There’s something skunky about medical marijuana in Iowa

Branstad speaks in Washington D.C.
Iowa Gov. Terry Branstad speaks at the U. S. Capitol on Mar. 25, 2014. — photo via the USDA

When Gov. Terry Branstad signed a bill on May 30 allowing some Iowans to posses cannabidiol oil, an orally-taken cannabis extract that lacks the intoxication effects normally associated marijuana, Iowa joined a list of 33 other states in allowing some form of medical marijuana regulation.

Critics have since argued that Iowa’s law is too narrow in scope — that the need to travel outside of Iowa to actually obtain the cannabidiol oil is unnecessary, and perhaps even cruel.

Tina McDermott, whose son suffers from a rare form of epilepsy called Dravet Syndrome, explained in a July 2 interview with WQAD:

“It means I’d have to drive to Colorado, or fly to Colorado, and then I obviously can’t fly back with it, so I’d have to drive back with it. Then [I’d have to] cross over Nebraska state lines illegally and come home with it.”

Meanwhile, some Iowans have decided to uproot their families and leave the state altogether. The subjects of these stories are not marijuana tourists looking for an easy high. They’re desperate families with sick children. Tired mothers. Exhausted parents who feel they have no other options.

And it’s working. Earlier this month, The Grittman family told KCCI that after moving to Colorado from Tama, Iowa to seek medical marijuana care for their son, who suffers from chronic seizures, the three-year-old had gone the entire month of June without incident.

Until recently, most medical marijuana assessments boiled down to a “yes or no” analysis. Either a state had some form of medical marijuana, or it did not. But as evidenced by Iowa, and the patchwork of medical marijuana laws and regulations embraced by various other states, this sort of analysis is no longer adequate. Complicating matters is the fact that some medical marijuana laws are not working as originally intended.

In short: We need a better way to evaluate state medical marijuana laws.

The Americans for Safe Access foundation, a 501(c) non-profit advocacy organization based in Washington D.C., believes it has the solution.

In its July 7 report entitled “Medical marijuana access in the U.S.: A patient-focused analysis of the patchwork of state laws,” the non-profit uses an extensive, 47-item rubric to evaluate medical marijuana regulations in each state, focusing on four broad categories: Patient rights and civil protection from discrimination, access to medicine, ease of navigation and functionality.

It may not come as a shock that Iowa is one of 11 medical marijuana states to receive an “F” grade. In this regard, the state finds itself joining the likes of Mississippi, Alabama, Florida, Kentucky, South Carolina and Tennessee.

The report’s rubric scored Iowa at 51 points out of a potential 400. Illinois, which skirted by with a “D” grade, scored a 259.

So, why the low marks? Beyond the narrow scope of Iowa’s medical marijuana law, the lack of civil discrimination protection for medical marijuana patients is one of the biggest areas for improvement, according to the report, as well as the limitations Iowa’s medical marijuana law places upon physicians. As it stands, only those who suffer from severe epilepsy may qualify, and certification must come from a neurologist.

Put another way, if a licensed neurologist believes cannabidiol oil may alleviate a patient’s chronic illness, but that patient does not suffer from intractable epilepsy as stipulated by the Iowa Medical Cannabidiol Act, said neurologist is powerless to help. Rather than certifying patients based on their own medical expertise, physicians are required to work within the confines of arbitrarily narrow medical marijuana program.

The report concludes its Iowa section with a number of suggestions:

Areas for improvement: Future legislation and regulations must: create civil discrimination protection for patients, establish access to THC and whole plant cannabis from dispensaries, allow patients to cultivate their own medicine, recognize physicians’ right to recommend medical cannabis to any patient who can receive medical benefit from it, and institute consumer safety and provider requirements

Why is Iowa, a state so often recognized for its early adoption of civil rights protections, behaving so stubbornly on this issue? Why must an otherwise forward-thinking state be dragged, kicking and screaming, into an era where the benefits of medical marijuana might be more thoroughly explored? The rationale offered up by Iowa politicians is often reductive, and at odds with the 81 percent of Iowans who, according to a March 2014 poll conducted by Quinnipiac University, say they support allowing adults in Iowa to “legally use marijuana for medical purposes if their doctor prescribes it.”

