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P R O C E E D I N G S
TERRY WITKOWSKI:  Good morning,
everyone.  We apologize for the late start, but
unfortunately, our court reporter got stuck on the
interstate behind a major accident, so that's what
caused our delay.  But we will get started.
We want to welcome you to the fourth
and final public hearing on medical marijuana.
This hearing is being held by the Iowa Board of
Pharmacy pursuant to Iowa Code Section 124.20l(1).
I am Terry Witkowski, the executive officer for the
board.
With me today are two board merrbers,
Ed Maier, pharmacist from Mapleton, and Susan Frey,
a pharmacist and the vice chairperson of the board
from Villisca, Iowa.  Also with me today is Board
Compliance Officer Jennifer O'Toole at the back
table.
SueAnn Jones, Johnson Reporting
Services, is serving as the certified court
reporter for this hearing.
The purpose of this hearing is to
receive information from the public.  A transcript
of all comments that are received at today's
hearing will be reviewed by all seven members of
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the Iowa Board of Pharmacy.
Iowa law imposes upon the board the
duty to periodically recommend to the legislature
changes in conrolled substance schedules.  The
board views this statutory responsibility with
great seriousness, both because of the specificity
of Iowa Code Chapter 124 and because marijuana use
and the use of drugs in general is a sensitive
medical, social, and political issue.
Any board recommendation for changes
to the controlled substance schedules will be
preceded by a thoughtful review and analysis of the
most helpful and current scientific information
available to the board.
In making a recommendation to the
legislature regarding marijuana, the board will
consider the following 12 factors, marijuana's
actual or relative potential for abuse, marijuana's
pharmaceutical -- excuse me -- pharmacological
effect, current scientific knowledge regarding
marijuana, the history and current pattern of abuse
of marijuana, the scope, duration, and significance
of abuse of marijuana, the risk to the public
health from moving marijuana from Schedule I to a
different controlled substance schedule, the
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potential of marijuana to produce psychic or
physiological dependence liability, whether
marijuana is an immediate precursor of a substance
on some other controlled substance schedule,
whether marijuana's potential for abuse or lack
thereof is not properly reflected in its inclusion
in Schedule I, whether marijuana lacks a high
potential for abuse, whether marijuana has an
accepted medical use in treatment in the United
States, and whether marijuana does not lack
accepted safety for use in treatment under medical
supervision.
This hearing will be held according to
the following ground rules and will proceed in the
following manner.  Both proponents and opponents of
medical marijuana wlll be allowed to speak.  All
speakers are to come to the stage and speak into
the microphone at the podium.  Speakers must speak
slowly and clearly so their comments can be
accurately recorded.
Speakers need to identify themselves
on the record.  They should at a minimum provide
their first name.  Full names and addresses would
be appreciated but will not be required.  If
speakers are representing an organization or are
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speaking on behalf of an organization, they should
state that before making their comments,
Speakers who wish to offer exhibits or
written materials to the board need to have them
properly identified for the record.  Testimony that
references an exhibit should identify the exhibit
number.
Depending on the number of people who
wish to speak at today's hearing, time limits will
be imposed.  In general, each person will be
allowed a minimum of five minutes to speak.  If
feasible, additional time may be allowed.  However,
the board wants to ensure that every person who
wishes to speak receives an opportunity to do so.
Speakers will be called according to
the order on our sign-up sheet.  Some speakers
reserved time prior to today's hearing, and they
will provide their comments as previously
scheduled.  Some speakers have also requested
additional time.  All requests for additional time
will be allowed as circumstances permlt.
We will notify each speaker as you
approach the end of ycur allotted time by holding
up signs indicating four mlnutes remaining, two
minutes remaining, thirty seconds remaining, and
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thank you when your time is up.
The board wishes to remind everyone
that this hearing is not an opportunlty for debate.
We are here today to receive comments concerning
the medical use of marijuana.  As part of this
process, I and/or the board members or board staff
may have questions for the speakers.  Please be
aware that we are not here to receive comments
regarding the legalization of marijuana.
Speakers are also reminded to avoid
repetitious or irrelevant comments.  Speakers
should be as short and concise as possible.
Speakers will only be allowed to speak once.
