Response to the Board’s decision to Table my Petition

Carl Olsen
130 E. Auro­ra Ave.
Des Moines, Iowa 50313–3654

Decem­ber 1, 2014

Des Moines 20100822 066
The Iowa Board of Phar­ma­cy

Iowa Board of Phar­ma­cy
400 SW Eighth Street, Suite E
Des Moines, Iowa 50309–4688

To the Iowa Board of Phar­ma­cy:

Thank you for con­sid­er­ing my peti­tion for mar­i­jua­na sched­ul­ing on Wednes­day, Novem­ber 19, 2014.  I would like to thank the mem­bers of the sub­com­mit­tee, Edward Maier, Sharon Mey­er, and LaDon­na Gra­tias, for their out­stand­ing work which is both accu­rate and detailed.  I am pleased with the subcommittee’s pro­posed rul­ing and ask that the full board adopt it as your rec­om­men­da­tion to the Iowa leg­is­la­ture at your next reg­u­lar­ly sched­uled board meet­ing on Jan­u­ary 5, 2015.

At the meet­ing on Novem­ber 19, 2014, some mem­bers of the board asked for more time to con­sid­er the subcommittee’s pro­pos­al and expressed con­cern with the rela­tion­ship between state and fed­er­al sched­ul­ing.  I’m pleased that the board wants to take a clos­er look at this pro­pos­al.

1.  BACKGROUND INFORMATION

I will start by men­tion­ing some of the his­to­ry involved in marijuana’s clas­si­fi­ca­tion at the inter­na­tion­al, nation­al, and state lev­el.  I sub­mit­ted a doc­u­ment for the sub­com­mit­tee hear­ing from the Expert Com­mit­tee on Drug Depen­dence (ECDD) of the World Health Orga­ni­za­tion (WHO) that gives a good sum­ma­ry of the his­tor­i­cal back­ground at the inter­na­tion­al lev­el.  I hope you have tak­en the time to review it.

Our nation­al and state con­trolled sub­stances acts were writ­ten to com­ply with these inter­na­tion­al treaties, the Sin­gle Con­ven­tion on Nar­cot­ic Drugs, 1961, and the Con­ven­tion on Psy­chotrop­ic Sub­stances, 1971.  Mar­i­jua­na was added to sched­ules 1 and 4 of the Sin­gle Con­ven­tion in 1961 and THC was added to sched­ule 1 of the Con­ven­tion on Psy­chotrop­ic Sub­stances in 1971.  The first thing to note is that THC (the prin­ci­ple psy­choac­tive ingre­di­ent in mar­i­jua­na) was sched­uled less restric­tive­ly than mar­i­jua­na when it was added in 1971.  Inter­na­tion­al sched­ule 4 is the equiv­a­lent of our state sched­ule 1, and inter­na­tion­al sched­ule 1 is the approx­i­mate equiv­a­lent of our state sched­ule 2.  So, THC was clas­si­fied as good for lim­it­ed med­ical use in 1971, after mar­i­jua­na had been clas­si­fied as being good for noth­ing in 1961.

To pro­vide some con­trast, the opi­um plant, the coca plant, mor­phine, and cocaine were all placed in sched­ule 1 of the Sin­gle Con­ven­tion in 1961, because all of them had some lim­it­ed med­ical use at that time.  When THC was added to inter­na­tion­al sched­ule 1 in 1971, the sched­ul­ing of mar­i­jua­na was not adjust­ed accord­ing­ly by remov­ing it from inter­na­tion­al sched­ule 4.  When THC was down sched­uled to inter­na­tion­al sched­ule 2 in 1991, mar­i­jua­na still got left behind in inter­na­tion­al sched­ule 4 (the most restric­tive sched­ule).

Trans­fer of delta-9-THC and its stere­o­chem­i­cal vari­ants from Sched­ule 1 to Sched­ule 2 of the Con­ven­tion on Psy­chotrop­ic Sub­stances, 1971:

https://www.unodc.org/documents/commissions/CND/Drug_Resolutions/1990–1999/1991/CND_Decision-34–2_XXXIV.pdf

https://cms.unov.org/llsulinkbase/contenttree.aspx?nodeID=1832

Sched­ule 4 of the inter­na­tion­al treaties is for sub­stances that have no med­ical use, which rais­es the obvi­ous ques­tion of where THC comes from if you’re not get­ting it from a mar­i­jua­na plant.  Marijuana’s clas­si­fi­ca­tion has not been reviewed by the inter­na­tion­al health orga­ni­za­tion since 1935.  The World Health Orga­ni­za­tion is cur­rent­ly review­ing the clas­si­fi­ca­tion of mar­i­jua­na.  I’m fair­ly opti­mistic the WHO is going to rec­om­mend down sched­ul­ing of mar­i­jua­na at the inter­na­tion­al lev­el in 2016, but that’s hard to deter­mine at this time.  Obvi­ous­ly, the Unit­ed States is mov­ing us in that direc­tion.

At the fed­er­al lev­el, mar­i­jua­na and THC were both placed in sched­ule 1 in 1970, and at the state lev­el here in Iowa, mar­i­jua­na and THC were both placed in sched­ule 1 of the Iowa Uni­form Con­trolled Sub­stances Act in 1971, con­sis­tent with both hav­ing no accept­ed med­ical use in treat­ment any­where in the Unit­ed States at that time.

