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[Full Transcript] Monday’s Show on Medical Marijuana on Iowa Public Radio’s River to River

If you missed the medical marijuana discussion on Iowa Public Radio’s River to River program this past Monday, here’s a transcript of the show. Audio recording of the show available here.

River to River with Iowa Public Radio on IPR
Illinois recently became the 20th state to legalize medical marijuana. Some in Iowa are pushing for a similar initiative.

It’s River to River from Iowa Public Radio News. I’m Ben Kieffer. This hour, we’ll hear from Iowa Patients and families, including an Iraq War veteran, who believe cannabis can be an effective medicine. Also, two doctors on the benefits and concerns of using the drug as medicine. And we’ll discuss the issue in the upcoming Iowa Legislative session. The Governor says he would veto any bill legalizing medical marijuana in any capacity.
Join our discussion. Medical marijuana, after this news.

It’s River to River from Iowa Public Radio News. I’m Ben Kieffer. Illinois recently became the 20th state to legalize medical marijuana. Doctors can start prescribing medical marijuana in our neighbor state in January. Now, some in Iowa are pushing for a similar change our laws. Later in this hour, we’ll have two doctors on, two physicians to weigh in on the benefits and their concerns of using the drug as medicine. We’ll also discuss the issue as it pertains to the upcoming Iowa Legislative session.

But before that, we want to start with some personal stories from Iowans who believe cannabis can be an effective medicine. We want to hear from you this hour as well. Do you think Iowa should join 20 other states in legalizing medical marijuana. Does cannabis help a medical condition you have? 1-866-780-9100. River to River at Iowa Public Radio dot org. We’re also on Facebook, or you can tweet us @iprtalk.
Joining me first of all in the Iowa City studio, Logan Edwards with us, an Iowa Marine Corps veteran from Davenport. Logan Edwards, welcome to our program.

Logan: Hey, how you doing.

BK: I understand you served in Iraq from a certain period, from 2007-2008, what can you tell us about your tour of duty there?

Logan: Um, it was long, boring, and – I mean, I guess the best way to put it, is its comparable to sitting on the moon and watching the Earth spin. You know, that’s kind of how it felt to be there. I left life behind here in America, went to Iraq, and went through a series of changes and things over there that a lot of my generation and people back here in America didn’t necessarily go through.

BK: You saw combat over there?

Logan: Correct.

BK: When did your symptoms of post traumatic stress turn up? Were they first when you returned from Iraq, to Iowa in this case, to Davenport?

Logan: Yeah, the symptoms really started manifesting, at times, when they were there, I had lots of anxiety, and periods of depression and stuff when I was there. When I came back was when I really started to notice the anxiety. The panic attacks and things like that. When I was in crowded places, driving, you know, around lots of people, things like that. I noticed I had a lot of anxiety, and problems sleeping as well.

BK: So these would come onto you on a daily basis?

Logan: Yeah. I mean, it was really unrelenting. I think back on it, and it really started like, the moment we walked off the plane. And the guys I was with for 8 months, and we’d never left each other’s sides, all of a sudden we were going home to our families and things, and that’s kind of, I felt like, an alone feeling, and an anxious feeling.

BK: What are your thoughts, when you were feeling that?

Logan: At first I thought it was just kind of a situational type thing that was going to go away eventually. Everything that I’d heard from senior Marines, as well as medical doctors and stuff, was, you know, hey I was 20 years old, I just came back from a war zone, and these were just natural feelings and they would go away after a period of time.

BK: So you sought medical treatment, what kind of treatment did you get initially?

Logan: Well, at first, when I first I came back, nobody really told me I had a problem. I did what a lot of Marines do, I just kind of slipped into, you know, the drinking, and using that as kind of a way to numb my mind and kind of get the anxiety to dissipate. After getting into some trouble with alcohol, and realizing that that was, you know, not beneficial to me, and after some coercion from some senior Marines, I decided to go to the VA and seek treatment, yes.

BK: What did they prescribe? Or what did they diagnose you with?

Logan: Um, at the time in 2008, PTSD wasn’t as, prevalent I guess, as it is now, it wasn’t talked about as much. They diagnosed me with anxiety, and depression and insomnia, at first. They gave me lots of different antidepressants and tranquilizer type benzodiazepines and things like that to calm me
down, as well as therapy and talking to people –

BK: Cognitive therapy, that you were having on a regular basis?