Additional thoughts may be submitted to the board
in writing following today's hearing
Unruly behavior such as booing or
hissing or harassing remarks will not be tolerated.
Speakers will not be allowed to make personal
attacks.  Please hold any applause until each
speaker has finished making their comments.
In addition to receiving oral comments
at today's hearing, the board welcomes and
encourages written comments.  Any comments or other
information received at today's hearing will be
public information and may be referred to or
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referenced in reports or recommendatlons issued by
the board to the legislature.
This hearing will be in session until
7 o'clock p.m.  We will take a lunch break from
11:30 to 1.  We will also take two 15-minute breaks
during the afternoon.  Are there any questlons?
We will now begin with our first
speaker.  We are supposed to have someone calling
in on the phone in about five or ten minutes.  Is
there -- the next speaker would be Shane Prokop,
and I apologize if I mispronounce names.  I'll
apologize before we get started.  Is Shane ready to
speak now?
Is there anyone else that would like
to speak that would speak for maybe five minutes?
Okay.  What is your speaker number?
JACQUELINE PATTERSON:  It's No.2.
TERRY WITKOWSKI:  Okay.  Come up.
JACQUELINE PATTERSON:  Good morning.
My name is Jacqueline Patterson.  I was a resident
of Iowa from 1999 until 2001 when was informed
that I could not continue to pursue my criminology
degree at the University of Northern Iowa
because -- because my stutter interfered too much
with my -- with my -- with my participation in
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my -- in my -- in my -- in my -- in my classes.
I have been on many prescription
medications, including -- including -- including --
including amphetamine and a new drug called
Provigil.  And those did not -- did not assist me
in controlling -- in controlling my -- in
controlling my stutter nearly as effectively as
cannabis -- as cannabis -- as cannabis does.  When
I am able to use cannabis, there is a 90 percent
reduction in my stutter and --
TERRY WITKOWSKI:  Excuse me,
Jacqueline.
Could you answer that?
RAPHAEL MECHOULAM:  Hello.  This is
Professor Mechoulam.  I am calling from Jerusalem.
I was asked to give evidence.
TERRY WITKOWSKI:  Professor?
Professor?  Can you hold for just a moment? We do
have another speaker presenting right now.
RAPHAEL MECHOULAM:  I understand.  I
hope it's not too long.  After all, I'm on an
international call.
TERRY WITKOWSKI:  I'm sure that it
will not be.  Would you prefer to wait?
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RALPH SMITH:  He's calling from
Israel.
BOARD MEMBER FREY:  Thank you.
TERRY WITKOWSKI:  Okay, Professor.
You may begin.
RAPHAEL MECHOULAM:  Thank you.  My
name is Raphael Mechoulam.  I am a professor of
medicinal chemistry at the Hebrew University in
Jerusalem.  I've been involved in research in
cannabinoids and marijuana for many years.
In 1960 we isolated the active
component of cannabis.  It's a little bit strange,
but the active component of opium was isolated
100 years ago, and so was cocaine.  Anyway, we
isolated this.  There had been a lot of work on
this particular active -- psychoactive compound.
For many years that we worked on the metabolism and
therapeutic effects, both in animals and in humans.
Then in the 1990s, about 10 -- 10,
15 years ago, we started presenting finding the
compounds in the brain that act on those particular
receptors that are found in the brain and which THC
by chance also works.  So I'm thinking we're well
aware of the whole field that that works in this
respect.
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Now, I was asked to tell you something
about my experlence or my views on medical
cannabis -- medical cannabis, is that correct?
RAPHAEL MECHOULAM:  Okay.  There are
several aspects.  One ot them, of course, is the
identifying compounds, the active THC.  Another one
is called cannabidiol.  These compounds are
approved -- THC is approved in the U.S. as a
compound called dronabinol, and cannabidiol may be
shortly approved.  It's a mixture of both, being --
which have been approved in Canada.
These compounds should be looked at as
pure compounds and should be under the FDA
supervision, which is what is happening, and I hope
they will be more widely used than at present.
But the point is, what about medical
marijuana, the mixture, the actual marijuana plant?