THC (syn­thet­ic only) has been down sched­uled twice at the fed­er­al lev­el, to sched­ule 2 in 1986, and to sched­ule 3 in 1999. 51 Fed. Reg. 17476 (May 13, 1986); 64 Fed. Reg. 35928 (July 2, 1999).  Syn­thet­ic THC has also been down sched­uled twice at our state lev­el here in Iowa, to sched­ule 2 in 1986, and to sched­ule 3 in 2000. 1986 Iowa Acts Chap­ter 1037 § 4 (April 7, 1986); 2000 Iowa Acts Chap­ter 1140 § 10 (April 25, 2000).

The unusu­al thing about THC’s sched­ul­ing is that both fed­er­al and state law made a dis­tinc­tion between nat­u­ral­ly occur­ring THC and syn­thet­ic THC, leav­ing the nat­u­ral­ly occur­ring THC in sched­ule 1 and trans­fer­ring only syn­thet­ic THC to sched­ule 2 and then to sched­ule 3.  This dis­tinc­tion has nev­er exist­ed at the inter­na­tion­al lev­el.  Both nat­u­ral­ly occur­ring and syn­thet­ic THC were trans­ferred to inter­na­tion­al sched­ule 2 in 1991.  Iowa has since that time cor­rect­ed this dis­tinc­tion by trans­fer­ring nat­u­ral­ly occur­ring THC to state sched­ule 3 here in Iowa in 2008.  Iowa Code § 124.208(9) (2014)2008 Iowa Acts Chap­ter 1010 § 4 (March 5, 2008).  The fed­er­al gov­ern­ment pro­posed mov­ing nat­u­ral­ly extract­ed THC in 2010, 75 Fed. Reg. 67054 (2010), but nat­u­ral­ly occur­ring THC remains in fed­er­al sched­ule 1 as of this date.  So, here you have an exam­ple of where Iowa is not fol­low­ing fed­er­al sched­ul­ing on nat­u­ral­ly occur­ring THC.  Iowa is lead­ing instead of fol­low­ing.  If you read the fed­er­al pro­pos­al you’ll see the rea­son­ing the fed­er­al gov­ern­ment makes is that a mol­e­cule is still that same mol­e­cule whether it occurs nat­u­ral­ly or it’s made syn­thet­i­cal­ly.

The recent Med­ical Cannabid­i­ol act our state enact­ed on July 1, 2014, is anoth­er exam­ple of where our state is not fol­low­ing fed­er­al sched­ul­ing.  Cannabid­i­ol (CBD) is the main non-psy­choac­tive chem­i­cal com­po­nent of mar­i­jua­na.  The US Depart­ment of Health and Human Ser­vices (HHS) was award­ed Unit­ed States Patent #6,630,507 for CBD and oth­er cannabi­noids on Oct. 7, 2003.  Cannabid­i­ol is in fed­er­al sched­ule 1.  The fed­er­al chem­i­cal code for cannabid­i­ol is 7372.  See:

http://www.deadiversion.usdoj.gov/drugreg/reg_apps/225/225_instruct.htm

http://www.deadiversion.usdoj.gov/fed_regs/imprt/app/2008/fr08064.htm

Iowa is lead­ing instead of fol­low­ing the fed­er­al sched­ul­ing of cannabid­i­ol.  This is not just some mishap or con­sti­tu­tion­al abnor­mal­i­ty; it’s a pat­tern.

You can see a sim­i­lar pat­tern at the inter­na­tion­al lev­el where it was the Unit­ed States that request­ed the down sched­ul­ing of THC in 1991.  Report on the 27th ses­sion, Expert Com­mit­tee on Drug Depen­dence (1991), at pages 9–12: http://whqlibdoc.who.int/trs/WHO_TRS_808.pdf?ua=1.  The inter­na­tion­al, nation­al, and state sys­tems of sub­stance con­trol are not designed to be top down.  It’s a com­pre­hen­sive sys­tem dri­ven from the bot­tom up.  Local gov­ern­ment rep­re­sents the peo­ple and this is where the process begins.  The inter­na­tion­al treaties all have lim­i­ta­tion claus­es in them which pro­tect con­sti­tu­tion­al due process of the sig­na­to­ry par­ties.

Marijuana’s place­ment in fed­er­al sched­ule 1 in 1970 was so con­tro­ver­sial that Con­gress appoint­ed a com­mis­sion to study it.  “The Com­mis­sion rec­om­mend­ed that ‘the Unit­ed States take the nec­es­sary steps to remove cannabis from the Sin­gle Con­ven­tion on Nar­cot­ic Drugs (1961), since this drug does not pose the same social and pub­lic health prob­lems asso­ci­at­ed with the opi­ates and coca leaf prod­ucts.’”  NORML v. DEA, 559 F.2d 735, 751 n.7 (D.C. Cir. 1977).

Mar­i­jua­na is the only sub­stance in sched­ule 1 with a long his­to­ry of med­ical use in treat­ment in the Unit­ed States.