Logan: Yeah. We did a lot of work with that, and I really didn’t see much improvement, and a lot of times, the pharmaceutical drugs didn’t agree with me, and I would get lots of side effects. And I’ve spent thousands of dollars in ER room visits in Davenport, going to them after having adverse side effects and making my symptoms much worse.

BK: Ok. So along comes cannabis, how did you hear about that, also from your military buddies?

Logan: Well, what happened with it is, I mean I’d gotten to the point where literally I tried – after three years of trying every treatment that I could through the VA, I got to be, to the point of honestly contemplating suicide, as a lot of returning veterans are unfortunately, you know, are doing –
BK: Did you get past contemplating? Did you attempt?

Logan: Yeah, I got past it, I mean, the reason that I held on was I had just had a newborn daughter, and I really did not, you know, like the idea of my daughter growing up without a father. One more victim I guess of this war, and my own stubbornness kind of led me, I’m not going to give up yet, and I said, you know, and I decided to give the VA one more chance. I submitted myself to an inpatient program for three months, with the VA, that specialized specifically on veterans mental issues, and I tried every pharmaceutical therapy they had, under doctors supervision, as well as emotional therapy, anything like that. After three months of it, my symptoms were no better than they were before, and one thing I noticed when I was in this treatment program was lots of Vietnam veterans that had been suffering for forty years plus. They’re in their sixties now, suffering from the same symptoms that I have. And it’s at that point that I really started to realize maybe the treatments and the answers weren’t going to be given to me by the VA. And so I started to look for alternatives, and that’s when I realized that veterans were having good success with treating some of these symptoms out in states that allowed it. And that’s when I, you know, having no other options and basically feeling like I had nothing left to use, was when I started to use, you know, cannabis. And it did things for me immediately.

BK: What for instance? What did it alleviate?

Logan: Well, from the minute, I mean I used it by inhaling it, I didn’t use it by, the oils or anything like that. I smoked it.

BK: Just standard cannabis that is available now legally in some states?

Logan: Correct. And from the minute I inhaled it, my anxiety dissipated. I mean, we’re talking unrelenting anxiety that had been plaguing me for the past years, that I had tried so hard to get away from it – it helped that immediately. It helped me in ways, also, that I really can’t describe. As far as, allowing myself to, you know, mend relationships that I had destroyed after coming home from Iraq and kind of suffering through some of the, you know, anxieties and things I had, put a real – and you know, using the alcohol – put a real strain on relationships I had. And when I used cannabis, it allowed me to treat the symptoms — get rid of the anxiety, help me sleep – as well as mend relationships with these people in a way I don’t think I would have been able to do had I not used cannabis.

BK: Any downside? Any side effects? You mentioned the other drugs you were given having side effects. What about marijuana?

Logan: Um, the side effects – I mean really, the worst side effect that I’ve seen, it sounds cliché but it’s the munchies. You do get hungry. That’s not, maybe, the greatest side effect to have, but that’s really been the worst side effect I’ve encountered. It does make me sleepy if I use too much of it, but not any further than something like narcotic pain killers that have been prescribed to me. I mean, those impair me so much more, and cause so much, you know, withdrawal effects and side effects associated with them. I have none of those problems with cannabis. If I miss a dose of cannabis, you know, it’s not something I need every day, it’s not something I need every hour, on the hour, as I do with the prescription drugs. And I feel no withdrawal symptoms when I don’t use it.

BK: Logan Edwards is with us, an Iowa Marine Corps veteran from Davenport. He served in Iraq, a tour of duty in 2007 and 2008. As you just heard, has found relief from post traumatic stress disorder in medical marijuana. That’s the topic of our program today. 20 states have legalized medical marijuana. Should Iowa do the same? Perhaps you have a personal story, a personal medical condition that you’ve used marijuana for. 1-866-780-9100. River to River at Iowa Public Radio dot org. We’re also on Facebook, or you can tweet us @iprtalk.

Logan Edwards, please stay with us, we’ll get back to you in just a moment, because we want to learn now from Rachael Selmiski, a native Iowan joining us by phone. Rachael, hi are you there?

Rachael: Yes.