When pressed by IPTV to clarify why Branstad’s Office of Drug Control Policy is so unwilling to budge on the issue, director Steve Lukan offered a more detailed explanation:

Well, that has not been our position actually. We have supported research. Many people don’t know that the FDA actually has clinical trials underway currently on several medications which would have cannabis based, marijuana based medicines.

What we have really tried to look at is making sure that we are keeping a very safe, secure health care system. Many of these drugs that are out there, there’s been no long-term studies, we don’t know the long-term side effects. American Medical Association, American Psychiatric Association have expressed some reservations, there is concern about, there is research that says people who use some of these drugs may actually develop things like schizophrenia. We don’t know how these drugs interact with other medications. Many people are taking a lot of other medications.

So there’s a lot of legitimate policy questions that I think really need answers and that is one of the things we try to do is try to do some research and try to see what we can do to help answer questions.

Throughout the interview, Lukan makes repeated references to the “unknowns” of medical marijuana, and to his credit, he’s not wrong. There’s a dearth of research on the topic, a problem exacerbated by a decades-long taboo among the research community. In fact, the National Institute on Drug Abuse declared in 2010, “We generally do not fund research focused on the potential beneficial medical effects of marijuana.”

And yet the fact remains that medical marijuana is helping some Iowa families, as well as thousands of others across the country. Clinical studies and comprehensive reviews are becoming harder to ignore, and Lukan’s argument that there are just too many “unknowns” to warrant a more aggressive stance on medical marijuana is starting to ring hollow. However, a March 2014 presentation created by the Office of Drug Control Policy indicates the department has already made up its mind on the issue.

Titled, “Marijuana Legalization? The Rest of the Story,” the 56-page presentation — which encompasses legalization for medical and recreational purposes — makes no reference to the efficacy of medical cannabis, nor does it reference a single clinical trial. The cited studies, meanwhile, focus almost entirely on harm.

One bullet point reads, “The Institute of Medicine has declared smoking marijuana is unsafe, and ‘marijuana is not modern medicine.'” Another reads, “The FDA has not approved the use of marijuana as medicine, saying ‘there is currently sound evidence that smoked marijuana is harmful.'”

Despite numerous references to prestigious organizations, public figures and publications, the presentation is selective and clearly meant to push a specific point of view. Most of all, it contradicts Lukan’s assertion that the Office of Drug Control Policy is keen on playing a cautious game of ‘wait and see.’

Iowa State Sen. Joe Bolkcom of Iowa City thinks we could — and should — be doing more. While participating in an IPTV round-table interview with Lukan and West Des Moines Mayor Steven Gaer, Bolkcom criticized Lukan and Branstad’s approach to medical marijuana, and suggested the governor “do his homework.” He continued:

…I think there is a path forward here in Iowa where we could develop safe, legal access in a restricted way and carve out this legal space where people are not going to lose their homes or face prison time or have a big legal bill because they get arrested for basically trying to improve their quality of life by treating their conditions with a doctor’s order with cannabis. I think there is a path forward and I hope that the governor gets a little bit more engaged and gets a little bit more up to date on this issue.

Mayor Gaer, whose daughter experiences violent seizures, echoed Bolkcom’s thoughts:

I have heard from families all over Iowa who have challenges medically who have said, my doctor said if I could get access to medical cannabis it would help me. And my position is, is that we shouldn’t have to move from Iowa to another state to get the help that we need. I’m a fourth generation West Des Moines resident. My son lives here so he is our fifth generation. Our health care shouldn’t be dictated by what zip code we live in.

Gaer later added, “Our point is, let us have access to this medicine if our doctor thinks it is going to help my daughter while they go ahead and do studies. She has been on two of those medications already. Don’t deny us something that we know and people have testified have had dramatic improvement in people’s health care.”

More lenient medical marijuana regulations may soon be on the way whether politicians like it or not, however. The Americans for Safe Access Foundation sees the differing state policies as part of an “ongoing experiment that will one day lead Federal policy into alignment with the overwhelming public support for legal access.”

In the mean time, Iowans deserve better.

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