First, while Cal­i­for­nia in 1996 became the first of the six­teen states that cur­rent­ly legal­ize med­ical mar­i­jua­na, the his­to­ry of med­ical mar­i­jua­na goes back much fur­ther, so that use for med­ical pur­pos­es was not unthink­able in 1990.  At one time, “almost all States … had excep­tions mak­ing law­ful, under spec­i­fied con­di­tions, pos­ses­sion of mar­i­hua­na by … per­sons for whom the drug had been pre­scribed or to whom it had been giv­en by an autho­rized med­ical per­son.”  Leary v. Unit­ed States, 395 U.S. 6, 17, 89 S. Ct. 1532, 23 L. Ed. 2d 57 (1969).  What’s more, the Fed­er­al gov­ern­ment itself con­duct­ed an exper­i­men­tal med­ical mar­i­jua­na pro­gram from 1978 to 1992, and it con­tin­ues to pro­vide mar­i­jua­na to the sur­viv­ing par­tic­i­pants.  See Conant v. Wal­ters, 309 F.3d 629, 648 (9th Cir. 2002).  The exis­tence of these pro­grams indi­cates that med­ical mar­i­jua­na was not a con­cept utter­ly for­eign to Con­gress before 1996.

James v. Cos­ta Mesa, 700 F.3d 394, 409 (9th Cir. 2012) (Berzon, J., dis­sent­ing).  And, of course, mar­i­jua­na is the only sub­stance in sched­ule 1 that has been accept­ed for med­ical use in treat­ment in any state since 1970.  Mar­i­jua­na now has accept­ed med­ical use in treat­ment in thir­ty-four states and in two fed­er­al juris­dic­tions, DC and Guam.

2.  OUR LEGISLATURE HAS GIVEN THE BOARD EXPLICIT INSTRUCTIONS

Our state leg­is­la­ture has giv­en the board the fol­low­ing instruc­tions.  If a sub­stance has a high poten­tial for abuse, it must be placed in either sched­ule 1 or sched­ule 2.  Iowa Code §§ 124.203(1)(a) and 124.205(1)(a) (2014).  If a sub­stance has accept­ed med­ical use in treat­ment in the Unit­ed States, it can­not be placed in sched­ule 1 and must be placed in one of the oth­er four sched­ules or removed from the sched­ules entire­ly.  Iowa Code §§ 124.203(1)(b) and 124.203(2) (2014).  If a sub­stance has both accept­ed med­ical use in treat­ment in the Unit­ed States with severe restric­tions and a high poten­tial for abuse, then it must be placed in sched­ule 2.  Iowa Code §§ 124.205(1)(a) and 124.205(1)(b) (2014).

This is not the first time the board has con­sid­ered marijuana’s clas­si­fi­ca­tion.  As the result of a peti­tion for mar­i­jua­na sched­ul­ing I filed with the board in 2008, the board held a series of pub­lic hear­ings in four cities across the state.  These hear­ings were prompt­ed by an Iowa Dis­trict Court rul­ing in McMa­hon v. Iowa Board of Phar­ma­cy, Polk Coun­ty No. CVCV007415 (April 21, 2009) (judi­cial review of my 2008 peti­tion for mar­i­jua­na sched­ul­ing).  “Both Sched­ule 1 and Sched­ule 2 con­trolled sub­stances share the same char­ac­ter­is­tic of hav­ing a high poten­tial for abuse.  A find­ing of accept­ed med­ical use for treat­ment in the Unit­ed States alone would be suf­fi­cient to war­rant rec­om­men­da­tion for reclas­si­fi­ca­tion or removal pur­suant to the lan­guage of Iowa Code sec­tion 124.202.”  Id. at 4 n.1.  “The Board must deter­mine whether the evi­dence pre­sent­ed by Peti­tion­er is suf­fi­cient to sup­port a find­ing that mar­i­jua­na has accept­ed med­ical use in the Unit­ed States and does not lack accept­ed safe­ty for use in treat­ment under med­ical super­vi­sion.”  Id. at 5.

The only evi­dence I pre­sent­ed in 2008 was the exis­tence of twelve state laws defin­ing mar­i­jua­na as med­i­cine.  I said that the exis­tence of state laws defin­ing mar­i­jua­na as med­i­cine proves that mar­i­jua­na has accept­ed med­ical use in treat­ment in the Unit­ed States as a mat­ter of law.  The board was obvi­ous­ly uncom­fort­able with accept­ing a legal argu­ment with­out look­ing at the eight fac­tors our leg­is­la­ture has instruct­ed the board to con­sid­er in mak­ing sched­ul­ing deci­sions.  Iowa Code § 124.201(1)(a)-(h) (2014).  The board decid­ed to take input from the pub­lic over a peri­od of four months (from August of 2009 through Novem­ber of 2009) and in four pub­lic hear­ings held in var­i­ous cities across the state.  On Feb­ru­ary 17, 2010, the board vot­ed unan­i­mous­ly to rec­om­mend our leg­is­la­ture remove mar­i­jua­na from state sched­ule 1 in Iowa.

