Iowa lawmakers should expand access to medical cannabis, but federal guidance is crucial – Des Moines Register

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Nearly 80 percent of Iowans support expanding access to the state’s “medical marijuana” program, according to a new Des Moines Register/Mediacom Iowa Poll.

To be clear, the state’s fledgling medical cannabis program does not clear the way for anyone to smoke pot. Whole-plant medical cannabis is not the same thing as extracts of cannabinoids from cannabis plants. So we’re talking about oils, creams and capsules, not Iowans buying leaves, pipes and edibles from a state-approved dispensary. 

Currently, patients wanting to participate in the state program must get a physician to certify they have a qualifying medical condition, such as Crohn’s disease, AIDS, Lou Gehrig’s disease or untreatable pain. More than 1,300 Iowa patients have obtained state-issued cards allowing the purchase of products.

Senate File 256, sponsored by Sen. Brad Zaun, R-Urbandale, would expand the range of qualifying health problems to include “severe” and “chronic” pain, post-traumatic stress disorder and any condition for which a health professional determines cannabinoids could be “medically beneficial.” It also would let nurse practitioners and physician assistants certify patients for the program. 

Giving more health professionals more discretion makes sense. 

Yet Iowans need to understand cannabis may not be effective in treating the health conditions listed in state law and rules. 

There is “conclusive or substantial” evidence that some cannabinoids can be effective for treatment of chronic pain, chemotherapy-induced nausea and symptoms of multiple sclerosis, according to a 2017 report from the National Academies of Sciences, Engineering and Medicine. 

But there is limited evidence it helps those with many other conditions, including glaucoma, anxiety and PTSD. The Iowa Department of Public Health warns early research suggests taking high doses can make tremors worse in people with Parkinson’s disease. 

Meanwhile, the U.S. Food and Drug Administration has not approved marijuana as a safe and effective drug to treat any condition, and it has approved only a few cannabinoids and synthetic substances to treat some conditions. More research on safety and effectiveness is desperately needed. 

State lawmakers, public opinion polls and voter referendums have become the deciding factors for whether certain drugs are available to patients. Politicians who are not medical experts pass laws giving their “blessing” to use cannabis for specific health conditions. That is not how legitimate medical treatment is supposed to work in this country.

Cannabinoids should be treated like every other medication and follow a regulatory pathway, based on clinical evidence, through the process established within the U.S. Food and Drug Administration. The importance of this cannot be underestimated.

The agency requires scientific studies and issues guidelines for the use of drugs. It imposes manufacturing standards to ensure consistency across state lines. Doctors are trained to prescribe approved drugs, and pharmacists are trained to answer questions about them. Adverse events can be reported to gather information about safety over time.

All of that needs to exist for medical cannabis — especially when states including Iowa are legitimizing and expanding access to substances intended to help sick people.

 

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