BK: Hi. You were a native Iowan, where are we reaching you today?

Rachael: We’re actually in Colorado, in Denver.

BK: Ok. And you are the mother of a 17 year old baby, daughter Maggie?

Rachael: She’s actually 17 months old.

BK: Sorry, sorry sorry.

Rachael: That’s ok.

BK: But anyway, you’re out in Colorado, and actually, you’re in Colorado because Colorado laws are different, and allow you to treat your baby with cannabis. How? What is the condition, first of all, I guess we’d better start there.

Rachael: At six weeks old, she began having full tonic-clonic or grand mal seizures. And we went through a host of hospital stays. Numerous anti-convulsants, IV therapies that wouldn’t work. Then we thought, we were doing something called manual therapy, we thought we were seeing some good progress, which I think her body was, but then she developed something called infantile spasms. Which are real brief spasms, basically a generalized seizure. Between that and mild clonic jerks, which are another form of seizures, she has over 500 a day –

BK: What do they look like? What does it look like, when you observe her face, and then she has a seizure?

Rachael: So, with the infantile spasms, it looks like a startle response, and her eyes kind of do a really quick roll. And then, it’s very brief, but every time it’s her brain basically short circuiting, and it completely stunts growth development. And actually, she’s even – I mean, we didn’t have much progress that we were able to make – but she’s actually regressed since this started as well. She’s actually 18 months old, and she’s at a 3 to 4 month old neurodevelopment age.

BK: We want to talk about treatment with cannabis in just a moment. Before that treatment, what sort of treatment did she get from conventional medicine?

Rachael: We had, she’s gone through six different anticonvulsants, at one point actually this time last year she was on four at once. And they’re all sedating medicines. So, they maybe, they’re trying to slow the seizure activity down, but obviously it’s not effective. It’s also slowing all the rest of her systems down. So right now, she’s on three anticonvulsants still. One, I nearly had to sign my life away, that she would lose her vision. And then, just the side effects, the lists are exhaustive of the damage that can be caused by these anticonvulsants.

BK: So you have tried, you’re out in Colorado, where, cannabis, marijuana is now legal. Is there a certain type of oil treatment you’ve been using for Maggie? Tell us about that.

Rachael: So there’s a specific strain that has only been around for a little while. It’s extremely high in CBD and low in THC.

BK: The THC, just to be clear, is what makes people high, right?

Rachael: Mm-hmm. So that’s what people look for with the psychoactive effects, and actually, in the recreational realm, people are trying to grow it higher and higher for higher THC. The oil Maggie is getting is very low in THC and high in the CBD. And I know people have presented me with synthetic forms, but actually the whole plant is very beneficial. The THC can be, sometimes, the redheaded step child of that, but really, it has purpose – appetite stimulant, pain reducer, and things like that. So I, that still is a vital component and compound of her actual oil. But what she gets – that plant oil is extracted. Where we get it from is all organically grown, it’s tested in the plant form for solvents, pesticides, mold – and then it’s also tested in the oil form for those things. And then we have a printout of the levels of the different cannabinoids in her oil, and we give it to her through an oral syringe, just like we do all the rest of her medicines.

BK: Ok, so it’s just like a medicine, like an oil she’s drinking?

Rachael: Mm-hmm.

BK: What difference has it made? You’ve been at it for just a couple weeks, two or three weeks, something like that?

Rachael: Mm-hmm. She’s been at it for about two and a half weeks right now. And we intentionally started very slow, and are going very very slow with her. There’s a delicate balance of trying to wean her off of her other anticonvulsants. And one of the side effects, initially, is that it can magnify some of the anticonvulsants, so trying to get those out of her system will actually prove to be more beneficial. But right off the bat, just her alertness, her awareness of her surroundings and – and we’re talking about an 18 month old that can’t hold her head up, can’t see very well, doesn’t necessarily know where she’s at –

BK: What about the seizures? Have they lasted in intensity or number?

Rachael: At this point we don’t notice a direct correlation with some lessening, but there’s a holistic effect of letting it build up in her body as well. One thing we have seen, as Logan said as well, she definitely has the munchies. Her appetite has increased. And, not that it’s majorly newsworthy, but her elimination is tremendous. And anyone that knows, dealing with sedative medicines, that the digestive system – it slows everything down, and once you do that, you just become toxic. So that is a battle we deal with constantly, and the fact that she’s going to the bathroom everyday is a huge success in our department.