Our state leg­is­la­ture has not autho­rized the board to con­sid­er fed­er­al sched­ul­ing in deter­min­ing whether mar­i­jua­na con­tin­ues to meet the con­di­tions for place­ment in sched­ule 1.  Fed­er­al sched­ul­ing is not one of the eight fac­tors the leg­is­la­ture has instruct­ed the board to con­sid­er.  Iowa Code § 124.201(1)(a)-(h) (2014).  The only instance where the leg­is­la­ture requires the board to con­sid­er fed­er­al sched­ul­ing is when the fed­er­al gov­ern­ment adds a new sub­stance to the fed­er­al sched­ules.  Iowa Code § 124.201(4) (2014).  When the fed­er­al gov­ern­ment does add a new sub­stance to the fed­er­al sched­ules, the board is not legal­ly bound to make that same rec­om­men­da­tion to the Iowa leg­is­la­ture.  Iowa Code § 124.201(4) (2014); 657 IAC 10.37(3).  Sim­i­lar­ly, the Iowa leg­is­la­ture is not legal­ly bound to fol­low fed­er­al sched­ul­ing deci­sions.  Iowa Code § 124.201(4) (2014).  This is no mere acci­dent on the part of our leg­is­la­ture, it is a con­sis­tent pat­tern.

“In our fed­er­al sys­tem, the Nation­al Gov­ern­ment pos­sess­es only lim­it­ed pow­ers; the States and the peo­ple retain the remain­der.”  Bond v. Unit­ed States, 572 U.S. ___, ___, 134 S. Ct. 2077, 2087 189 L. Ed. 2d 1, 10 (2014).  “It is incum­bent upon the fed­er­al courts to be cer­tain of Con­gress’ intent before find­ing that fed­er­al law over­rides the usu­al con­sti­tu­tion­al bal­ance of fed­er­al and state pow­ers.”  Gre­go­ry v. Ashcroft, 501 U.S. 452, 460, 111 S. Ct. 2395, 115 L. Ed. 2d 410 (1991) (quot­ing Atas­cadero State Hos­pi­tal v. Scan­lon, 473 U.S. 234, 243, 105 S. Ct. 3142, 87 L. Ed. 2d 171 (1985).  “Con­gress nor­mal­ly pre­serves ‘the con­sti­tu­tion­al bal­ance between the Nation­al Gov­ern­ment and the States.’”  Bond v. Unit­ed States, 564 U.S. ___, ___, 131 S. Ct. 2355, 2364, 180 L. Ed. 2d 269, 280 (2011).

“The CSA explic­it­ly con­tem­plates a role for the States in reg­u­lat­ing con­trolled sub­stances, as evi­denced by its pre-emp­tion pro­vi­sion.”  Gon­za­les v. Ore­gon, 546 U.S. 243, 251 (2006) [foot­note 1].  “The Attor­ney Gen­er­al has rule­mak­ing pow­er to ful­fill his duties under the CSA.  The spe­cif­ic respects in which he is autho­rized to make rules, how­ev­er, instruct us that he is not autho­rized to make a rule declar­ing ille­git­i­mate a med­ical stan­dard for care and treat­ment of patients that is specif­i­cal­ly autho­rized under state law.”  Id. at 258.  “Con­gress did not del­e­gate to the Attor­ney Gen­er­al author­i­ty to car­ry out or effect all pro­vi­sions of the CSA.  Rather, he can pro­mul­gate rules relat­ing only to ‘reg­is­tra­tion’ and ‘con­trol,’ and ‘for the effi­cient exe­cu­tion of his func­tions’ under the statute.”  Id. at 259.  “As for the fed­er­al law fac­tor, though it does require the Attor­ney Gen­er­al to decide ‘[c]ompliance’ with the law, it does not sug­gest that he may decide what the law says.  Were it oth­er­wise, the Attor­ney Gen­er­al could author­i­ta­tive­ly inter­pret ‘State’ and ‘local laws,’ which are also includ­ed in 21 U.S.C. § 823(f), despite the obvi­ous con­sti­tu­tion­al prob­lems in his doing so.”  Id. at 264.  “The statute and our case law amply sup­port the con­clu­sion that Con­gress reg­u­lates med­ical prac­tice inso­far as it bars doc­tors from using their pre­scrip­tion-writ­ing pow­ers as a means to engage in illic­it drug deal­ing and traf­fick­ing as con­ven­tion­al­ly under­stood.  Beyond this, how­ev­er, the statute man­i­fests no intent to reg­u­late the prac­tice of med­i­cine gen­er­al­ly.  The silence is under­stand­able giv­en the struc­ture and lim­i­ta­tions of fed­er­al­ism, which allow the States ‘great lat­i­tude under their police pow­ers to leg­is­late as to the pro­tec­tion of the lives, limbs, health, com­fort, and qui­et of all per­sons.’  Medtron­ic, Inc. v. Lohr, 518 U.S. 470, 475, 116 S. Ct. 2240, 135 L. Ed. 2d 700 (1996) (quot­ing Met­ro­pol­i­tan Life Ins. Co. v. Mass­a­chu­setts, 471 U.S. 724, 756, 105 S. Ct. 2380, 85 L. Ed. 2d 728 (1985)).”  Id. at 269–270.

