First in a two-part series on medical cannabidiol dispensaries opening in Iowa.
WATERLOO — Iowa’s new law allowing limited medicinal uses of cannabidiol was signed in 2017, and five dispensaries will open to legally registered patients Saturday. One of those dispensaries is in Waterloo — the Iowa Cannabis Co., 1955 La Porte Road.
Before that happens, here are four things to know about medical marijuana in Iowa:
How it started
In 2017, the Legislature passed and then-Gov. Terry Branstad signed the Medical Cannabidiol Act, which allows up to two in-state operations to grow marijuana and process 3 percent THC cannabidiol to be distributed by five state-approved dispensaries.
Iowa-based doctors — for now, only doctors — can certify a patient has one of several approved conditions treatable with cannabidiol. A board oversees and periodically updates the law in conjunction with the Iowa Board of Medicine.
The law, an update to the 2014 law decriminalizing cannabis oil for epilepsy patients, was modeled after Minnesota’s regulations, which have been in place for a few years, said Sarah Reisetter, deputy director of the Iowa Department of Public Health.
State law requires everything to be up and running by Dec. 1.
What is legal?
The law defines “medical cannabidiol” as any approved strain of cannabis, but it can’t have more than 3 percent of tetrahydrocannabinol, or THC — the psychoactive compound in marijuana that gets a recreational user high. (In states where marijuana is legal for adult use, like Colorado, THC levels can reach 15-20 percent or more.)
“Minnesota doesn’t have any limit on THC,” said Reisetter. “Our law caps the THC content at no more than 3 percent.”
The Iowa law allows pharmaceutical-grade “marijuana extracts,” which can include nebulizers or inhaled products, but MedPharm — the company making all legal products for sale in Iowa — is selling only capsules, tinctures and creams.
“I think the biggest thing that people should realize, and one of the things that’s kind of confusing, is that the products available in these dispensaries are not what most people think about when they think about marijuana — there won’t be smoking products, there won’t be joints, there won’t be edibles,” Reisetter said.
Who is it for?
The law is intended for patients with what the Legislature defined as a “debilitating medical condition:”
- Cancer patients with “severe or chronic pain,” nausea, severe vomiting or severe wasting.
- Multiple sclerosis patients with “severe and persistent muscle spasms”
- Seizures, including epilepsy.
- HIV or AIDS.
- Crohn’s disease.
- Amyotrophic lateral sclerosis, or ALS.
- Terminally ill patients with a life expectancy of less than one year who have “severe or chronic pain,” nausea, severe vomiting or severe wasting.
- Parkinson’s disease.
- “Untreatable pain.”
Petitions to add conditions are taken on the Office of Medical Cannabidiol’s website at http://idph.iowa.gov/cbd/Petition-to-Add-Qualifying-Conditions.
Reisetter said the Board of Medicine is taking a look at adding severe, intractable pediatric autism with self-injurious or aggressive behavior.
“There’s concern that THC can have negative effects on a developing brain,” she said. “But children with autism this severe — adverse effects don’t really apply here. They felt like it was a compassionate use.”
“Compassionate use” has come to define the state medical cannabidiol board’s mission, Reisetter said. It has already approved ulcerative colitis, which also has been approved by the Board of Medicine and will join the list early next year.
“It’s been interesting to listen to their discussions,” said Reisetter of the nine-member board. “As it relates to ulcerative colitis, they said Crohn’s was passed by the Legislature, and it has symptoms that are very similar to ulcerative colitis. They said they are not sure why they would include one and not the other.”
Research has shown both THC and cannabidiol, or CBD, both naturally found in the marijuana plant, can have medical benefits. CBD can be used to treat seizures, mental disorders, inflammatory bowel syndrome and depression, while THC can be used to treat muscle spasticity, glaucoma, low appetite and insomnia. Both can be used to treat pain, nausea and anxiety.
How do I get it?
To obtain cannabidiol products, patients or their primary caregivers must download a form on the IDPH’s website: http://idph.iowa.gov/cbd/Patient-Registration. They then take that form to their doctor to sign.
“The doctor is not prescribing — they’re certifying that patient has one of the eligible debilitating conditions,” Reisetter said.
There’s already a snag in the process: Only about 325 of Iowa’s 7,000 doctors have certified people for medical cannabidiol, in part because many are uneasy about their role in the system, according to a recent article in the Des Moines Register.
UnityPoint Health said in a statement the company “defers decisions regarding patient care to its physicians,” and doctors who choose to certify patients for medical cannabidiol have a “responsibility to remain informed about the associated clinical and regulatory guidelines.”
UnityPoint spokesman Carson Tigges said he was unaware of any local physicians who had certified patients. Covenant Medical Center did not respond.
Certified patients must complete a patient registration application and submit that along with the form signed by their doctor, a valid photo ID and $100 for a patient registration card.
The IDPH notifies patients if they’ve been approved, said Reisetter. Approved patients or caregivers then go to their local Department of Transportation Office — yes, the driver’s license stations — to receive their registration card.
Patients with valid registration cards can then visit one of the five cannabidiol dispensaries around the state. In Northeast Iowa, that’s the Iowa Cannabis Company, located at 1955 La Porte Road, Waterloo. (The others are in Sioux City, Council Bluffs, Windsor Heights and Davenport.)
“Then, generally how they work is the patient or primary caregiver will go back, talk to staff about what products are available and are efficacious for treatment,” Reisetter said.
Read part two of our series, as The Courier interviews Iowa Cannabis Company owner Aaron Boshart: