The Elephant We Don’t Talk About

Iowans for Med­ical Mar­i­jua­na

The Iowa Med­ical Cannabid­i­ol Act of 2017
(and the ele­phant in the room we don’t want to talk about)

June 26, 2017

On April 22, 2017, the Iowa leg­is­la­ture passed the Med­ical Cannabid­i­ol Act, H.F. 524.  The Med­ical Cannabid­i­ol Act of 2017 was signed into law on May 12, 2017, by Gov­er­nor Ter­ry E. Branstad.

Sec­tion 9(1)(a) of the Act, Iowa Code § 124E.5(1)(a) (2017), autho­rizes the Iowa Depart­ment of Pub­lic Health to license “up to two med­ical cannabid­i­ol man­u­fac­tur­ers to man­u­fac­ture and to pos­sess, cul­ti­vate, har­vest, trans­port, pack­age, process, or sup­ply med­ical cannabid­i­ol with­in this state.”

What the Med­ical Cannabid­i­ol Act of 2017 fails to men­tion is whether grow­ing mar­i­jua­na to man­u­fac­ture cannabis prod­ucts is con­sis­tent with exist­ing fed­er­al law.  Penal­ties for grow­ing cannabis are quite severe, with penal­ties rang­ing from 5 years in prison to a pos­si­ble life sen­tence and fines rang­ing from $250,000 to $50 mil­lion.[1]

While Iowa House Speak­er Lin­da Upmey­er has sug­gest­ed that fed­er­al pol­i­cy might con­tin­ue to over­look state med­ical mar­i­jua­na pro­grams under the Trump Admin­is­tra­tion, recent state­ments from the Unit­ed States Attor­ney Gen­er­al, Jeff Ses­sions, have indi­cat­ed oth­er­wise.[2]

Recent rul­ings from the Supreme Court of Col­orado high­light this incon­sis­ten­cy.  Coats v. Dish Net­work, 350 P.3d 849, 850 (Col­orado 2015) (“an activ­i­ty such as med­ical mar­i­jua­na use that is unlaw­ful under fed­er­al law is not a ‘law­ful’ activ­i­ty under sec­tion 24–34-402.5”); Peo­ple v. Crouse, 388 P.3d 39, 43 (Col­orado 2017) (“Con­sis­tent with our hold­ing in Coats, then, we again find that con­duct is ‘law­ful’ only if it com­plies with both fed­er­al and state law.”)

 

Fed­er­al Law

Fed­er­al law does not pro­hib­it the med­ical use of mar­i­jua­na.  Fed­er­al law depends upon the clas­si­fi­ca­tion a con­trolled sub­stance is placed in.  Ini­tial place­ment of mar­i­jua­na was decid­ed by Con­gress in 1970, but cur­rent place­ment of mar­i­jua­na is an admin­is­tra­tive process under fed­er­al law.[3]

 

Ini­tial Clas­si­fi­ca­tion of Mar­i­jua­na by Con­gress

The Con­trolled Sub­stances Act of 1970, Pub­lic Law 91–513, cre­at­ed the Nation­al Com­mis­sion on Mar­i­hua­na and Drug Abuse to study mar­i­jua­na abuse in the Unit­ed States.  While the Con­trolled Sub­stances Act was being draft­ed in a House com­mit­tee in 1970, Assis­tant Sec­re­tary of Health Roger O. Ege­berg had rec­om­mend­ed that mar­i­jua­na tem­porar­i­ly be placed in Sched­ule I, the most restric­tive cat­e­go­ry of drugs, pend­ing the Commission’s report.  See 21 U.S.C. § 812©, Sched­ule 1©(10) (1970).  On March 22, 1972, the Commission’s chair­man, Ray­mond P. Shafer, pre­sent­ed a report to Con­gress and the pub­lic enti­tled “Mar­i­hua­na, A Sig­nal of Mis­un­der­stand­ing,” which favored end­ing mar­i­jua­na pro­hi­bi­tion and adopt­ing oth­er meth­ods to dis­cour­age use.

 

Fed­er­al Admin­is­tra­tive Process

Con­gress autho­rized the Attor­ney Gen­er­al to keep the clas­si­fi­ca­tions cur­rent.  The Attor­ney Gen­er­al of the Unit­ed States, in con­junc­tion with the Sec­re­tary of Health and Human Ser­vices, may add sub­stances to, trans­fer sub­stances between, or remove sub­stances from the clas­si­fi­ca­tions.  See 21 U.S.C. § 811(a) (1970).  The Drug Enforce­ment Admin­is­tra­tion is del­e­gat­ed by the Depart­ment of Jus­tice to per­form this func­tion, in con­junc­tion with the Food and Drug Admin­is­tra­tion which is del­e­gat­ed by the Depart­ment of Health and Human Ser­vices for this pur­pose.  See 21 U.S.C. § 811(b) (1970).