“Even though reg­u­la­tion of health and safe­ty is ‘pri­mar­i­ly, and his­tor­i­cal­ly, a mat­ter of local con­cern,’ Hills­bor­ough Coun­ty v. Auto­mat­ed Med­ical Lab­o­ra­to­ries, Inc., 471 U.S. 707, 719, 105 S. Ct. 2371, 85 L. Ed. 2d 714 (1985), there is no ques­tion that the Fed­er­al Gov­ern­ment can set uni­form nation­al stan­dards in these areas.  See Raich, supra, at 9, 125 S. Ct. 2195, 162 L. Ed. 2d 1.  In con­nec­tion to the CSA, how­ev­er, we find only one area in which Con­gress set gen­er­al, uni­form stan­dards of med­ical prac­tice.  Title I of the Com­pre­hen­sive Drug Abuse Pre­ven­tion and Con­trol Act of 1970, of which the CSA was Title II, pro­vides that

‘[The Sec­re­tary], after con­sul­ta­tion with the Attor­ney Gen­er­al and with nation­al orga­ni­za­tions rep­re­sen­ta­tive of per­sons with knowl­edge and expe­ri­ence in the treat­ment of nar­cot­ic addicts, shall deter­mine the appro­pri­ate meth­ods of pro­fes­sion­al prac­tice in the med­ical treat­ment of the nar­cot­ic addic­tion of var­i­ous class­es of nar­cot­ic addicts, and shall report there­on from time to time to the Con­gress.’ § 4, 84 Stat. 1241, cod­i­fied at 42 U.S.C. § 290bb-2a.

“This pro­vi­sion strength­ens the under­stand­ing of the CSA as a statute com­bat­ing recre­ation­al drug abuse, and also indi­cates that when Con­gress wants to reg­u­late med­ical prac­tice in the giv­en scheme, it does so by explic­it lan­guage in the statute.”  Id. at 271–272.

Trans­fer­ring mar­i­jua­na from state sched­ule 1 to state sched­ule 2 does not pro­mote drug abuse, because the poten­tial for abuse of sub­stances in our state sched­ule 1 is iden­ti­cal to the poten­tial for abuse for sub­stances in our state sched­ule 2.  Our state sched­ule 2 does not pro­mote the unau­tho­rized use (abuse) of any con­trolled sub­stance.

Like­wise, our state sched­ule 2 does not cre­ate any pos­i­tive con­flict with fed­er­al law, because it does not autho­rize any­one to use, pre­scribe, or dis­pense any con­trolled sub­stance with­out a fed­er­al license.  Our leg­is­la­ture was not unaware of the 1970 fed­er­al sched­ul­ing scheme when it adopt­ed the Uni­form Con­trolled Sub­stances Act in 1971.  Our state leg­is­la­ture under­stood that state sched­ul­ing can be dif­fer­ent than fed­er­al sched­ul­ing and that is exact­ly what the leg­is­la­ture intend­ed.  This is called due process.

It would be absurd to say that mar­i­jua­na does not have accept­ed med­ical use in treat­ment in the Unit­ed States in the face of thir­ty-four state laws that accept its med­ical use, as well as the two fed­er­al juris­dic­tions of DC and Guam.  Our leg­is­la­ture saw the pos­si­bil­i­ty of this change in cir­cum­stances when it set the con­di­tions for place­ment in state sched­ule 1 back in 1971.

The fed­er­al courts have pro­vid­ed us with instruc­tions on how to inter­pret the fed­er­al con­trolled sub­stances act.  “Nei­ther the statute nor its leg­isla­tive his­to­ry pre­cise­ly defines the term ‘cur­rent­ly accept­ed med­ical use.’”  Alliance for Cannabis Ther­a­peu­tics v. Drug Enforce­ment Admin­is­tra­tion, 930 F.2d 936, 939 (D.C. Cir., 1991).  “Con­gress did not intend ‘accept­ed med­ical use in treat­ment in the Unit­ed States’ to require a find­ing of rec­og­nized med­ical use in every state or, as the Admin­is­tra­tor con­tends, approval for inter­state mar­ket­ing of the sub­stance.”  Grin­spoon v. DEA, 828 F.2d 881, 886 (1st Cir. 1987).

3.  IOWA’S SCHEDULES ARE NOT IDENTICAL TO THE FEDERAL SCHEDULES

Our state sched­ule 3 includes prod­ucts con­tain­ing nat­ur­al dron­abi­nol (derived from the cannabis plant), which are in fed­er­al sched­ule 1.  Iowa Code § 124.208(9) (2014)2008 Iowa Acts Chap­ter 1010 § 4 (March 5, 2008).  Although the fed­er­al gov­ern­ment has pro­posed a rule to trans­fer prod­ucts con­tain­ing nat­ur­al dron­abi­nol (derived from the cannabis plant) from fed­er­al sched­ule 1 to fed­er­al sched­ule 3, this rule has nev­er been final­ized.  See Fed­er­al Reg­is­ter, Vol. 75, No. 210 / Mon­day, Novem­ber 1, 2010 / Pro­posed Rules, at page 67054, “List­ing of Approved Drug Prod­ucts Con­tain­ing Dron­abi­nol in Sched­ule III,” (“Dron­abi­nol is a name of a par­tic­u­lar iso­mer of a class of chem­i­cals known as tetrahy­dro­cannabi­nols (THC).  Specif­i­cal­ly, dron­abi­nol is the Unit­ed States Adopt­ed Name (USAN) for the (-)-iso­mer of [Delta]\9\-(trans)-tetrahydrocannabinol [(-)-[Delta]\9\-(trans)-THC], which is believed to be the major psy­choac­tive com­po­nent of the cannabis plant (mar­i­jua­na).”  Id. at page 67055).  Our leg­is­la­ture approved this change over 2 years before the fed­er­al gov­ern­ment even pro­posed mak­ing the same change in the fed­er­al sched­ules.  As of this time, the fed­er­al gov­ern­ment still clas­si­fies prod­ucts con­tain­ing nat­u­ral­ly derived dron­abi­nol as fed­er­al sched­ule 1 sub­stances.