BK: Rachael Selmiski is with us, a native Iowan. Mother of a 17 month old baby with epilepsy, a severe form of epilepsy, and is living now in Colorado. I want you to stay with us Rachael, but answer this briefly, are you in Colorado – I mean, if Iowa’s laws were different in terms of medical uses of cannabis, would you be living here with your family?

Rachael: We would definitely reassess where we’re at. We live each day, seeing what each day holds, so when that becomes available, that is definitely an option, so definitely. The other thing is visiting family. At this point, we can’t leave the state of Colorado so Maggie’s relationship with her family –

BK: It would be illegal for you to have, possess that oil in Iowa?

Rachael: The minute we cross over the state lines of Colorado we become criminals. It’s a Schedule I substance. And then it’s child abuse on top of that, that we are giving it to our child.

BK: Ok. Joining us now, Dr. Steve Jenison, he’s an Iowa native and a graduate of the University of Iowa College of Medicine. Dr. Jenison, welcome.

Dr. Jenison: Glad to be here.

BK: And let me point out, that you’re the first director of New Mexico’s medical cannabis program. And tell us, you were back in Iowa to do some other medical training. But you were also here to speak out on behalf of using cannabis medicinally. You’ll be discussing this Monday, December 2nd at the Des Moines Public Library at six pm in the evening. What is the message you want to deliver here in the state as a physician?

Dr. Jenison: Well, I think that every state needs to deal with the issue of whether or not they’re going to establish a medical cannabis program for those people who might benefit from its use. Every state goes about it differently. I think there are some parallels between New Mexico and Iowa that the New Mexico experience can inform the discussions that will go on here. Most of those discussions took place in New Mexico between 2000 and 2007, when medical cannabis bills were being considered by the New Mexico legislature.

BK: What parallels exactly do you see?

Dr. Jenison: Well first of all we don’t have a citizens’ initiative process in New Mexico. So it was necessary in order to establish a medical cannabis program to do it through the legislative process. And it’s my understanding that the same is true in Iowa.

BK: Ok, we’ll talk about that a little bit later in the program. What is your reaction to the two personal stories that we saw there? Logan Edwards, also we heard from Rachael about her baby. Give us the length and breadth of where you see as a medical doctor, cannabis being used thus far. Because there is a lot of research that needs to be done, isn’t there?

Dr. Jenison: The stories that I’ve heard today are very similar to a lot of the stories that I heard over the period of time that the medical cannabis bill in New Mexico was being heard, as well as the stories that I heard when I was the first medical director of the program in New Mexico, where it was my authority and responsibility to sign off on applications that were made for enrollment in our program. Almost without exception, all of the stories that I heard were people that suffered from severe, debilitating illnesses, who had sought treatment through conventional medicines, and had not received relief. Had tried cannabis, or were anticipating trying cannabis because other people had suggested it to them, and had found that it derived relief where nothing else had brought them relief before. So when I was first assigned this by the Department of Health, I was a little nervous about it, because I didn’t really know what I thought about it, and hadn’t had a lot of experience talking to people. But the more stories that I heard, the more I became convinced that the great great majority of individuals who were interested in having access were very sincere.

BK: Stories. But is there medical evidence, research evidence, to back up the stories, the anecdotes you’re hearing?

Dr. Jenison: Yeah, absolutely. Even at the time when New Mexico was considering it’s bill, between 2000 to 2007, there was a study, a review of the available research that was done by the Institute of Medicine, where they looked at the available research, and found that there were certainly some conditions for which there was already adequate evidence. One was people with cancer undergoing chemotherapy, controlling their nausea and vomiting. People with HIV and Aids, in terms of their peripheral neuropathy and their anorexia, their lack of appetite. People with multiple sclerosis. So there was already a lot of evidence, but the evidence, the body of evidence, has grown substantially since then.

BK: Dr. Steven Jenison is with us, and before we take our break, we’ve got a minute or so left, I want to introduce another physician we have on our program, Dr. Dan Gillette is with us by phone. A psychiatrist from Sioux City, Dr. Gillette, welcome.

Dr. Gillette: Thank you.