 

Fed­er­al­ism

The U.S. Con­sti­tu­tion, as well as the Iowa Con­sti­tu­tion, divides our gov­ern­ment into three branch­es.  The leg­isla­tive branch makes the laws.  The exec­u­tive branch enforces the laws.  The judi­cial branch resolves ques­tions about the con­sti­tu­tion­al­i­ty of a law and can over­rule a law in whole or in part.  The judi­cial branch can also enforce cor­rec­tive action if the exec­u­tive branch (an admin­is­tra­tive agency or the chief exec­u­tive) does not inter­pret the law cor­rect­ly.

Fed­er­al­ism is the oth­er fun­da­men­tal prin­ci­ple in our dual sys­tem of gov­ern­ment.  The states gave up some of their author­i­ty in order to form the fed­er­al union and the fed­er­al union must respect the indi­vid­ual sov­er­eign­ty of the states.  In every sit­u­a­tion, the ques­tion is how much state author­i­ty has been removed and how much has been retained.  When Con­gress makes a law, Con­gress may, or may not, explain clear­ly where the lines are drawn.

 

Con­tex­tu­al Analy­sis

The Med­ical Cannabid­i­ol Act of 2017 says mar­i­jua­na has med­ical use in the state of Iowa (for mak­ing an extract) and there is an out­dat­ed fed­er­al reg­u­la­tion that says mar­i­jua­na has no med­ical use in the states.  It might seem like a sim­ple ques­tion of who has the greater author­i­ty, a state or a fed­er­al admin­is­tra­tive agency.  But, Con­gress can autho­rize a fed­er­al admin­is­tra­tive agency to inter­fere with state law, so the analy­sis starts with the ques­tion of whether Con­gress autho­rized the Attor­ney Gen­er­al to inter­fere with state med­ical mar­i­jua­na laws.

To begin the analy­sis, fed­er­al courts have deter­mined that accept­ed med­ical use of a con­trolled sub­stance in the Unit­ed States can exist with­out fed­er­al inter­state mar­ket­ing approval.

Grin­spoon v. DEA, 828 F.2d 881, 886 (1st Cir. 1987):

We add, more­over, that the Administrator’s clever argu­ment con­ve­nient­ly omits any ref­er­ence to the fact that the per­ti­nent phrase in sec­tion 812(b)(1)(B) reads “in the Unit­ed States,” (empha­sis sup­plied).  We find this lan­guage to be fur­ther evi­dence that the 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, 887 (1st Cir. 1987):

Unlike the CSA sched­ul­ing restric­tions, the FDCA inter­state mar­ket­ing pro­vi­sions do not apply to drugs man­u­fac­tured and mar­ket­ed whol­ly intrastate.  Com­pare 21 U.S.C. § 801(5) with 21 U.S.C. § 321 (b), 331, 355(a).  Thus, it is pos­si­ble that a sub­stance may have both an accept­ed med­ical use and safe­ty for use under med­ical super­vi­sion, even though no one has deemed it nec­es­sary to seek approval for inter­state mar­ket­ing.

This may seem like a dumb ques­tion, but how do we know whether med­ical use of mar­i­jua­na has been accept­ed?  After the rul­ing in Grin­spoon, the fed­er­al courts and the admin­is­tra­tive agency began to address this ques­tion.

Alliance for Cannabis Ther­a­peu­tics v. DEA, 930 F.2d 936, 939 (D.C. Cir. 1991):

The dif­fi­cul­ty we find in peti­tion­ers’ argu­ment is that nei­ther the statute nor its leg­isla­tive his­to­ry pre­cise­ly defines the term “cur­rent­ly accept­ed med­ical use”; there­fore, we are oblig­ed to defer to the Administrator’s inter­pre­ta­tion of that phrase if rea­son­able.

