The White House’s announcement last week of a new drug control policy puts Iowa at the forefront of a decades-long debate over how to treat substance abuse and crime — and may affect the case for legalizing medical marijuana in the state.
President Barack Obama’s administration announced a $22 million grant program in Iowa, Arizona and New Jersey that aims to identify potential substance abuse problems before they becomes full-blown disorders. In doing so, the program eschews decades of a war-on-drugs philosophy based primarily on law enforcement in favor of increased prevention and treatment.
The Screening, Brief Intervention and Referral to Treatment grants would go to four federally qualified health centers across Iowa as well as Camp Dodge, home to the state’s National Guard. Iowa applied to participate in the program; states were selected based on proposals they sent which were independently reviewed.
“We want to identify problems that are lurking and might be going unaddressed,” said Pamela Hyde, administrator of the Substance Abuse and Mental Health Services Administration. “High-risk patients are referred to specialty care, but there are others that can achieve treatment earlier.”
Members of Iowa’s congressional delegation said they were open to the new approach.
“I’ve always believed that prevention is the cheapest and best approach,” said Sen. Tom Harkin, D-Iowa, who also said many law enforcement organizations have long supported more prevention efforts.
“When you look at how long the war on drugs has taken place in our country, and the continuing problem we have with drugs that have negative and disastrous implications in people’s lives, it’s reasonable to look at alternatives that try to focus on keeping people from becoming addicted to drugs,” Rep. Bruce Braley, D-Iowa, told The Gazette.
Only Rep. Dave Loebsack, D-Iowa, was wary, saying that emphasis shouldn’t shift away from law enforcement.
“It’s not a matter of replacing one approach with the other,” he said. “In the short term, law enforcement is absolutely necessary. But I am certainly open to new ways to accomplish our goals.”
In the announcement, Obama administration officials made it clear that medical marijuana would still be classified as illegal under the program which would identify users for intervention.
Gil Kerlikowke, director of the White House Office of National Drug Control Policy — the administration’s so-called ‘drug czar’ and a former Seattle police chief — said only drugs that have been approved by the Food and Drug Administration would be allowed.
“And of course marijuana has never gone through that process,” Kerlikowke said. “When you’re talking about screening and substance misuse, one misuse could be medical marijuana.”
Legally prescribed and legally used medical marijuana would be allowed, the officials said, if it were in a state that has approved the practice. But Iowa isn’t one of them. The issue is actually at a stalemate. In 2010, the state Board of Pharmacy said the state should allow it’s use for medical purposes, and referred the matter to the Legislature.
But lawmakers said they shouldn’t have to act, and that the pharmacy board already has the authority to set up guidelines and a system.
The board, in reply, has insisted it needs legislative authority. Attempts at a resolution were unsuccessful in the 2011 and 2012 legislative sessions.
Among Eastern Iowa’s four congressmen, Harkin and Braley said they would support a legalized system for medical marijuana.
“It’s appropriate from a medical standpoint for certain diseases,” Braley said. “If it’s legally prescribed and heavily regulated, and it’s for medically appropriate reasons, there ought to be an option available for pain management.
Only Sen. Chuck Grassley, R-Iowa, said he opposed legalizing medical marijuana.
“Prescribed medicine should have the approval of the FDA,” Grassley said. “And there’s been no attempt to get the FDA to make a decision about this, and until you do, it shouldn’t happen. I’ve also seen dozens of studies that show there’s no benefit, so I’m going by science-based decisions.”
How program works
The Screening, Brief Intervention and Referral to Treatment program would work by establishing screening centers in a variety of inpatient and outpatient medical clinics as well as non-traditional locales such as tribal areas and military bases.
Patients who are determined to be potential risks would be given a short, 10-minute interview to evaluate the possibility of a future substance abuse problems. The interviews would avoid a lecture-style or judgmental approach, officials said.
“It’s about challenging the paradigm, not dividing the world into two groups,” said Daniel Alford, medical director for the Massachusetts Screening, Brief Intervention, Referral and Treatment Program, which received federal grants from 2007 to 2012. “There’s a group in the middle that we can intervene with.”
Alford, too, said medical marijuana will be one of the drugs for which clinicians will look.
“We’re screening for unhealthy use, so if it’s being done well and legally, in a state where it’s allowed, it’s no problem,” he said. “If it’s being used in a way that’s not prescribed, that will get identified.”