BK: And we want to of course have you on for the entire rest of the hour, but in the minute before the break, let me ask you, do you think that cannabis has legitimate medical uses?

Dr. Gillette: Well let’s just mention, there is research showing that it is effective for a couple of conditions. You know, with use as an anti-nausea agent in chemotherapy being the oldest of those to be researched. In my view, the real issue is that, in every state I’m familiar with, the creation of a program for medical cannabis consisted of using the political process to replace a requirement for medical research demonstrating safety and efficacy. And that’s where I have concern.

BK: Ok, so that, we get the experts out of there, and the political process. Steve Jenison, with your experience in New Mexico, a quick reply to that?

Dr. Jenison: Well I would say that, medical cannabis programs in states are really a response to the fact that even though medical cannabis has a lot of potential, that research that should be done has been largely obstructed.

BK: Ok, we’ll be back as we discuss medical marijuana this hour on River to River.

BK: Back with more of River to River from Iowa Public Radio News. I’m Ben Kieffer, talking about medical marijuana this hour. Illinois, our neighbor state, became the 20th state to legalize medical marijuana this past year. Actually, doctors can start prescribing medical marijuana in Illinois beginning in January. And some in Iowa are pushing for a similar change in our state laws, so we’re getting various perspectives on that today. Logan Edwards, with us, an Iowa Marine Corps veteran from Davenport who has found that he can effectively treat his PTSD, his post traumatic stress disorder, with it. All other conventional medicines, also with a lot of side effects, seem to have failed in that case. Rachael Selmiski is with us, a native Iowan now in Colorado treating her 17 month old baby who has a severe form of epilepsy. Now with some cannabis oils that are available in Colorado, that are illegal in other states, most other states I should say. Dr. Steven Jenison with us, an Iowan native, the first director of the New Mexico medical cannabis program, telling us how that state’s program works. Also Dan Gillette, a psychiatrist from Sioux City. We left off and gave

Dr. Gillette very little time, we want to get to our callers as well. Dr. Gillette, list your biggest concerns in changing Iowa’s laws specifically just to limit the use of cannabis where prescribed by a doctor.

Dr. Gillette: Ok. And, you know, the big concern is going around the normal process to demonstrate safety and efficacy of any medication before it goes on the market. And my longtime experience has been that when politicians get involved in the delivery of medical care, that does not lead to medical care improving, generally. But my concern –

BK: On that point, before you go on, wasn’t it back in 2010 that the Iowa Board of Pharmacy voted 6-0 to propose legislation that would reclassify marijuana, make it possible to legalize the drug for medical purposes? Now, the Iowa Board of Pharmacy, a lot of medical expertise there, yet, that was including experts, and the Legislature chose to ignore it.

Dr. Gillette: Yeah well as Dr. Jenison mentioned, one of the problems is that, because of how marijuana is classified at the federal level, it’s hard to do the research that would prove that it’s safe and effective. And my feeling is that the appropriate response is to apply political pressure so that that research can be done, not to use political pressure to do away with the need for doing such research. Some of the things we do know about medical marijuana of course, it’s intoxicating, and through history, there have been tendencies for things that are intoxicating to be considered medicinal at some point, and that has, you know, certainly, people got prescriptions for whiskey during prohibition and that sort of thing.

BK: So you see it as increasing the chances for abuse, possibly as a gateway drug, especially when we think of the youth of our state and country?

Dr. Gillette: Potentially so. My biggest concern is the effect of the marijuana itself. There have been a couple of studies that I think are important. One was done in the last couple of years, and it was on driving, using driving simulators. An older study was done on, flying a computer simulated airplane. And I’d like to briefly summarize what they’ve found. The two studies found the same thing. But the airplane study, what they did, was they took college students who tested negative for drugs and alcohol, hadn’t used anything for a while. Taught them to fly a computer simulated airplane, they learned to land the aircraft. Then they had them smoke marijuana. The amount was about the equivalent of two joints. So they were stoned, and surprise surprise, stoned people can’t land airplanes. They kept these students in the lab overnight. Nobody was using anything, and the next day, nobody was stoned anymore either. 24 hours later, none of them could land the aircraft. So, they kept them in the lab another 24 hours. Nobody was using anything, they were just watching TV or doing homework. Came back 48 hours later, no one could land the airplane. It was 72 hours before any of them could land the airplane again. The driving study similarly found that people were clearly impaired for 72 hours, meaning it was clearing up 72 hours out. Now that’s after using marijuana once.

