Jason Noble

jnoble2@dmreg.com

Who knew the secret to getting marijuana legalized in Iowa would be giving it to kids?

Iowa lawmakers are poised in the waning days of the 2014 legislation to legalize — or at least decriminalize — a form of marijuana that relieves symptoms for severely epileptic children. If they actually pull it off, it'll mark one of the most surprising turnabouts in recent Iowa legislative history.

A year ago, medical marijuana advocates were all but laughed out of a House committee hearing and as recently as February sponsors were calling this year's bill dead on arrival. Now, the Legislature's fiercest critic of medicinal cannabis is helping to write the legalization bill that bipartisan majorities in the House and Senate are expected to support.

"The short answer is: Democracy works," said John Cacciatore, a lobbyist and former staffer who's been watching action in the Iowa Legislature for more than 20 years. "The folks who care about this issue have petitioned their government in a really effective way, and they've persuaded the leading policymakers involved in it."

The catalyst for the shift has been a group of moms. Maria La France and Sally Gaer, both mothers of children with a rare and debilitating form of epilepsy known as Dravet syndrome, became the public face of Iowa's medical marijuana movement this year, and their stories and persistence have completely changed the terms of the debate.

State Sen. Joe Bolkcom, an Iowa City Democrat who has advocated for years to legalize medical marijuana, said Gaer, La France and others have been "tenacious."

"The moms that have come up with their sick kids have been quite powerful," Bolkcom said. "I don't think anybody really expected the power of those stories to change this debate, but it certainly has."

Gaer, La France and others were motivated initially by a CNN broadcast last summer highlighting the potential for cannabis oil to provide relief from seizures caused by epilepsy. They formed a private Facebook group of interested parents, and then began meeting with Bolkcom and other advocates.

La France called 25 legislators personally last fall, and sent letters describing the science supporting medical cannabis for children with epilepsy to all 150 lawmakers shortly before the session began.

Since the session convened, Bolkcom has organized a series of informational hearings in which parents and others have shared their stories and described how medical marijuana could help. La France and Gaer, meanwhile, have haunted the Capitol's second-floor rotunda, calling lawmakers out of the chambers one by one to plead their case. Since February, they estimate they've spent two to three days a week at the Statehouse.

"We're just constantly up there in their faces," said La France, a small-business owner from Des Moines.

Their lobbying efforts have even extended back to lawmakers' home districts. Parents facing similar medical situations across the state have been attending legislative forums, making the case not only to their representatives and senators but also their neighbors.

"Once you start educating the Iowans in their districts and it makes sense to them and they're supportive, that gives the legislators the power to go ahead and support it too," Gaer said.

And indeed, lawmakers have begun changing their minds.

A year ago, state Rep. Clel Baudler told a packed legislative hearing that legalizing medical marijuana would be one of the stupidest things the Iowa Legislature has ever done. "There is no reason to legalize medical marijuana," the Greenfield Republican declared at the January 2013 hearing.

Now, the House Public Safety Committee chairman and former state trooper is predicting a bill legalizing cannabis oil for epilepsy treatment may yet pass the Legislature this year — and he's even helping to write it. He sat in the nearly vacant House chambers last Thursday afternoon reviewing proposed language line-by-line and marking up final changes before the bill is officially enrolled.

"If I had to bet today, I'd bet something will come out of this legislative session that is very, very limited to epilepsy," he said, adding that he remains concerned even a narrow bill could lead to further liberalization of Iowa's marijuana laws.

Baudler's evolving opinion, cautious and qualified though it is, is indicative of a startling shift among Iowa political leaders of all stripes.

House Majority Leader Linda Upmeyer, a Republican and a nurse practitioner, has acknowledged the potential merits of legal marijuana for medicinal purposes. So has Democratic Senate Majority Leader Mike Gronstal.

Even Gov. Terry Branstad — who just weeks ago worried aloud that prescription marijuana could fall into the hands of kids and recreational users — told Iowa Public Radio this month that there were approaches he could sign his name to.

One big driver of the changing perception is the very specific form of marijuana under consideration. Lawmakers are looking to legalize possession of cannabidiol, a marijuana-derived oil that provides relief to epilepsy patients but contains little THC and is ingested by mouth or in pill form.

In short, it can't be smoked and it won't get anybody high.

But that's not the only reason medical cannabis has gained legitimacy this year. The moms — La France and Gaer — identified several reasons their presence has turned on the debate.

