State medical cannabidiol leaders met in Dubuque this week to discuss opportunities and limitations stemming from Gov. Kim Reynolds’ decision to veto a bipartisan expansion to the program.

At the invitation of Iowa lawmakers from Dubuque, Owen Parker, the state Department of Public Health program manager for the Office of Medical Cannabidiol, and MedPharm General Manager Lucas Nelson explained the status quo of Iowa’s medical cannabis system.

MedPharm was the first company approved to manufacture, develop, package and distribute medicine under the medical CBD program in Iowa.

Meanwhile, their audience of 30-odd area residents at the Dubuque County Fire Training Center, told stories of the obstacles they have faced in pursuit of relief through the program.

Iowa’s medical CBD program made big news recently when Reynolds vetoed an expansion bill that had passed both houses of the Legislature by a huge majority and with wide bipartisan support.

Parker said the veto stopped all kinds of improvements to the program, especially those that would have expanded access for people. Currently, for instance, only medical doctors can certify that a patient has one of the conditions that qualify for treatment.

“One of my critiques of the veto was (the bill) was going to allow (advanced registered nurse practitioners) to certify,” he said. “We have rural communities who are essentially boxed out.”

Currently, any Iowan can qualify for a medical CBD card if he or she is certified as having one of a list of conditions. More than 60% of patients participating in the program suffer from “untreatable pain.”

However, Parker said, the original bill doesn’t define the term, so physicians can decide for themselves what that means.

“It’s nebulous,” he said. “It’s an oxymoron. How can you treat untreateable pain? The bill would have simplified that definition to be severe or chronic pain.”

David Barnett, a veteran, traveled from just outside Waterloo to attend the meeting. He follows any news he can of Iowa’s program because he said he is disabled and thinks CBD could help.

But, because his care is through the Department of Veterans Affairs, he said buying the medicine out-of-pocket is in no way affordable.

The cost of this treatment and program is a big hurdle for many, a challenge Parker and Nelson said could have been lowered by the 2019 bill.

Currently, for instance, individual doses are limited to having 3% or less THC in them. But that doesn’t mean anything, according to Parker.

“It is an arbitrary amount,” he said. “If you expand the amount of inert material in any of those products, you can put as much THC in it as you want. It is one of the situations we always speak to, one of the horror stories we’re getting. If you want to put 120 milligrams in a capsule, as long as that capsule is 660 milligrams, that is 3% by weight.”

The 3% limitation is a problem for production as well, according to Nelson — one that also increases cost.

“You’re having to take a larger capsule so we can fit 10 milligrams of THC, one with more filler because that 97% has to be something other than THC,” he said. “We could make those capsules smaller, just THC, so people don’t have to take as many, don’t have to spend as much money.”

Parker and Nelson both stressed that THC is not the most important chemical in the CBD medicines — most have CBD levels that range from 20 times to equal with the THC. Only THC is limited by percentage, however.

Given the veto, Iowa’s medical CBD program will remain as it has for years for now, with all of its current limitations, unless a special session of the Legislature is called yet this year.

Democratic lawmakers unanimously signed a petition for one. However, they have yet to be joined by the Republicans it would take for the body to come together, even though most voted for the expansion in session.

Other questions and problems from the crowd abounded.

Jennifer McFadden’s son Lee has to reside in a group home, where, according to Iowa statute, medical CBD cannot be kept. So for months she would have to take him out of the home, administer the medicine and take him back, two times per day.

She eventually turned to an alternative medication and gave up Lee’s CBD card because it was too much.

Over and over, from the crowd, came the question: “What is it going to take?” — to expand the program, to increase access, to make treatment affordable.

Iowa Reps. Chuck Isenhart and Lindsay James, and Iowa Sen. Pam Jochum, all Dubuque Democrats, each said that direct contact with elected officials in both parties, including Reynolds, could help turn the tide.

“We would not be where we are, as limited as it is, if it weren’t for a group of moms and grandmas who showed up to a committee meeting where we saw their babies literally seizing in front of us,” Jochum said.

Reynolds’ spokesman says the governor is looking to next year.

“The governor supports the medical marijuana program that’s in place now, and she looks forward to working with lawmakers and the Medical Cannabidiol Board next year to safely build on Iowa’s current program.”

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