BY: Brianne Pfannenstiel
Rep. Dave Maxwell was firmly opposed to Iowa’s limited medical cannabis oil program, approved in 2014.
He worried about opening the door to recreational drug use and about whether enough scientific evidence supported the medicinal use of marijuana. But nearly three years later, Maxwell is among more than a dozen Republican state legislators who are slowly getting on board with expanding Iowa’s medical cannabis laws.
“I think it’s probably time to face up to the fact that there might be some good things coming from it,” he said.
Maxwell is among 14 Republicans who voted last month to expand Iowa’s cannabis oil program after previously voting against the 2014 bill that created it. By and large, those legislators said that in the three-year interim, they’ve been swayed by the stories of Iowans who have lobbied at the Capitol, seen the positive effects on patients and are ready to take the next, small step toward a more comprehensive program.
“It didn’t take nearly as much arm-twisting or conversations as it did three years ago,” said Senate President Jack Whitver, R-Ankeny. He was among those who voted against the 2014 bill but supported this year’s legislation.
In the closing hours of the 2017 legislative session, lawmakers approved a bill that, for the first time, would allow the state-sanctioned growing of marijuana within state lines — something that in recent years had been a sticking point for Republicans who worried doing so could open the door to higher rates of drug abuse.
“I think overall, people were a lot more open-minded to it,” Whitver said. “They saw and heard some of the results coming back from Iowans, and we’re just more comfortable with the program overall. So really there wasn’t a lot of infighting about it.”
What changes under the new legislation
The 2014 law, which is scheduled to sunset in July, decriminalized the possession of cannabis oil for epilepsy patients, but it gave them no legal means of obtaining the product. It still is a violation of federal law to transport marijuana products across state lines.
The legislation approved last month attempts to alleviate those concerns by allowing manufacturers to submit proposals to set up growing facilities and distribution centers in Iowa. It also expands the number of medical conditions that could be treated with cannabis oil to include most terminal illnesses, cancer, Parkinson’s disease and others.
Senate Republicans were willing to go even further. Whitver and all but four Senate Republicans voted 45-5 to advance a different bill that would have vastly expanded the conditions that could be treated with medical marijuana and allowed for medical cannabis and other products with any level of THC.
Whitver credited freshman Sen. Tom Greene, R-Burlington, for sharing his experience as a 43-year career pharmacist with Senate Republicans and helping them to take a “giant step forward” as a caucus.
“I just cannot imagine having that potential benefit out there and telling Iowans, ‘No, you can’t have access to this,'” Greene said.
The Senate bill, which drew praise from patient advocates and from Democrats, died in the House, where Republicans in that chamber said it went too far too fast.
“We knew it was going to be a harder climb on the House side,” said Threase Harms, a lobbyist representing the Epilepsy Foundation and the Upper Midwest Chapter of the National Multiple Sclerosis Society. “You have more members, and you have more personalities and a lot more people that have been involved in this issue over the years.”
House Republicans said they were not prepared to let the 2014 law expire with nothing to replace it. At the very least, they said, they would have removed the sunset. But they felt they could do more to help Iowans, and negotiations over how to do that lasted through the night April 21 and into the next morning, when the legislation was finally put to a vote and approved.
Branstad has indicated his willingness to sign the bill, and he has until May 22 to do so.
What convinced many House Republicans
Many House Republicans said they preferred to turn more of the decision-making over to medical professionals, and establishing a new advisory board helped persuade them to vote for the bill.
“One of my biggest issues was having medical professionals be involved in the process of picking conditions and (being) more involved in the whole process,” said Rep. Walt Rogers, R-Cedar Falls, who voted for this year’s legislation but not the 2014 bill. “And I like that, because as we move forward with this issue in Iowa, it’ll be governed by that board.”
The legislation lawmakers ultimately sent to the governor’s desk creates the framework of a new Medical Cannabidiol Advisory Board under the purview of the Department of Public Health, which could recommend raising the 3 percent cap on the THC limits if necessary. That board also could recommend adding or eliminating conditions approved for access to the product. The Legislature would have to act on those recommendations.
Detractors of the bill say patients with many of the conditions approved for treatment will not see much or any benefit from products made with only 3 percent THC. But Harms said she’s hopeful the board would recommend raising the THC limits for some conditions. Advocates are not pushing for recreational use, she said.
“People have to see and understand this as a medicine and not an illegal substance,” Harms said, noting that different medical conditions and different people require varying dosages and product types, just like they do with any other medication.
Erin Miller’s son was having seizures and all the motor skills he had gained disappeared. Now, after being on cannabis for a year and a half, he’s walking, running, giving high-fives and hugs, and being a little boy Zach Boyden-Holmes/The Register
Tom Swegle, a partner at MedPharm Holdings, which creates state-based medical cannabis production facilities, said his company hopes to submit a proposal to the state to open a production facility. It would likely take a $4.5 million investment, and the company would need a roughly 15,000-square-foot facility, he said.
“We’re doing a market analysis right now on the patient count in the state of Iowa, but it’s a matter of economics,” Swegle said. “So the more disease conditions that you have that would have the availability to use medical cannabis, the bigger the patient pool would be for industry. … I think it can work in Iowa.”
Rep. Jarad Klein, a Republican from Keota who helped lead both the 2014 and 2017 efforts in the House, said it was reassuring for some Republicans to discuss that process with industry professionals who have been operating in other states.
“I think they provided a level of security that they know how this is being done and that this is being done in laboratory settings,” he said. “This is being done in a scientific manner. This isn’t being done in somebody’s garage.”
Laws around the country
Nationally, more states than not already have the kind of comprehensive medical cannabis programs that Harms and other advocates are pushing for in Iowa.
According to the National Conference on State Legislatures, 29 states and the District of Columbia allow for comprehensive medical marijuana and cannabis programs. Those programs provide protection from criminal penalties for using marijuana for a medical purpose; allow access to marijuana through home cultivation or dispensaries; allow a variety of strains including those not categorized as low-THC; and allow the smoking or vaping of some marijuana products, plant materials or extracts.
Seventeen states, including Iowa, allow the use of low-THC products for medical reasons in limited situations or as a legal defense.
Meanwhile, public support is growing. A Des Moines Register/Mediacom Iowa Poll published in February found 80 percent of Iowa adults favored allowing medical marijuana. That total is dramatically higher than the 58 percent who favored the idea in a 2013 Iowa Poll.
“I think the thing, probably most important, is for policymakers to understand that we didn’t get everything that we need in order to have meaningful medical cannabis law in this state,” said Harms. “I think the advocacy community has indicated that they will have to continue to come back and ask for changes and improvements to the law.”
Greene, the pharmacist and lawmaker, said he also expects to continue pushing for expansions next year when the Legislature reconvenes in January.
“I’m hoping the federal government in a year’s time will move medical cannabis to a C-II as far as the (Drug Enforcement Administration’s) classification of it,” he said, saying the federal government’s failure to act has been a hold-up for many Republicans. “That would make it much easier to move the process (in Iowa).”