BK: Ok, let’s let Dr. Jenison reply please briefly to that, and we want to add a couple people to our conversation. Dr. Jenison, what do you have to say to that?

Dr Jenison: Yeah, I don’t think that anyone whose using medical cannabis for any reason should necessarily be flying airplanes. I think that people that use medical cannabis tend to have very severe, chronic debilitating conditions, for which they’re using a lot of other drugs that also have profound effects, including opioids and benzodiazepines. Drugs that are licensed, drugs that we prescribe to people on a very regular basis for the same sorts of debilitating conditions.

BK: Also joining the conversation, state Senator Joe Bolkcom is with us, a Democrat from District 43, and Steve Lukan, Iowa’s drug control policy coordinator, director of the Iowa Office of Drug Control Policy. You’re proposing the change, Senator Bolkcom, what proposal do you want to make, and then we’ll have Steve Lukan respond to that.

Senator Bolkcom: Thanks Ben. I would start with the notion that cannabis reduces suffering for patients that have debilitating conditions where all other medicines and conventional approaches have failed. And I think it’s time that we put in place a system that’s safe, provides legal access, with adequate controls to address the needs of thousands of Iowans, some of whom are leaving the state, and some of whom we’ve driven out into the streets to conduct their own illegal cannabis buys. I think it’s time for an adult conversation here in Iowa for how we meet the needs of those folks. The New Mexico model I think gives us some guidance in terms of a possible model that I believe has the kind of strict controls that Iowans would like to see.

BK: Steve Lukan, respond to that. Are you still in favor of keeping marijuana a Schedule I classification in the state?

Steve Lukan: I think my big concern, actually today as I listen to some of these conversations going on here and also across the country, there are a small amount of people who have some very true medical problems and conditions, and they are actually in some ways I think being used by people who are trying to create a new addiction industry out there with the whole legalization effort. And that’s one of my concerns, is trying to actually find some way to help some very targeted people. You talk about the New Mexico program, and the Colorado program, and I would encourage people to actually dig into some of the details and find out what’s happening on the ground there. Some of the names of the medical cannabis in New Mexico I just find really interesting. Agent Orange, AK47, Green Crack. I mean, are we actually using something, you know – what I’m concerned about, I think, is that in some of these states, these programs have started out with good intentions and they have gotten out of hand and have actually become a way for people to make profit on addictions.

BK: Ok, you’re the first director of New Mexico’s medical cannabis programs. Steve Jenison, how do you deal with those charges?
Dr. Jenison: I would say first of all, that all of the medical cannabis producers in the state of New Mexico are not for profit organizations. They are required to be by New Mexico law. So I don’t think there’s really anyone making a lot of profit. They all have to be New Mexico not for profit companies. I would say that the strains are named after strains that have been developed over very long periods of time, and that the producers have just chosen to continue to use the names of the strains that they’re growing.

BK: It sounds like you want to create a law, Steve Lukan, or would be in favor of creating a law that could accommodate the people with justifiable needs here, justifiable medical needs. Do you see a way of doing that?
Steve Lukan: Well I think to Dr. Gillette’s point earlier, you know, I think we need to work with some of the programs that are there today to help a very targeted number of people. There is something called the Innovative New Drug, uh, system, which you can actually work with a doctor, to work with the FDA, to work with the DEA, to access some drugs that are currently being worked through the FDA approval process. There are drugs, such as epidiolex and Sativex, that are working their way through the FDA approval process to be administered in a safe environment, and a controlled environment. And I think there are some ways to do that. You look at some of these other states, you know, New Mexico for example, people who are in hospice care that are currently getting the medical cannabis, at least in a recent survey was 16 people, yet there was over, close to 3,000 people who simply claimed chronic pain. I think that’s one of our big concerns, is actually trying to find a way, and I think there are existing routes today, making sure we work through the FDA and the DEA, in a, in a safe way, to help some of these people in very rare instances, get access to experimental treatments, without opening up a program that really in many states has kind of become a joke. I mean you look at Colorado, for example, where today you actually have more medical marijuana dispensaries in towns like Denver than you do Starbucks.

