the bill to contact legislators, especially Upmeyer, and bring their personal stories to the capitol as soon as possible. Both said changes in policy have been driven by patient advocacy, which has greatly impacted them both.

“When these families with the children got involved, the dynamic completely flipped and you were a jerk if you were against helping the kids,” Bolkcom said.

Bolkcom said over the last couple years more citizens have come forward and speak about their experiences despite the fact that they may have broken the law.

“It’s really kind of a cross section of people that have come forward. It’s basically just average Iowans who are suffering today and frankly begged the legislature to provide this legal protection,” Bolkcom said.

Bolkcom related a story of a woman with breast cancer who got medication in Colorado and finally felt well enough to eat dinner with her family.

“It’s time to end the suffering for people,” Bolkcom said. “No more excuses.”

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