Now, from my experience, the activity there is
mostly due to the THC which used to be lower
amounts than previously.  Now it's very high
amounts, and my view is yes, it should be used.
Yes, it has to be under supervision.  Just going
the route of taking anything with 2 percent of THC
in marijuana to 30 percent THC marijuana, in my
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view is not appropriate.  It should be administered
under, in your case, state supervision.
We have had an intro.  Our minister of
health allows the use of medical marijuana under
medical supervision.  Patients have to get the
permit through his physician to get medical
marijuana.  In this case it's free of charge, but
this will probably change.  They'll have to pay
something for it.  But he should know exactly what
he's getting, not just anything.  Even aspirin we
don't take without knowing the appropriate amounts,
so it should be approved under certain conditions.
That's my view.
It should go through medical --
medical committee to approve it, and in Israel, for
example, it is.  There is a medical board that
approves it, and it's used in the cases of
gastrointestinal diseases, Crohn's disease, side
effects of multiple sclerosis, some kinds of
tremors, vomiting and nausea, even in children.  We
use that in children that are undergoing -- who use
THC that are undergoing chemotherapy.  In
post-trauma, it seems to be effective.
And so this -- it should be, in my
view allowed but under supervision, not just like
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any -- anybody who wants to sell it could
supplement, if you wlsh.  This is my view.
If you want to ask me about it, I'll
be glad to answer.  I was also asked to say
something about the legalization of marijuana, not
as a medical drug.  Now, I think that this is not
what you're interested in, and if you want me to
say something on it, I'll be glad to do so.
BOARD MEMBER FREY:  I think we would
like to have comments confined to the use of
medical marijuana, please.
RAPHAEL MECHOULAM:  Yes.  Like I said,
it has to basically, it should be allowed.  It
should be under supervision, both in growing the
plants and in its administration.  Not just go to
the store and pick up something.  It's not a
vegetable.  It's not something else.  It's not a
vegetable.
It should be under supervision in the
sense the patient should be -- should get permit.
It should be allowed by a medical doctor using it,
not just saying that he has a runny nose but should
be allowed to use it, and they should go through a
medical board that wlll approve it, which is most
essentially what we do with any drug in a more free
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way.
BOARD MEMBER FREY:  Professor, I'm
Susan Frey with the Iowa Board of Pharmacy.  Could
you maybe expand a little bit on if a patient does
have a permit, where do they obtain the marijuana,
and how is that governed and monitored by the
medical board?
RAPHAEL MECHOULAM:  Well, in our
case -- and of course, I can't speak about Iowa.
No idea what you will decide, but in our case, if a
patient is not sufficiently taken care of by the
existing therapy that he has, his physician writes
a letter -- can write a letter to a medical board
at the minister of health, and this medical board
decides whether the case is suitable, and then it
will issue a permit.
It has issued now permits to about 7,
800 patients in various diseases, and the patient
then takes the permit, the written permit, and
he -- he has to go to a supplier that gets it from
a farm that again is under supervision.  So both
the farm is under supervision and the -- the
registration is under supervision, and you can get
it throughout -- can't get it without supervision.
It is people go to the minister of
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health to allow some patients to grow small amounts
of marijuana at home rather than go ahead and get
the marijuana from a grower, but to the best of my
knowledge, it is not yet -- not being used that
way,
BOARD MEMBER FREY:  So if I understand
you right, are you telling me that the patient has
to have tried other means of therapy before medical
marijuana is considered as treatment?
RAPHAEL MECHOULAM:  At the moment,
this is the case -- the case for most of these
things.  Some of them won't and don't.  In some
cases in some medical situations, it's not the
case.
For example, in post-trauma, nothing
seems to work as well as cannabinoids, and cannabis
seems to work, and it has been strong, for example,
that both the crude medical marijuana and the
compound which is structured -- whose structure is
like THC to work in a clinical trial.  So in this
case I would say no, it doesn't have to be -- no
drug should be used before that because nothing
works.
We are using in bone -- bone marrow
transplantation essentially guite -- quite a large
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number of patients to get their bone marrow
transplantation, these patients are that.  I can't
recommend that kind of treatment to anybody if you
can manage without it.  But they vomit.  They feel
badly.  They have pain.  They're terribly
depressed, and together with the many drugs that
they're getting, they're also getting in this case
THC, but we would be glad to get the medical
marijuana if possible, and they feel better.  They
start eating, which normally they don't.