Mar­i­jua­na Sched­ul­ing Peti­tion, DEA Dock­et No. 86–22, 57 Fed. Reg. 10499 (March 26, 1992) 10506:

Clear­ly, the Con­trolled Sub­stances Act does not autho­rize the Attor­ney Gen­er­al, nor by del­e­ga­tion the DEA Admin­is­tra­tor, to make the ulti­mate med­ical and pol­i­cy deci­sion as to whether a drug should be used as med­i­cine.  Instead, he is lim­it­ed to deter­min­ing whether oth­ers accept a drug for med­ical use.  Any oth­er con­struc­tion would have the effect of read­ing the word “accept­ed” out of the statu­to­ry stan­dard.

The answer as to who decides whether a sub­stance has accept­ed med­ical use was con­clu­sive­ly deter­mined by the fed­er­al courts in 2006.

Gon­za­les v. Ore­gon, 546 U.S. 243, 258 (2006):

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.

 

State Law

The Iowa Med­ical Cannabid­i­ol Act of 2017, H.F. 524, Sec­tion 5(6), Iowa Code § 124E.2(6) (2017), defines “med­ical cannabid­i­ol” as “any phar­ma­ceu­ti­cal grade cannabi­noid found the plant Cannabis … that has a tetrahy­dro­cannabi­nol lev­el of no more than three per­cent …”  The Act specif­i­cal­ly autho­rizes cul­ti­va­tion and har­vest­ing of mar­i­jua­na plants for the pur­pose of man­u­fac­tur­ing med­ical cannabid­i­ol.  See H.F. 524, Sec­tion 9(1)(a), Iowa Code § 124E.5(1)(a) (2017).

Because states deter­mine “accept” med­ical use, mar­i­jua­na plants “specif­i­cal­ly autho­rized” for med­ical use are “accept­ed” for med­ical use with­in the mean­ing of the fed­er­al Con­trolled Sub­stances Act.

 

The Ele­phant in the Room

H.F. 524 fails to remove mar­i­jua­na from Iowa sched­ule 1, which says mar­i­jua­na has no accept­ed med­ical use in treat­ment in the Unit­ed States.  Iowa Code § 124.204(4)(m) (2017); Iowa Code § 124.203(1)(b) (2017).

This house­keep­ing mat­ter has been over­looked and it can have trag­ic con­se­quences.  The Iowa Sen­ate bill that passed by a vote of 45–5 on April 17, 2017, includ­ed the Iowa Board of Pharmacy’s rec­om­men­da­tion on Feb­ru­ary 17, 2010, that mar­i­jua­na should be removed from Iowa sched­ule 1.  This was care­less­ly stripped out of the House ver­sion.  The House ver­sion, H.F. 524, wasn’t pub­licly avail­able until 3:00 a.m. on the morn­ing after the day the leg­is­la­ture was sched­uled to adjourn for the year.  It was passed in the Iowa House at 5:30 a.m. and in the Iowa Sen­ate at 6:30 a.m.  This was not a care­ful­ly thought out, or care­ful­ly delib­er­at­ed, process.

 

Com­par­ing Clas­si­fi­ca­tions

A care­ful read­ing of both the state and fed­er­al drugs laws reveals that we don’t put plants with med­ical use in sched­ule 1.[4]

 

Mar­i­jua­na has Med­ical Use in 46 States

Since 1996, four years after the DEA issued it inter­pre­tive rule in 1992, thir­ty states have accept­ed the med­ical use of mar­i­jua­na, and anoth­er six­teen states have accept­ed the med­ical use of mar­i­jua­na extract (cannabid­i­ol), bring­ing the total to 46 out of 50 states that now depend on access to mar­i­jua­na for med­ical use or for mak­ing extracts for med­ical use.  In addi­tion, DC, Puer­to Rico, and Guam have accept­ed the med­ical use of mar­i­jua­na.

Con­tin­ued place­ment of mar­i­jua­na in sched­ule 1 is both pro­hib­i­tive and unlaw­ful.

 

Con­clu­sion

As the Supreme Court of Col­orado has shown, state law must explain how it com­plies with exist­ing fed­er­al law.  Fail­ure to address clas­si­fi­ca­tion of mar­i­jua­na in H.F. 524 leaves Iowa patients at risk of los­ing access to cannabid­i­ol, and puts grow­ers at risk of fed­er­al penal­ties up to life in prison and fines up to $50 mil­lion.  The leg­is­la­ture must address this mat­ter when it recon­venes in 2018.

