That move illustrates the hesitation among board members to expand the program without further knowledge of its potential impact.

Members of the Iowa Medical Cannabidiol Board approved a set of recommendations to state lawmakers ahead of the 2020 legislative session that includes a proposal to remove the 3 percent cap on THC in products and replace it with a purchase limit of 4.5 grams of THC over 90 days.

Under Iowa law, medical marijuana products must not contain more than 3 percent THC, or tetrahydrocannabinol, which is the psychoactive component of cannabis.

Board member Dr. Stephen Richards, a Spirit Lake pharmacist and board member, charged Rep. John Forbes, D-Urbandale, who was present during the meeting, to pass the limit during the board meeting on Friday.

“Give us that policy,” Richards said in the meeting. “Put it in play and give ability us to provide (these products) to people, but know that we’re not potentially causing harm.”

He added, “Do the right thing and be careful about the THC you’re asking for.”

The purchase limit would not apply to the terminally ill. The limit also could be increased by the certifying health care provider without board approval.

Gov. Kim Reynolds referred to the board’s opinion in her veto of House File 732. That legislation, passed earlier this year, would have removed the 3 percent THC cap and instead limit the amount of medical cannabis a patient can have to 25 grams over 90 days.

“This change was not recommended by the board,” Reynolds said in a statement at the time of her veto in June. “And if approved, it would drastically expand Iowa’s medical CBD program far beyond its original scope of CBD-based treatments and could open the door to significant unintended consequences to the health and safety of Iowans.”

The eight members on the Iowa Medical Cannabidiol Board — who met on Friday on the Des Moines Area Community College campus in Ankeny — are appointed to the board by the governor.

Richards said in an interview after the meeting that he does not want to expand THC access to Iowans at this time because “there’s not a lot of good evidence out there about what a safe THC level is.”

“We do what we do so we don’t potentially cause harm,” he said.

COMPANIES BACK PURCHASE LIMIT OVER THC CAP IN PRODUCTS

Several forces have been pushing to remove the THC cap, including companies seeking to profit from the expansion and those in support of creating an avenue to a recreational program in Iowa, said Dr. Lonny Miller, board member and a family practice doctor from Creston.

“Because this is a medical cannabidiol program with the medical advisory board, it’s incumbent upon us to do our due diligence to make it the best program that we can,” Miller said in an interview with The Gazette.

Rep. Forbes said he had concerns for the potential affect a 4.5 gram purchase limit could have on certain patients, particularly those who rely on high amounts of THC to deal with chronic pain.

Lucas Nelson, MedPharm general manager, said in an interview earlier this week some patients taking medical cannabis to manage their chronic pain need at least 200 milligrams a day. The recommended purchase limit would limit patients to about 50 milligrams a day.

“They would have to go back to those patients and say, ‘I’m sorry, but now you can only get 50 milligrams per day,’” Forbes told The Gazette after the meeting. “So what that will do is, if you’ve got a patient that’s 150 to 200 milligrams a day, they’re going to drop off the program.”

Forbes also expressed concern for what that would mean for the two for-profit medical marijuana manufacturers operating in the state — Iowa Relief in Cedar Rapids and Des Moines-based MedPharm.

BOARD BACKS PTSD AS CONDITION TO RECEIVE MEDICAL MARIJUANA

The board also voted to add post-traumatic stress disorder and intellectual disability with aggression and/or self-injury to the list of medical conditions that are eligible to use the medical cannabis program.

The recommendation now will to go to the Iowa Board of Medicine, which will vote on whether to approve the conditions in an upcoming meeting. If members of that board approve the recommendation, it will be given an effective date in which patients with that condition can begin to take advantage of the rule change.

Despite hesitation among the cannabidiol board to expand access to THC, some members stated they felt the need to offer an avenue for recovery to patients who have no other treatment option.

“I guess in the absence of strong evidence for or against, we still have to take into account the compassionate needs of Iowans and go with the limited evidence that we do have,” Miller said.

The PTSD petition was brought before the board in a previous meeting earlier this year, but it had been rejected.

The Iowa Medical Cannabidiol Board is scheduled to meet again on Feb. 14.