So different cases in different
diseases.  Crohn's disease, for example, I don't
think that people wlll start immediately with
medical marljuana, only if they start with other
drugs that are available, and a few are, but these
medications, they don't work well, and in that
case, her physician will have to go and ask for the
existing drugs or give it as a solo.
BOARD MEMBER FREY:  Thank you.
RAPHAEL MECHOULAM:  Okay?  Is that the
only thing?
BOARD MEMBER FREY:  You have another
ten minutes, Professor, if you have anything else
that you wish to add.
RAPHAEL MECHOULAM:  Well, if I have
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some more time, I would say that there should be
some more research, clinical investigation, both on
marijuana and on the pure procedures.  We really
don't have enough science behind medical marijuana.
While we have some of it on THC, there is not
enough on medical marijuana, and if it is -- the
laws have changed and there is a way of using
medical marijuana the way we do it here at the
moment, then I would very strongly suggest that
there should be -- that you should encourage
clinical investigations in well-defined marijuana,
whatever is set to the side, 10 percent of THC, and
patients should be investigated, should be -- they
should undergo clinical trials in addition to what
we know at the moment because we really don't have
enough well-conducted medical trials, clinical
trlals, with that supervision.
Anything else you would like to know?
Hello?
BOARD MEMBER FREY:  Yes.  We're still
here.  Have you researched looking at our criteria
of things that we need to look at?  One of them is
potential for abuse.  Have you in your studies,
have you looked at that aspect?
RAPHAEL MECHOULAM:  We do not -- yeah.
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It is known that there are many users.  About
9 percent of various users do become addicted to a
certain extent.  Look at the addiction.  It is not
a very deep one and therefore sounds like every --
cocaine addictions which are very -- that are the
more mild ones, and we have not seen any kind of
addiction in our patients, but one has to follow
that.
And like with the morphine that's
being given to a lot of patients or many for pain
and so on, one has to follow the possibility, and
in that case seems to be we have not seen yet cases
of addiction.
BOARD MEMBER FREY:  In your patients
that are treated on a chronic basis, do you have
issues or do you see any increase in secondary
medical illnesses?  That might --
RAPHAEL MECHOULAM:  What kind of side
effects?
BOARD MEMBER FREY:  Well, things that
might be associated with, say, smoking, like, for
instance, do you see an increase in lung cancer or
lung issues?
RAPHAEL MECHOULAM:  No.  We -- lung
cancer, it is well known that it does not produce
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lung cancer.  There is a very -- a group in
California that has looked into it very thoroughly
and very objectively, and they have not seen any
cases of cancer.
There may be because of the smoking,
some information.  One has to -- to take care of
that to see whether there isn't any lung cancer
information.  It is not, to the best of my
knowledge, a major issue at the moment.
Side effects that we see, not -- not
really.  One has to take that into consideration
like with any -- any drug.  Anything else you would
like to -- like me to address?
BOARD MEMBER FREY:  Let's see.  We're
kind of looking over our list here of --
RAPHAEL MECHOULAM:  My main point
is -- while you're looking at the list, my main
point is yes, it should be allowed, but it should
be under supervision like any other drug, not just
going to the store and picking up some some
marijuana.  That is not the way a drug should be
used.  There should be -- it should be allowed use
for additional properties, I think.
CARL OLSEN:  How about the last bullet
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point, safety for use under medical supervision?
BOARD MEMBER FREY:  Okay.  We've got a
question.  One of our factors is whether or not
marijuana does not lack accepted safety for use in
treatment under medical supervision.
RAPHAEL MECHOULAM:  What do you mean
by that?  mean I'm not sure I understand your
question.
BOARD MEMBER FREY:  When we make a
recommendation to the legislature as to whether or
not to reschedule this from an experimental
schedule to a controlled substance or to schedule
it at all, we have to answer the question whether
or not marijuana does not lack accepted safety for
use in treatment under medical supervision.
