Medical Cannabidiol Board Report

From the Iowa Osteopathic Medical Association

By Jacqueline Stoken, D.O.

The Iowa Medical Cannabidiol Advisory Board had an urgent meeting on April 16, 2019 to discuss HF 732. The Board had made recommendations to the legislature including the limits of amounts

of THC to be contained in the CBD products. While the legislature accepted some of our recommendations, they did not accept our limits of THC. The bill came out of the House with

limits of 25 gm/90days that could be purchased by the patient.

After review and a thorough discussion of the medical literature, the Board made the following recommendations:

  1. Eliminate the 3% THC cap on medical cannabidiol products currently codified in Iowa Code section 124E.2.

  2. Establish a THC purchase limit for patients of 4.5 G (4,500 mg) THC every 90 days. This is 50 mg/d of THC which is well into the psychoactive range for all but the most experienced and tolerant patients. This covers the full range of doses supported in the medical literature for Iowa’s approved debilitating medical conditions. (Note – the average amount of THC estimated in a marijuana joint is @ 20mg.)

  3. For Pediatric patients under 18 years of age, limit access to THC by allowing pediatric patients to only purchase products with a 20:1 ratio of CBD:THC, and establish a maximum CBD dose for pediatric patients of 10 mg CBD/kg (weight of patient)/d.

However, the Senate passed HF 732 allowing the 90-day limit of THC to be 25 gm. (25 grams of THC as a 90-day limit was startling to me and every provider I have encountered. 25 grams is 25,000 milligrams (mg))

As you can imagine, we are all upset by this. This is 5.6X the safe limits that we had recommended. The legislature is now referring to CBD/THC as a medicine/drug. Note that it is out of our hands in how much to recommend as all that our duty, if we choose, is to certify the allowed condition of the patient. The person who works at the dispensary will be recommending the dose, route and frequency of use to the patient. The person who works at the dispensary is not required to be a medical professional but is to have minimum amount of training done by the distributor.

As physicians, we are concerned of serious side effects of large dose of CBD/THC which include but are not limited to cannabinoid hyperemesis syndrome (CHS) and psychosis. THC can also cause brain damage when used chronically.

The Board member take its advisory role seriously. Please contact me at jstodo2@gmail.com or the Iowa Department of Public Health, Office of Medical Cannabidiol, http://idph.iowa.gov/cbd if you have any questions.

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