Medical marijuana expansion seems unlikely in Iowa this year

Tony Leys and Brianne Pfannenstiel, The Des Moines Register Published 5:33 p.m. CT April 3, 2018

Iowa’s sole legal producer of medical marijuana says legislators must loosen the law’s rules if they want the state to have a sustainable program, but that’s unlikely to happen this year.

The leader of Iowa’s House of Representatives wants to wait until next year’s legislative session to consider changes to the state’s medical-marijuana law. Gov. Kim Reynolds doesn’t want to rush into an expansion of the program either.

MedPharm Iowa leaders say that doesn’t make sense. The company is spending more than $10 million to set upthe state’s first medical-marijuana production facility in a Des Moines warehouse. The company also landed two of five licenses Iowa awarded last week for dispensaries to sell the products, starting in December. It plans to spend hundreds of thousands of dollars starting those stores.

Too few people will be able to get medical marijuana under the restrictive rules of the year-old medical marijuana law, advocates contend. Just 337 Iowan patients or caregivers have obtained state-issued cards allowing them to buy the medications, which are to include oils, capsules and creams and are often referred to as cannabis products.

MedPharm wants the state to lift a 3 percent limit on the amount of THC the products may have. THC is the chemical that makes recreational marijuana users high, but medical-marijuana proponents say it’s also crucial for treating symptoms such as pain and muscle spasms. MedPharm also wants legislators to expand the list of ailments for which Iowans may purchase cannabis products. The current list has nine conditions, including seizures, cancer, Parkinson’s disease, Lou Gehrig’s disease and untreatable pain.

Company owner Christopher Nelson was asked Tuesday whether his fledgling company could stay in business without an expansion of the rules.

“We are going to give it the very best try that we can,” he replied. “…I think the jury is out whether we can survive under the current law or not. We’ve made a commitment that we’re in it for multi-years. We’re not going to give up, certainly, after 2020. But I can say this: Long term, if the state’s laws are so restrictive that patients don’t get any relief, patients won’t get cards, patients won’t buy material — and so there will be no reason to have MedPharm Iowa.”

Nelson, who also is the longtime president of Kemin Industries, made the comments in a meeting with Des Moines Register editors and writers.

Iowa House Speaker Linda Upmeyer told reporters recently she doesn’t want to change the law before receiving recommendations from an advisory panel set up under the law passed last spring. The Medical Cannabidiol Board, composed mainly of physicians, has not made recommendations on changing the THC limit or adding to the list of ailments for which Iowans may purchase medical-marijuana products. The board is not scheduled to meet again until after the Legislature adjourns for the year.

Upmeyer, R-Clear Lake, said the formation of the expert committee was a selling point last spring to legislators who were considering the medical marijuana bill. “To disregard that and throw it all overboard, I think they would feel like that was a disingenuous move,” she said. “… It just makes sense to me that we’d wait for those recommendations from them because my understanding is the grower won’t have product until the end of the year anyway. We’ll be coming back in January. Hopefully, we’ll have additional recommendations.”

Upmeyer said she wasn’t surprised to hear predictions that Iowa’s fledgling medical marijuana industry could struggle at first because that’s what happened in Minnesota after it started a similar program in 2015. Minnesota has since expanded its program, including allowing uses for intractable pain and for post-traumatic stress disorder.

Brenna Smith, spokeswoman for the governor, said Tuesday that Reynolds is aware the physicians’ committee has not made a recommendation on the THC question. “The governor believes further study would be needed before expanding the program,” Smith wrote in an email to the Register.

The committee has met five times since September. Its next meeting is scheduled for May 4, after the Legislature is expected to go home for the year. An administrator said Tuesday that the board does not expect to make recommendations on THC or qualifying ailments at that meeting.

The committee has made a few other recommendations, including that nurse practitioners and physician assistants be allowed to sign cannabis-program forms confirming a patient has a qualifying condition. That role is reserved for physicians in the current law.

Sen. Joe Bolkcom, one of the Legislature’s leading proponents of medical marijuana, said there is support in the Senate for an expansion of the program, but House leaders are balking.

Bolkcom, D-Iowa City, noted the Senate passed a broader bill last spring on a 45-5 vote, but wound up compromising with the House on the last day of the 2017 session. The resulting law is far too restrictive to work, he said. “The program is headed for failure without some pretty significant changes,” he said.

Iowa’s new law allows for two marijuana producers, but MedPharm was the only one that applied. “That should have been a red flag,” showing how impractical the program’s rules are, Bolkcom said. The senator said he can’t see how MedPharm can break even financially under those regulations. “I think they’re looking at red ink for the foreseeable future.”

Sen. Brad Zaun, R-Urbandale, who also supports expanding Iowa’s medical marijuana program, estimated Tuesday that there’s a less than 50 percent chance of getting such a bill passed before the Legislature heads home for the year in a few weeks.

Zaun said he’d like to give the expert committee authority to raise the THC cap and to add to the list of qualifying ailments, without having to have legislators vote on the specific recommendations. He also favors a proposal to let doctors approve medical marijuana use for any medical condition for which they think it would help.

Nelson, Medpharm’s owner, said such a change would be similar to the way physicians now can prescribe medicine “off-label,” for conditions besides the ones they’re approved for by the Food and Drug Administration.

Nelson added that his company would like legislators to clarify allowable uses of cannabis products for the treatment of pain. The law now says the products can only be used for “untreatable pain,” which makes it sound like the condition could not be eased at all, Nelson said. Instead, he said the law should allow use of the products for “severe, chronic pain,” he said.

Research has clearly shown the benefits of cannabis for pain patients, Nelson said. For example, he said, many such patients can gain relief from pain with significantly smaller doses of opioid painkillers than they otherwise would need. That lessens the risk of addiction and overdose from those painkillers, which have been causing a deadly epidemic nationwide. “We know there is tragedy happening literally every day with opioids,” he said.

MedPharm background

MedPharm Iowa is owned by Christopher Nelson, the longtime president of Kemin Industries. Kemin, which is based in Des Moines and does business around the world, specializes in growing plants and extracting beneficial ingredients from them. Its best-known product is a marigold extract called lutein, which is used to prevent blindness.

Nelson also is one of three owners of MedPharm Colorado, which produces marijuana products for that state’s legal medical and recreational markets. Nelson said MedPharm Colorado was formed about three years ago and has been perfecting methods of growing specific breeds of marijuana plants and manufacturing products with exacting levels of healthful ingredients.

Nelson said the Iowa venture is bringing much of the Colorado expertise to MedPharm’s new facility in Des Moines. That facility, which is on the grounds of Kemin Industries, is designed to serve Iowa’s market, but it could easily be expanded to make products for other states if federal laws are eased to allow interstate shipments, Nelson said.

https://www.desmoinesregister.com/story/news/health/2018/04/03/medical-marijuana-expansion-seems-unlikely-iowa-year/482554002/

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