RAPHAEL MECHOULAM:  Well, to the best
of my knowledge, there's no major safety problems
associated with marijuana use as long as it is
supervised.
I would -- one of the things that I
would suggest that a person who is being treated
with medical marijuana should not be allowed to
drive, for example, while he's under the effect of
the treatment.  Maybe he doesn't feel that he has
the effect of the treatment.  He should not.
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Now, actually, to me to say quite a
few -- it's like Valium, for example, or other
drugs that I don't know what situation it's in in
the U.S. and Iowa in particular, but under certain
drugs, people should not be allowed to use them
under something because they may not be under full
control.
Now, I don't know whether under the
way THC, marijuana, people will be less -- will
be -- they will have these problems, but just for
at the beginning at least, I would say no, one
should not drive.  One should not drive under
certain conditions.  I don't see many other
problems at the moment.
TERRY WITKOWSKI:  Thank you very much,
Professor.
BOARD MEMBER FREY:  And Jacqueline,
would you like to finish yours, please?
JACQUELINE PATTERSON:  Yeah.  I'll
finish it real quick.
I moved to California in in 2007.
Also in 2007 lost custody of one of my children
to his father in Cerro Gordo County.  The judge
the -- the -- the judge told me that I wasn't a fit
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parent, not only because I used medical cannabis
but, because I have lobbied -- because I have
lobbied for fundamental changes in medical cannabis
policies here.
Nobody -- nobody deserves to lose
their children because of the -- because of the
medicine that they -- that they -- that they --
that they -- that they -- that they use.  Nobody --
nobody -- nobody deserves to feel like a criminal.
And as for medical safety, I have many
doctors willing to recommend that I do use -- I do
use cannabis, and the way that you worded --
BOARD MEMBER FREY:  Could you speak
into the microphone?  Thank you.
JACQUELINE PATTERSON:  What was the
way that you worded your last --
JACQUELINE PATTERSON:  -- question to
the professor?
BOARD MEMBER FREY:  Okay.  That's out
of the law, and the way the law -- the way the
statute reads, whether marijuana does not lack
accepted safety for use under medical supervision.
JACQUELINE PATTERSON:  The Institute
of Medicine in 1990 -- in 1999 determined that
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further studies of medical cannabis -- or of -- of
cannabis's medical attributes were needed.  The
human body has an endocannabinoid system which --
which is why -- which is why cannabis is so -- is
so effective when prescriptions are not, and the --
I think that the doctors in the 13 states in which
cannabis has been made medically available have
proven that it can be -- it can be -- it can be
safely utilized under a -- under a physician's --
under a physician's -- under a physician's care.
Thank you.
TERRY WITKOWSKI:  Is Shane -- is Shane
Prokop available?  Brenda Peterson and Steve Gooch,
if you're ready, we can move forward with yours.
RALPH SMITH:  Excuse me.  Do you have
a phone call-in number?  We've been trying to get
it for some time.
(Off-the-record discussion.)
TERRY WITKOWSKI:  Speaker No.1?  Is
Speaker No.  1 available to speak?
RALPH SMITH:  That was me except I'm
going to speak whenever it was marked.
TERRY WITKOWSKI:  Oh, okay.  Would you
let Jennifer know, because she would have your
other name tag.
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RALPH SMITH:  I could make scme
comments if you need time -- if you need some time.
TERRY WITKOWSKI:  We'll see who else
is here.  Do we have a Speaker No. 3?  Are you
ready to speak?
Hi.  My name is Jeff Elton, E-l-t-o-n.
I live in Des Moines.  I suffer from diabetic
neuropathic gastroparesis, which is Greek for
paralyzed stomach.  Symptoms are chronic nausea
chronic, chronic nausea, vomiting, and if those
aren't controlled, wasting -- wasting loss
syndrome.
I wasn't planning on speaking today
because I've spoke at the other ones, but I felt I
needed to share this experience.  We drove from
Des Moines here this morning in my car, and I was
driving.  I was able to make it all the way in the
parking lot, and then had to give up the car
because I kept having waves and waves of nausea.  I
thought I was going to vomit three different times.
My doctor gives me a prescription for
Reglan, R-e-g-l-a-n, also called metoclopramide for
control of chronic nausea and vomiting.  If you
ever watch commercial television, you'll see the
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advertisements for people who have been damaged
from this FDA-approved drug.