BK: Ok, we want to go back to our phones. But Senator Joe Bolkcom, respond to that criticism, that the legitimate use is really only the thin end of the wedge, and the bulk of it is disguised recreational use, if we can say that.
Senator Bolkcom: Well, I think Mr. Lukan has a hard job, let’s just start there. And I’m actually hearing some agreement, that he believes that cannabis, and the properties of cannabis, have some value for these chronically sick people. But he has a hard job, he has to represent a Governor who is opposed to helping these Iowans. I’d like us to rely on medical experts, science, and frankly the stories from many of these Iowans that I’ve heard from and the stories we’ve heard today on your show Ben, that have experienced significant health benefits – pain reduction, improved quality of life – from using cannabis as medicine.

BK: Ok, let’s get back to our callers. We have a good number of them, just to hear, briefly if we could, these are people, we have been asking for people who have found some help in cannabis because of a medical condition. Sally in West Des Moines, hi.

Sally: Hi.

BK: What is your position on medical uses of cannabis?

Sally: Well, we have not had access to medical cannabis yet, and I am very eager to try it. We have a 23 year old daughter with Dravet Syndrome, a very rare and catastrophic form of epilepsy. And we currently, she’s on, currently, four anti-epileptic seizure meds, has more than one seizure a week, and one of her meds, we import under the compassionate use from France. All of these meds have terrible side effects, she functions at a four to five year old level, and there are many young patients with Dravet Syndrome getting help from cannabis. It is not addicting. It is a medicine. None of these children, and my daughter, will ever drive a car or fly an airplane. They just need help for their seizures.

BK: Sally, thank you for your view from West Des Moines. Let’s go to Larry in Cedar Falls, hi Larry.

Larry: Hello.

BK: Yes, Larry, you’re on the air, go ahead please.

Larry: Yeah. Can you hear me?

BK: Yes, Larry, we can hear you just fine. Go ahead .

Larry: Alright. I have a spinal cord injury. And I’ve been 32 years with spinal cord injury. And for most of that time I’ve been able to manage spasms and pain, but in the last few years I’ve had some real bad pain. I’ve taken and been prescribed narcotics and epileptic drugs, and other kinds of stuff. Muscle relaxers, and the side effects from that are so bad that I ended up trying about three years ago, marijuana, and found that it really worked, much better than anything else. So anyway, I would be for medical marijuana in Iowa.

BK: Ok, Larry, thank you, in Cedar Falls. What do the — Joe Bolkcom, I’m sure you have your fingers on the pulse of this. What do the polls in Iowa, and nationwide, say about medical uses of marijuana? Or Steve Jenison?

Dr. Jenison: Yeah, well, there’s been a Des Moines Register poll – this is a couple years old – I think it’s had 63% of Iowans in support of pursuing a medical cannabis program. And I think around the country, the polling is actually somewhat better than that and improving all the time. People – the citizens would like an opportunity to have this medicine.

BK: Ok. Senator Bolkcom, tell us exactly what you have in store for the next session. What you want to introduce, what you want to change, and we want to get Steve Lukan’s response to that.
Senator Bolkcom: Well, Steve will recognize, as a former legislator himself, that the legislative process takes time, and it takes citizen involvement, connecting with their legislators, and that’s really the process we’re in now. Two bills will be reintroduced in 2014, one that will reschedule marijuana from Schedule I to Schedule II, basically saying it has medical benefits; the other will provide an outline of the New Mexico program, the other piece of legislation. That will be, really a beginning point, for legislators here in Iowa and interested parties to get together and start talking about what an Iowa approach would look like. The states are where innovation occurs. You’ve got 20 models to choose from in terms of what’s going on around the country. I’ve looked at the New Mexico program – Dr. Jenison will talk about it next Monday night at the Des Moines public library at six o’clock for people that are interested – but those two bills will be introduced, and hopefully we will have some conversation about it. I’m under no illusions though. I think we’re still a couple years away, frankly, from moving this along.

BK: So you see, perhaps what has to happen is awareness, or further research. What has to happen? Why do you say two years away?

Senator Bolkcom: Well, I think more people need to hear Logan Edwards story, and Rachael Selmiski’s story, and other stories, to move this issue along. There’s people in our state, suffering today needlessly, and would like us to make progress on this. I’d like to say we’re going to make progress sooner, but we’re still in an education mode, and people need to reach – if they care about this, they need to reach out to their legislators and talk to them.