The incon­sis­ten­cy between state and fed­er­al sched­ul­ing does not cre­ate any pos­i­tive con­flict between our state and fed­er­al law.  No fed­er­al law is bro­ken when a state reclas­si­fies a con­trolled sub­stance to a dif­fer­ent sched­ule than the fed­er­al gov­ern­ment.  States are not required to have the same sched­ules or even the same cri­te­ria for inclu­sion in the sched­ules.  See, for exam­ple, State v. Eells, 72 Or. App. 492, 696 P.2d 564 (1985), review denied by 299 Ore. 313, 702 P.2d 1110 (1985) (“Although Or. Rev. Stat. § 475.005(6) states that a con­trolled sub­stance is defined by ref­er­ence to the sched­ules under the Fed­er­al Con­trolled Sub­stances Act, 21 USC §§ 811 to 812, the statute does not adopt the fed­er­al cri­te­ria, as Ore­gon has its own stan­dards for amend­ment of the sched­ule, as set out in Or. Rev. Stat. § 475.035”).

4.  STATE MEDICAL MARIJUANA LAWS ARE NOT PREEMPTED BY FEDERAL LAW UNLESS THEY SPECIFICALLY REQUIRE THE VIOLATION OF FEDERAL LAW

A state can cre­ate exemp­tions from its crim­i­nal laws with­out vio­lat­ing any fed­er­al law.  New York v. Unit­ed States, 505 U.S. 144, 120 L. Ed. 2d 120, 112 S. Ct. 2408 (1992), and Printz v. Unit­ed States, 521 U.S. 898, 138 L. Ed. 2d 914, 117 S. Ct. 2365 (1997).  Exempt­ing med­ical use of mar­i­jua­na is unique because of the rea­son giv­en for the exemp­tion, “med­ical use.”  “Sim­i­lar­ly, here, there is no con­flict based on the fact that Con­gress has cho­sen to pro­hib­it the pos­ses­sion of med­ical mar­i­jua­na, while Cal­i­for­nia has cho­sen not to.”  Gar­den Grove v. Supe­ri­or Court, 157 Cal.App.4th 355, 385, 68 Cal.Rptr.3d 656, 677 (2007), cert. denied, 555 U.S. 1044, 129 S. Ct. 623, 172 L. Ed. 2d 607 (2008).  “We fur­ther con­clude, as to the lim­it­ed pro­vi­sions of the MMP that Coun­ties may chal­lenge, those pro­vi­sions do not pos­i­tive­ly con­flict with the CSA, and do not pose any added obsta­cle to the pur­pos­es of the CSA not inher­ent in the dis­tinct pro­vi­sions of the exemp­tions from pros­e­cu­tion under California’s laws, and there­fore those lim­it­ed pro­vi­sions of the MMP are not pre­empt­ed.”  San Diego Coun­ty v. San Diego NORML, 165 Cal.App.4th 798, 809, 81 Cal.Rptr.3d 461, 468 (2008), cert. denied, 556 U.S. 1235, 129 S. Ct. 2380, 173 L. Ed. 2d 1293 (2009).  “Thus, it appears Jus­tice Scalia’s inter­pre­ta­tion sug­gests a state law is pre­empt­ed by a fed­er­al ‘pos­i­tive con­flict’ clause, like 21 U.S.C. sec­tion 903, only when the state law affir­ma­tive­ly requires acts vio­lat­ing the fed­er­al pro­scrip­tion.” Id., 165 Cal.App.4th at 821, 81 Cal.Rptr.3d at 477.

Coun­ties appear to argue there is a pos­i­tive con­flict between the iden­ti­fi­ca­tion laws and the CSA because the card issued by a coun­ty con­firms that its bear­er may vio­late or is immu­nized from fed­er­al laws.  How­ev­er, the appli­ca­tions for the card express­ly state the card will not insu­late the bear­er from fed­er­al laws, and the card itself does not imply the hold­er is immune from pros­e­cu­tion for fed­er­al offens­es; instead, the card mere­ly iden­ti­fies those per­sons Cal­i­for­nia has elect­ed to exempt from California’s sanc­tions.  (Cf. U.S. v. Cannabis Cul­ti­va­tors Club (N.D.Cal. 1998) 5 F.Supp.2d 1086, 1100 [Cal­i­for­ni­a’s CUA ‘does not con­flict with fed­er­al law because on its face it does not pur­port to make legal any con­duct pro­hib­it­ed by fed­er­al law; it mere­ly exempts cer­tain con­duct by cer­tain per­sons from the Cal­i­for­nia drug laws’].)  Because the CSA law does not com­pel the states to impose crim­i­nal penal­ties for mar­i­jua­na pos­ses­sion, the require­ment that coun­ties issue cards iden­ti­fy­ing those against whom Cal­i­for­nia has opt­ed not to impose crim­i­nal penal­ties does not pos­i­tive­ly con­flict with the CSA.