Inhaled cannabis vapors, not smoke but
vapors, for me gives immediate relief from chronic
nausea, stopping the vomiting and stopping the
wasting syndrome.  There is no drug, legal or
illegal, in today's pharmacopeia that safely
controls chronic nausea as safely and as
effectlvely as cannabis.
So please do the compassionate and the
right thing and make your recommendation to
legalize medical marijuana for Iowa to the
legislature in 2010.  And thank you.
TERRY WITKOWSKI:  Is Shane Prokop
here?  Brenda Peterson or Steve Gooch?  Do we have
a Speaker No. 4?  Is there anyone who is scheduled
for a time this morning that would like to speak
now?  If not, we'll just wait.
BOARD MEMBER FREY:  I think we have
one here in the front row.
PAUL CARTER:  Excuse me.  I'm
scheduled for 11 o'clock, but I'll be glad to go
now if you like.
TERRY WITKOWSKI:  Okay.  Paul Carter?
PAUL CARTER:  Yes.
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TERRY WITKOWSKI:  Okay.  Thank you.
BOARD MEMBER FREY:  Okay.  Thank you.
PAUL CARTER:  Okay.  Oh, those aren't
challenging stairs at all.  I do have a ccuple of
folders that I'll share with you.
BOARD MEMBER FREY:  Okay, Thank you.
PAUL CARTER:  Good morning, everyone.
My name is Paul Carter, C-a-r-t-e-r.  I am the
execucive director of PRIDE Omaha, Incorporated.
PRIDE is an acronym for Parents Prevention
Resources and Information on Drug Educatlon, and I
thank you very much for the opportunity to appear
before the board and the same for all -- everyone
in the audience.
I think it's apparent that as you've
already listened to some of the people that have
spoken today that when you talk about marijuana and
when you talk about the possibility of its use in
the medical way that as you heard Jacqueline, it
could be a very emotional position taken if you're
living -- if you're listening to proponents and
pro-drug people as you have the professor calling
from Israel, I believe it was.  You have the
proponents' position, although I might comment that
I wasn't sure with some of the comments from the
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professor whether he was a proponent or opponent
because it sounded like a few of his statements
were more in opposition.
PRIDE, Incorporated has been working
since 1978 to promote a clear, consistent no use
message when it comes to drug use by young people.
We are a nationally recognized organization that
for 31 years has worked to change the cultural
influences that encourage young children to use
drugs.
In this metropolitan area, we work in
eight counties surrounding the greater Omaha/
Council Bluffs area, including counties in western
Iowa as well as in eastern Nebraska, Drug -- drug
prevention for our young people is extremely
important.  It is so important because studies have
found that children who reach age 21 without using
drugs virtually are certain that they never will.
Many of us know that the average age
of first use of a drug is somewhere between 11 and
a half and 12 years old and that every chlld you
know is at risk to use drugs.  In fact, drug use is
the No. 1 problem facing young people today.  So
our concern are our children.
Legalizing medical marijuana -- and
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that's hard for me to say because medical marijuana
is definitely an oxymoron.  And I think we need to
all understand that the real issue here when we
talk about legalizing medical marijuana
dispensaries is what kind of message is being sent
to our young people, to our children, the future of
this country?  Is it a message that marijuana is
okay because somebody can smoke it and feel better?
Is it the negative druggie role model for youth
that we see too many times already in the media?
And the question is then, what is wrong with
permitting the use of smoked marijuana for a
medical purpose?
Well, simply put, smoked marijuana is
not modern medicine.  The Food and Drug
Administration in 2006 issued an advisory
concluding that there is no sound medical
scientific research or studies that have supported
the medical use of smoked marijuana for treatment
in this country.  There's no animal data, there's
no human data to support the safety and the
efficacy of smoked marijuana for any kind of
general medical use.
We fully realize that there are a
number of states that have passed voter referenda
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or legislative actions making smoked marijuana
available for all kinds of medical conditlons upon
a doctor's recommendation or I might even say a
medlcal provider's recommendation.  It's not always
a doctor's.  And frankly, no medical doctor
licensed in the United States of America sits down
and writes a prescription on their prescription pad
for any kind of drug you smoke.