 

Carl Olsen, Exec­u­tive Direc­tor
Iowans for Med­ical Mar­i­jua­na, Iowa Busi­ness No. 334412
Post Office Box 41381, Des Moines, Iowa 50311–0507
http://www.iowamedicalmarijuana.org/

 

[1] Fed­er­al Penal­ties

21 U.S.C. § 841(b)(1)(A)(vii) (2017)
1000 kilo­grams (2204.62 pounds / 1.10231 tons) or more of a mix­ture or sub­stance con­tain­ing a detectable amount of mar­i­hua­na, or 1,000 or more mar­i­hua­na plants regard­less of weight
$10/50 mil­lion — 10 years to life in prison

21 U.S.C. § 841(b)(1)(B)(vii) (2017)
100 kilo­grams (220.462 pounds / 0.110231 tons) or more of a mix­ture or sub­stance con­tain­ing a detectable amount of mar­i­hua­na, or 100 or more mar­i­hua­na plants regard­less of weight
$5/25 mil­lion — 5 to 40 years in prison

21 U.S.C. § 841(b)(1)© (2017)
50 to 99 kilo­grams or 50 to 99 plants
$1/5 mil­lion — up to 20 years in prison

21 U.S.C. § 841(b)(1)(D) (2017)
less than 50 kilo­grams of mar­i­hua­na, except in the case of 50 or more mar­i­hua­na plants regard­less of weight, 10 kilo­grams of hashish, or one kilo­gram of hashish oil,
$250,000/$1 mil­lion — up to 5 years in prison

 

[2] Media Reports

March 27, 2017, KGLO Radio, Mason City, Iowa, “Upmey­er says leg­is­la­tors work­ing on med­ical mar­i­jua­na issue.”

June 13, 2017, The Cannabist, an edi­tion of the Den­ver Post, Den­ver, Col­orado, “Jeff Ses­sions has asked Con­gress to allow him to pros­e­cute med­ical mar­i­jua­na providers.”

June 16, 2017, Globe Gazette, Mason City, Iowa, “Ses­sions wants flex­i­bil­i­ty to pros­e­cute Iowa med­ical mar­i­jua­na pro­gram.”

June 23, 2017, Quad City Times, Dav­en­port, Iowa, “Edi­to­r­i­al: Jeff Ses­sions eyes pot crack­down on Iowa, Illi­nois.”

 

[3] Fed­er­al Clas­si­fi­ca­tions

Sched­ule 1
21 U.S.C. § 812(b)(1) (2017)
no med­ical use and high poten­tial for abuse with­out con­sid­er­a­tion for phys­i­cal or psy­cho­log­i­cal depen­dence.

Sched­ule 2
21 U.S.C. § 812(b)(2) (2017)
med­ical use with high poten­tial for abuse with phys­i­cal depen­dence and high psy­cho­log­i­cal depen­dence.

Sched­ule 3
21 U.S.C. § 812(b)(3) (2017)
med­ical use with low to mod­er­ate phys­i­cal depen­dence and high psy­cho­log­i­cal depen­dence

Sched­ule 4
21 U.S.C. § 812(b)(4) (2017)
med­ical use with phys­i­cal depen­dence and psy­cho­log­i­cal depen­dence less than sched­ule 3

Sched­ule 5
21 U.S.C. § 812(b)(5) (2017)
med­ical use with phys­i­cal depen­dence and psy­cho­log­i­cal depen­dence less than sched­ule 4

 

[4] Clas­si­fi­ca­tion Com­par­isons

Sched­ule 1
Iowa Code § 124.204(4)(m) (2017) Mar­i­jua­na

Sched­ule 2
Iowa Code § 124.206(2)(a)(1) (2017) Raw Opi­um
Iowa Code § 124.206(2)(a)(7) (2017) Codeine
Iowa Code § 124.206(2)(a)(10) (2017) Hydrocodone
Iowa Code § 124.206(2)(a)(13) (2017) Mor­phine
Iowa Code § 124.206(2)© (2017) Opi­um Pop­py and Pop­py Straw

Sched­ule 3
Iowa Code § 124.208(5)(a)(1) (2017) Codeine
Iowa Code § 124.208(5)(a)(2) (2017) Codeine
Iowa Code § 124.208(5)(a)(3) (2017) Hydrocodone
Iowa Code § 124.208(5)(a)(4) (2017) Hydrocodone
Iowa Code § 124.208(5)(a)(5) (2017) Hydrocodone
Iowa Code § 124.208(5)(a)(7) (2017) Opi­um

Sched­ule 5
Iowa Code § 124.212(2)(a) (2017) Codeine
Iowa Code § 124.212(2)(b) (2017) Hydrocodone
Iowa Code § 124.212(2)(e) (2017) Opi­um

 

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