Id., 165 Cal.App.4th at 825–826, 81 Cal.Rptr.3d at 481.

The Med­ical Cannabid­i­ol act that became effec­tive in Iowa on July 1, 2014, does not require any­one to vio­late any fed­er­al law.  641 IAC 154 (2014).  “A neu­rol­o­gist who has exam­ined and treat­ed a patient suf­fer­ing from intractable epilep­sy may pro­vide, but has no duty to pro­vide, a writ­ten rec­om­men­da­tion for the patient’s med­ical use of cannabid­i­ol to treat or alle­vi­ate symp­toms of intractable epilep­sy …”  Iowa Admin. Code 641–154.2(1) (2014).  A doctor’s “rec­om­men­da­tion” is not a “pre­scrip­tion” and is pro­tect­ed by the First Amendment’s pro­tec­tion of Free­dom of Speech.  Conant v. Wal­ters, 309 F.3d 629 (9th Cir. 2002), cert. denied, Wal­ters v. Conant, 540 U.S. 946, 124 S. Ct. 387, 157 L. Ed. 2d 276 (2003).

Our deci­sion is con­sis­tent with prin­ci­ples of fed­er­al­ism that have left states as the pri­ma­ry reg­u­la­tors of pro­fes­sion­al con­duct.  See Whalen v. Roe, 429 U.S. 589, 603 n. 30, 51 L. Ed. 2d 64, 97 S. Ct. 869 (1977) (rec­og­niz­ing states’ broad police pow­ers to reg­u­late the admin­is­tra­tion of drugs by health pro­fes­sion­als); Lin­der v. Unit­ed States, 268 U.S. 5, 18, 69 L. Ed. 819, 45 S. Ct. 446 (1925) (“direct con­trol of med­ical prac­tice in the states is beyond the pow­er of the fed­er­al gov­ern­ment”).  We must “show[] respect for the sov­er­eign States that com­prise our Fed­er­al Union.  That respect impos­es a duty on fed­er­al courts, when­ev­er pos­si­ble, to avoid or min­i­mize con­flict between fed­er­al and state law, par­tic­u­lar­ly in sit­u­a­tions in which the cit­i­zens of a State have cho­sen to serve as a lab­o­ra­to­ry in the tri­al of nov­el social and eco­nom­ic exper­i­ments with­out risk to the rest of the coun­try.” Oak­land Cannabis, 532 U.S. at 501 (Stevens, J., con­cur­ring) (inter­nal quo­ta­tion marks omit­ted).

Id. at 639.  In Iowa, a pre­scrip­tion drug is defined as, “A sub­stance for which fed­er­al or state law requires a pre­scrip­tion before it may be legal­ly dis­pensed to the pub­lic.”  Iowa Code § 155A.3(37)(a).

a.  In a pros­e­cu­tion for the unlaw­ful pos­ses­sion of mar­i­jua­na under the laws of this state, includ­ing but not lim­it­ed to chap­ters 124 and 453B, it is an affir­ma­tive and com­plete defense to the pros­e­cu­tion that the patient has been diag­nosed with intractable epilep­sy, used or pos­sessed cannabid­i­ol pur­suant to a rec­om­men­da­tion by a neu­rol­o­gist as autho­rized under this chap­ter, and, for a patient eigh­teen years of age or old­er, is in pos­ses­sion of a valid cannabid­i­ol reg­is­tra­tion card.

b.  In a pros­e­cu­tion for the unlaw­ful pos­ses­sion of mar­i­jua­na under the laws of this state, includ­ing but not lim­it­ed to chap­ters 124 and 453B, it is an affir­ma­tive and com­plete defense to the pros­e­cu­tion that the per­son pos­sessed cannabid­i­ol because the per­son is a pri­ma­ry care­giv­er of a patient who has been diag­nosed with intractable epilep­sy and is in pos­ses­sion of a valid cannabid­i­ol reg­is­tra­tion card, and where the pri­ma­ry caregiver’s pos­ses­sion of the cannabid­i­ol is on behalf of the patient and for the patient’s use only as autho­rized under this chap­ter.

2014 Iowa Acts Chap­ter 1125 § 7 (May 30, 2014).  Nowhere in the Iowa Med­ical Cannabid­i­ol Act of 2014 does it require or autho­rize any vio­la­tion of fed­er­al law.

5.  STATE RESCHEDULING DOES NOT MAKE MARIJUANA LEGAL IN IOWA – EVEN A CORRESPONDING CHANGE IN FEDERAL SCHEDULING WOULD NOT AUTOMATICALLY MAKE IT LEGAL IN IOWA

Remov­ing mar­i­jua­na from sched­ule 1 in Iowa will not make it legal for a med­ical prac­ti­tion­er to pre­scribe it and it will not make it legal for a phar­ma­cist to dis­pense it.  Take opi­um plants and coca plants for an exam­ple.  Both of those plants are in both state and fed­er­al sched­ule 2, yet there is no law that makes it legal to pre­scribe those plants in Iowa.