According to the FDA, these measures
are inconsistent with efforts to ensure medications
undergo the rigorous scientific scrutiny of the FDA
approval process, and as pharmacists, you certainly
recognize that.
Now, we know, because there's plenty
of evidentiary explanations by people that you've
already heard from today, that while smoking
medical marijuana in any form may allow patients to
temporarily feel better, again the medical
community makes an important distinction between
inebriation and controlled delivery of pure
pharmaceutical medication.
One of your points dealt with safety.
I'm going to address that in a minute because we
have to be concerned about drivers in vehicles on
highways with the rest of us that are stoned.
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The Instituce of Medicine, which had
been mentioned by Jacqueline, concluded that
smoking marijuana is not recommended.  The Iowa
Report declared that marijuana is not modern
medicine.  And again, we have to talk about smoking
marijuana, which may cause serious harm to
patients.
Since this -- since this issue came to
the forefront in the Midwest and because of a
statement that I was quoted making in the Omaha
World Herald, I have recelved phone calls from
quite a few states, East Coast, West Coast, as well
as in middle America, and all of them have been
very passionate.  That's the emotion part of
medical marijuana users, but we have to understand
the delicate immune system in seriously ill
patients may become compromised by the smoking of
marijuana.
Daily use of marijuana compromises
lung function and increases the risk for
respiratory diseases, often associated with the
same type of diseases related to smoking cigarettes
and the nicotine drug in them.
Marijuana has a high potential for
abuse and can incur addiction and I would disagree
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a little bit with the professor.  I'm not sure what
his medical background was.  He never qualified
himself or even if he has any.
Existing legal drugs do exist that
provide superior treatment for serious medical
conditions.  The FDA has approved safe and
effective medication for the treatment of glaucoma,
nausea, wasting syndrome, which was mentioned,
cancer, and multiple sclerosis.  Marinol, which is
the synthetic form of THC -- again, the pharmacists
are knowledgeable of that -- is already a legally
available drug.
Sometime today before you conclude
these hearings, someone is going to bring up the
recent Gallup poll that told you that in the United
States of America, Gallup's October crime poll
finds that 44 percent of Americans in favor of
making marijuana legal, 44 percent of Americans
are in favor of making marijuana legal, and
54 percent are opposed, I've been around
prevention long enough to know that those numbers
have changed, and I'm going to accept that poll.
However, I think if you're going to
accept the numbers in that poll, you also recognize
and can't just deal with that without looking at
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the numbers related to the polling of Midwestern
states, which is where we reside.  In that case,
the numbers were 34 percent were in favor opposed
to 64 percent that were against marijuana's
legalization.
And I think when you realize that we
are sitting here on Iowa soil adjacent to Nebraska
and realize that we are in two states that are
representative of very heavy social conservatism,
and we look at that part of the poll, you will see
that the numbers change again to only 27 percent in
favor of legalization and 72 percent opposed.
Does marijuana use pose a health risk
to its users?  Well, absolutely.  It is an
addictive drug.  It has significant health dangers
and consequences, both short-term effects as well
as long-term effects, and even the proponents in
this room who are knowledgeable and have done some
research could cite those short-term and long-term
effects.  They're not going to because that is not
acceptable.
I have to tell you a story.  I retired
several years ago as a school district
administrator, and I was called by a counselor and
a principal in one of our urban schools to visit
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with a third grade student.  The reason they wanted
me to visit with that student is that in a
discussion in their third grade classroom with the
teacher talking about the dangers of drugs that
this young man had used terms like blunt and
doobie, words that many of you are familiar with,
but the students in that classroom and the
counselor and the principal, while they were aware
of it, didn't really understand what the
significance was.
Upon investigation, we found that this
young man was very knowledgeable because his
71-year-old grandmother who was suffering from some
very specific and real physical ailments had been
smoking marijuana to relieve some of the effects of
her illnesses -- and you have to remember, the
psyche does amazing things -- had been smoking in
the evening while she would sit on the couch
reading for an hour or so with that third grade
young man.