BK: Steve Lukan, Director of the Iowa Office of Drug Control Policy, what sort of common ground do you see in the immediate future, in terms of changing laws to allow some sort of medical marijuana? Where do you see the most likely opportunity for change, if there would be one?

Steve Lukan: Well, you know, I think also I want to compliment Senator Bolkcom, because I think, like many people, he has compassion for people who are suffering. And I think every Iowan doesn’t like to see suffering needlessly. Nobody’s in favor of that. Nobody’s in favor of Grandma, whose on her deathbed, you know suffering needlessly – nobody wants that. Where I think there is some potential common ground, is in that. We both want to help people find relief, find medically safe ways, ways that have gone through rigorous testing and standards, and ways that don’t lead to further addiction, and don’t lead to further bleeding of marijuana into youth population. That’s some of our concerns with other states you have seen – actually, every state where you have seen a medical marijuana program, or a program of legalization happen, you have actually seen higher rates of usage among youth, which in our opinion is a bad step, it leads to a lot of other unintended consequences.

BK: Ok, we want to have a response to that in just a moment, but tell me – the question was, where do you see the common ground? Even if it’s a small bit of common ground, where do you see that? Where do you see the Governor, for instance, most likely agreeing to – on a limited basis – to use medical marijuana in the state?

Steve Lukan: Well I think the Governor would support individuals who are able to apply for the Innovate New Drug program, who are able to work with a doctor in Iowa, to use an experimental drug through the DEA process with FDA – you know, something that is going through FDA approval. I think that’s an area where we could certainly see some agreement.

BK: Dr. Jenison?

Dr. Jenison: Yeah, I would say that, for Investigational New Drugs – which is what I assume you mean – for Investigational New Drugs, I think that before you put that out to the public as a possible alternative, you really need to look into what that looks like. How difficult it is for someone to actually get enrolled in those programs. How difficult it is for a medical provider to be an investigator under that, before you propose that that’s an alternative.

BK: Steve Lukan?

Steve Lukan: Well, you know, again, I think the big concern is making sure, that, that these, don’t – these drugs don’t get out into the hands of youth. We have seen that happen in many of these other states where there is a program, and that’s really a cause of concern. It is a very serious drug in many cases. We actually have over 60% of youth who are in drug treatment here in Iowa, are in drug treatment for marijuana. So we want to make sure that, that we are keeping that, in a very tightly controlled program, and I think the Investigational New Drug is one that does that. And again, we want to make sure that these, these are, are actually things that have the potential to help people without simply being an avenue for people to feed addictions.

BK: Senator Bolkcom?

Senator Bolkcom: Well, Mr. Lukan continues to say in the press that we’ve seen the increase in youth use of medical marijuana, and that’s not true. So I just want to correct the record on that. The CDC actually does a national and state youth risky behavior survey. And there’s a recent study from 1993 through 2011 covering all 16 states with legalized medical cannabis, and the study results indicate that legalization of medical marijuana has not been accompanied by an increase in the use of marijuana – or other substances – by high schoolers. So I think if we want to have a discussion about this, we should be as factual as possible.

BK: Ok, Dr. Dan Gillette, we haven’t heard from you for several minutes. You’ve been listening to this, our psychiatrist from Sioux City. What do you need to know, to have the law changed, in whatever limited way?

Dr. Gillette: Well, changing the category from Schedule I to Schedule II would allow research, appropriate research, to be done. My bottom line is it shouldn’t be treated any differently than any other putative new medication. You need to prove that it’s safe, you need to prove that it’s effective, you need to determine what level of control there should be over its dispensing. I think it’s a mistake to create a political structure to replace the medical structure that’s used for all other medications.

BK: Ok, and Dr. Jenison, we have thirty seconds left. What do you see as the first step that Iowa is likely to take here?

Dr. Jenison: Well I think that every state has to find its own path in regard to a medical cannabis program, and you now have the advantage of examining about 20 different models. I would say that the more stringent your program, the more that it accomplishes what it is that you seek to do, which is to provide compassionate use of cannabis to people who are suffering from severe debilitating illnesses.

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