Iowa law does not allow the pre­scrip­tion of any sub­stance in fed­er­al sched­ule 1 in Iowa (with the lim­it­ed excep­tion of an FDA approved research study).  Iowa law also pre­vents the dis­pens­ing of any sub­stance in fed­er­al sched­ule 1 in Iowa (with the lim­it­ed excep­tion of an FDA approved research study).  Iowa Code §§ 124.303(1)©, 124.303(1)(f), 124.303(3), 124.303(4), 124.304(1)(b), 124.304(1)©, 124.307 (2014).

In order to prac­tice med­i­cine in Iowa a prac­ti­tion­er must com­ply with fed­er­al law to main­tain a license in Iowa. Iowa Code §§ 148.6(b), 148.6©, 148.6(d).

In order to prac­tice phar­ma­cy in Iowa a phar­ma­cist must com­ply with fed­er­al law to main­tain a license in Iowa.  Iowa Code §§ 155A.15(2)(a), 155A.6(3), 155A.6A(1), 155A.6A(5), 155A.6B(1), 155A.6B(5), 155A.15(2)(a), 155A.15(2)(i), 155A.17(2),155A.24(1)(b), 155A.26, 155A.27(1)(f), 155A.42(4); 657 IAC 10.12(1)©, 657 IAC 10.12(4)©, 657 IAC 10.12(4)(f).

6.  OTHER PLANTS WE USE TO MAKE MEDICINE ARE NOT IN SCHEDULE 1

Both opi­um plants and coca plants are in Iowa sched­ule 2, and nei­ther of these two plants are approved for pre­scrip­tion under either state law or fed­er­al law.  These two plants, opi­um and coca, are the source mate­r­i­al for pre­scrip­tion drugs, mor­phine and cocaine, that are derived from the plants.  Iowa now rec­og­nizes med­ical use of two sub­stances made from mar­i­jua­na plants, cannabid­i­ol (mar­i­jua­na extract) and dron­abi­nol (mar­i­jua­na extract).  Both of these plant based extracts are in fed­er­al sched­ule 1, which says they have no accept­ed med­ical use in treat­ment in the Unit­ed States, and, yet, Iowa is a state in the Unit­ed States which accepts both of them for med­ical use.  Cannabid­i­ol is now rec­og­nized by Iowa law as a med­i­cine.  Dron­abi­nol (nat­u­ral­ly derived from the mar­i­jua­na plant) is in state sched­ule 3 in Iowa, which by def­i­n­i­tion means it has accept­ed use for med­ical treat­ment in the Unit­ed States (because Iowa is “in the Unit­ed States”).  Iowa Code §§ 124.207(1)(b), 124.208(9).

7.  PRECEDENT

This board ruled unan­i­mous­ly in 2010 that mar­i­jua­na should be trans­ferred from state sched­ule 1 to state sched­ule 2.  That rul­ing stands as prece­dent as long new infor­ma­tion does not negate the 2010 rul­ing.  Iowa Code 17A.19(10)(h).  In order to reverse posi­tion, the board would have to explain why the evi­dence now shows that mar­i­jua­na is cor­rect­ly sched­uled in Iowa.  The pro­posed rul­ing from the sub­com­mit­tee says the evi­dence that mar­i­jua­na has med­ical use has only got­ten stronger, not weak­er, since 2010.  Pri­or to 2010, the board has nev­er take any posi­tion on whether mar­i­jua­na is sched­uled cor­rect­ly in Iowa.

8.  CONCLUSION

State admin­is­tra­tive agen­cies must fol­low state law.  State admin­is­tra­tive agen­cies can­not dis­re­gard the instruc­tions of our leg­is­la­ture.  Our state law rec­og­nizes marijuana’s med­ical use for both the pro­duc­tion of dron­abi­nol and the pro­duc­tion of cannabid­i­ol, which requires that mar­i­jua­na be removed from state sched­ule 1.  There is no vio­la­tion of fed­er­al law by remov­ing mar­i­jua­na from state sched­ule 1, and, there­fore, it is required by our state law unless there new evi­dence show­ing that mar­i­jua­na is sched­uled cor­rect­ly in Iowa.

Because mar­i­jua­na now has accept­ed med­ical use in treat­ment in thir­ty-four states (includ­ing Iowa), and two fed­er­al juris­dic­tions, DC and Guam, the board is bound by law to rec­og­nize that mar­i­jua­na now has accept­ed med­ical use in treat­ment in the Unit­ed States and must be removed from state sched­ule 1.

Thank you for con­sid­er­ing my peti­tion.  If there is any­thing fur­ther I can assist you with in mak­ing your deci­sion on Jan­u­ary 5, 2015, please let me know.

 

Carl Olsen

130 E. Auro­ra Ave.

Des Moines, Iowa 50313–3654

515–343-9933

carl-olsen@mchsi.com

[foot­note 1] “No pro­vi­sion of this sub­chap­ter shall be con­strued as indi­cat­ing an intent on the part of the Con­gress to occu­py the field in which that pro­vi­sion oper­ates, includ­ing crim­i­nal penal­ties, to the exclu­sion of any State law on the same sub­ject mat­ter which would oth­er­wise be with­in the author­i­ty of the State, unless there is a pos­i­tive con­flict between that pro­vi­sion of this sub­chap­ter and that State law so that the two can­not con­sis­tent­ly stand togeth­er.” 21 U.S.C. § 903 (Pub. L. 91–513, title II, §708, Oct. 27, 1970, 84 Stat. 1284).