First, the fact they're not sick themselves enables them to engage with lawmakers in a way that Iowans debilitated by cancer or multiple sclerosis cannot. And just as important, the presence of clean-cut suburban moms advocating on the issue helps dispel the notion that medical marijuana patients are recreational users in disguise.

"There were a lot of people that were recreational users up there appearing like recreational users and smelling like recreational users, which did not help the cause at all," Gaer said of past lobbying efforts. "We had to do a lot of repositioning the whole issue to prove to them that it is medicine."

There's also the fact that La France and Gaer could face far more severe consequences for providing marijuana to their children than a self-medicating cancer patient.

"If somebody has cancer they might just go out and get some rather than trying to change the law," La France said. "The penalties that the parents face are so much more severe that I think for us it might be easier to change the law than break it."

With those consequences in mind, La France demurred when asked if she's treated her son Quincy with cannabis oil. "I'll probably say no comment," she said.

There's another factor at play, too — a crassly political one. Sally Gaer's husband is Steve Gaer, the mayor of West Des Moines and one of the more prominent Republicans in the state. When U.S. Rep. Tom Latham announced his retirement, Steve Gaer's name was floated as a possible replacement.

Steve Gaer's engagement affected members of his party like perhaps no one else's could — a fact nearly everyone involved in the debate acknowledges.

"They brought credibility," Bolkcom said of the Gaers. "They've brought not only credibility but they have relationships with key people in the Legislature that are going to be helpful to moving this forward."

Several key lawmakers now in a position to vote on the issue know the family well and have met Margaret, Steve and Sally's 24-year-old daughter with Dravet syndrome.

"I had five or six really strong Republican legislators who knew our personal situation who I could approach as friends to say this is medicine my daughter needs," Steve Gaer said.

Advocates who for years lobbied the Legislature and worked through the Iowa Board of Pharmacy for action on medical marijuana said they agreed this year to step aside while the moms tried to advance the issue, and are now as surprised as anyone at the progress they've made.

"I didn't really see it coming, but it makes perfect sense now that I see it," said longtime medical marijuana advocate Carl Olsen.

Those advocates — as well as Bolkcom, Gaer, La France and others — say they had hoped for a more expansive bill allowing marijuana in forms beneficial to people with cancer, MS, Parkinson's Disease and Post Traumatic Stress Disorder, but saw whatever limited legislation that may emerge as a critical step toward legitimizing the drug.

The moms' role, they said, has been instructive.

"I think what we've learned from these moms — and we knew this — was that moms will go to any length to help their suffering child," Bolkcom said.

Not exactly marijuana: Legislation would legalize 'hemp oil'

If medical marijuana is legalized in Iowa, it won't be anything close to the near free-for-all seen in California and other states, where doctors may prescribe the drug for any number of serious or less-than-serious illnesses and maladies.

Rather, lawmakers are zeroing in on cannabidiol, or hemp oil, an oil derived from the marijuana plant shown to relieve seizures associated with epilepsy. The oil is low in THC — the stuff that gets you high — and cannot be smoked.

According to draft legislation that lawmakers were still tweaking late last week, individuals with "intractable epilepsy" and their caregivers could obtain state-issued identification cards allowing them to possess cannabidiol. The cards would be good for a year at a time, and could be renewed.

Production and sale of the substance would remain illegal, however, meaning patients or their caregivers will be required to acquire the drug out of state — likely in Colorado, where marijuana is legal. Iowa's ID cards will be recognized by authorities in Nebraska, presumably ensuring caregivers safe-passage from Colorado back to Iowa.

Iowa isn't alone

Prior to 2014, 20 states and the District of Columbia allowed medical marijuana, including Colorado and Washington, which have legalized the drug for recreational purposes as well.

Several more are poised to join them.

Maryland's legislature approved a wide-ranging medical marijuana program earlier this month, while Wisconsin, Alabama and Utah have passed cannabis oil bills for people with epilepsy similar to what's been proposed in Iowa. Cannabis oil legislation has advanced this year in Kentucky, Tennessee, South Carolina, Georgia and Florida as well.

Studies suggest benefits

Although researchers caution much more study is necessary, initial investigations suggest cannabidiol oil can radically reduce seizures in children with severe and treatment-resistant epilepsy.

One Stanford University survey of 19 parents with severely epileptic children found using marijuana oil reduced the frequency of seizures in 16 of the children, including two whose seizures stopped entirely, eight who reduced their frequency by 80 percent and six who reduced seizure frequency by between 25 and 60 percent.

The parents reported increased alertness, better moods and increased sleep among their children as well. Side effects included drowsiness and fatigue.