"We are not here to curse the darkness; we are here to light a candle."

Wednesday, August 19, 2009

Iowa Pharmacy Board's Review of Marijuana as a Medicine: Possibilities & Pitfalls

Overview

The State of Iowa has authorized the Iowa Pharmacy Board (pdf) to review drug schedule classifications and hence what medical use and circumstances, if any, apply to certain controlled substances.


Today, August 19, 2009, the Iowa Pharmacy Board holds the first of four public hearings as part of a review to determine whether there is sufficient evidence to warrant the legislature's authorizing the use of marijuana for any medicinal purpose.


Members of the seven person board are appointed by the serving governor at the time of vacancy for a term of 3 years. Currently, the Board consists of five licensed pharmacists and two public members. Four are Democrats, two are republicans and one is an independent.


I. The Pharmacy Board Hearings are important because they shift the focus of decision making from the partisan special interests inherent in the political process to a more objective review of the evidence based on scientific method.


George Washington University Constitutional law Professor Turley notes the partisan political interests involved in the issue marijuana for medicinal purposes has resulted in the major political party's acting in a manner that is completely at odds with their traditional view of the Constitution and the prevailing status of the defined Constitutional relationship between Federal and state governments. So too, Georgetown University adjunct law professor Peter J. Cohen, an apparent advocate for marijuana, provides a substantive confirmation of the problem in his Utah Law Review article "Medical Marijuana: The conflict Between Scientific Evidence and Political Ideology (pdf)." (download here) (or here).


Professor Cohen concludes:

(1) "activists on both sides are responsible for the current state of affairs..." Cohen, p. 42 (download here or here)

(2) "... advocacy is a poor substitute for dispassionate analysis" and "popular votes should not be allowed to trump scientific evidence in deciding whether or not marijuana is an appropriate pharmaceutical agent to use in modern medical practice." Cohen, p. 41

(3) ... scientific evidence devoid of political considerations should be allowed to guide future decisions regarding the status of Cannabis sativa when used for medical purposes." Cohen, p.42 .


II. Since the Iowa Pharmacy Board's review of "medical" marijuana is of both State and National importance, facilitating public access to all written evidence and oral testimony is crucial to public trust and conficence in the Board's report to the Legislature.


The Iowa Pharmacy Board's ground braking actions to determine if there is any appropriate medicinal use for marijuana, including any recommendations concerning production, distribution and consumption, will quite rightly be compared (Cohen, p. 42) to the standards and process by which the U.S. Food and Drug Administration approves the human use of any drug. (F.D.A. 1) (F.D.A. 2).


For policymakers and the public to have confidence in the Iowa Pharmacy Board's recommendations, both the recommendations and the process leading to those recommendations must be perceived to be, and actually be material, accurate, valid and reliable.


Moreover, the analysis of both Professors Turley and Cohen make it clear that no matter what the Iowa Pharmacy Board concludes those interests the Board's marijuana recommendations favor will promote the report, while those interests the Board's marijuana recommendations diminish will attack it.

Accordingly, to gain policymaker and public trust and minimize the possibility the Iowa Pharmacy Board's study is hijacked by special interests is if all concerned can review both included and excluded evidence and verify the evidentiary steps leading the Board to its ultimate conclusions.


To date the Iowa Pharmacy Board has shown an appreciated willingness to be transparent in its decision making process. Oral testimony will be transcribed and interested parties are encouraged to submit their views in writing. Most importantly the Board has informed the participants "All oral testimony and written comments received by the Board will be public information."


The concern here, however, is not with the Board's transparency but with access to that transparency. Open hearings are constrained by one's ability to attend them as well as the meeting halls ability to accommodate them. Also, the physical review or duplication of written comments is difficult, time consuming, and the cost may be prohibitive.


III. Given the widespread implications and interest in these hearings and statements however, it is hoped and the Board is asked to:

(1) make the testimony available via a pod cast on its web site or place a downloadable copy of the hearing transcripts on its web site.

(2) Place a downloadable copy of all written comments on its web site.