NOW, everyone knows the dangers of
tobacco and secondhand smoke, and again, I would
challenge anyone sitting in this room to tell me
that if you're sitting in that proximity that
you're not going to get stoned if Grandma is.
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Marijuana contains more than
400 chemicals, including most of them are
substacces, again, found in tobacco smoke.  More
teens today are in treatment for marijuana use than
for any other drug.
The Institute of Mediclne conducted a
very comprehensive study, again, which was already
mentioned by Jacqueline in 1999 and concluded that
smoking marijuana is not recommended for the
treatment of any disease, and the Institute of
Medicine concluded that there is little future to
smoked marijuana as a medically approved
medication.  That doesn't have any medical value.
Advocates like NORML have promoted the use of
marijuana to treat medical conditions such as
glaucoma, among others.
BOARD MEMBER FREY:  Your time is up,
sir.
TERRY WITKOWSKI:  If you could just
wrap it up, please.
PAUL CARTER:  I will wrap up with one
comment beyond just the cost and the safety
factors.  Marijuana is dangerous.  It's an
addictive drug.  It has no medical value.
Marijuana users are far more likely to use other
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drugs like cocaine and heroin than nonmarijuana
users, and drug legalizers use medical marijuana as
a red herring in an effort to advocate broader
legalization of all drugs.
Thank you very much to the board, and
thank you for the patience of the audience.  I
appreciated so much the head wagging and the eye
rolling.  Thank you.
BOARD MEMBER FREY:  Thank you.
TERRY WITKOWSKI:  Is Shane Prokop
here?  Brenda Peterson or Steve Gooch?  Do we have
Speaker No. 4?  Is Speaker No. 4 ready to speak?
Are you ready?
RALPH SMITH:  If you had time and
wanted me to present some things, we could do that
and come back.
TERRY WITKOWSKI:  We have other
speakers coming up here.
RAY LAKERS:  Well, hello, everyone.
Hello, ladies, Great to see you again.  This will
be my fourth appearance at the Iowa Board of
Pharmacy medical marijuana hearings here in Iowa.
The first thing I'd like to say --
BOARD MEMBER FREY:  Excuse me.  May we
have --
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RAY LAKERS:  My name is Ray Lakers.  I
have multiple sclerosis.  I'm with Iowans for
Medical Marijuana.  I was diagnosed in 2004.  I was
arrested in 2005 for less than a gram of marijuana,
and this gentleman, since you are from Nebraska,
you are familiar that marljuana is decriminalized
in Nebraska.  Okay.  So if I would have been in
Nebraska, I wouldn't have went to jail for a gram
of marijuana.  I went to jail and did six days in
county in Iowa for a gram of marijuana, so that's
where I'm coming from.
BOARD MEMBER FREY:  Sir, this is not a
debate, so please keep your comments directed to
the subject.
RAY LAKERS:  Thank you.  I just wanted
to -- thank you.
PAUL CARTER:  Actually, if he's going
to get to address a comment to me, I would think
that the fact that Iowa has not decriminalized,
Iowa would pose even a greater problem for both the
Board of Pharmacy --
RAY LAKERS:  It's a terrible problem.
BOARD MEMBER FREY:  Excuse me,
gentlemen.
TERRY WITKOWSKI:  Both of you.  Both
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of you.  This is not a debate.  We're here to
speak -- to allow each to speak their own piece.
TERRY WITKOWSKI:  And therefore no
comments regarding another individual's comments.
Thank you.
RAY LAKERS:  Thank you.  Cannabis is
medicine.  When police arrested me for marijuana in
Iowa, they have no concern if you're a medical
marijuana patient or not.  All that matters to them
is that you have marijuana.
Monday in Iowa this week Gil
Kerlikowske, director of the Office of National
Drug Control Policy, specifically cited problems
regulating the clinics in Los Angeles that dispense
medical marijuana.  He said the following:
Kerlikowski, the former chief of police in Seattle,
reported better results from medical marijuana law
in the Washington state.  It was not a significant
problem for law enforcement in the state of
Washington.
So you know what I did?  I took a look
at the state of Washington provision for medical
marijuana patients.  In the state of Washington,
Senate Bill 6032, guidelines allowing patients to