Des Moines: Iowa's medical marijuana program grew in 2022 as registered patients increased and sales increased at the state's licensed medical marijuana dispensaries.

As of November, the number of medical marijuana cardholders in Iowa's program stood at 14,466 and nearly doubled the number of patients enrolled in December 2021, according to a new study from Iowa's Medical Cannabidiol Board, which administers the program.

More healthcare professionals are certifying patients for the program. As of November, 1,920 practitioners had approved at least one patient, compared with only 1,603 from the previous year.

According to Lucas Nelson, the president of Bud & Mary's (formerly known as MedPharm), one of two licensed marijuana manufacturers in Iowa that operates dispensaries in Windsor Heights and Sioux City, the uptick in patient enrollment shows a need for more access in the number of dispensaries and the types of products available.

Iowa's five dispensaries in the last year saw sales increase by $4.1 million. August recorded the program's first month with more than $1 million in sales. Nelson said the Bud & Mary's Windsor Heights location handles about 300 transactions daily, while the Sioux City location sees about 50 transactions daily.

Iowa Cannabis Company operates dispensaries in Waterloo, Iowa City, and Council Bluffs. The Iowa Cannabis Company began producing cannabis for the program in Cedar Rapids in 2021 before relocating its planned facility to Iowa City. According to the board's report, that facility will be operational in May 2023.

Bud & Mary's has begun a multi-million dollar expansion of its production operations because of the increased demand. According to Nelson, the new facility would be operational in the first quarter of 2023. The new process will triple the company's production.

Nelson said the company would continue to lobby legislators to approve the sale of vaporized flower, which is accessible in several other states' medical cannabis programs. The change would allow the state's dispensaries to sell whole marijuana flower that patients could vaporize.

Currently, Iowa's program only allows for the sales of topical, oral, nebulizers, suppository products, and oil vaporizers. In 2022 vape products were the most popular forms sold at dispensaries, accounting for 66 percent of sales.

Producing cannabis flowers is more cost-effective than other marijuana products. Nelson concedes the change would attract more patients to the program and decrease costs for cardholders.

While the board has yet to recommend that change, Nelson and the committee agree that the state needs to increase licensed dispensaries; state law currently allows for five.

According to a study by the Medical Cannabidiol Board, they recommend allowing the department to issue more licenses and removing the number of dispensary licenses from state law.

Regarding taxes, the board recommended exempting medical cannabis products from sales tax to ease the economic impact on patients. It also advocated a tax tweak allowing marijuana companies to apply business expense deductions on state income taxes.

In a technical modification, the board also recommended updating the state law, and by extension, the program name, from the "Iowa Medical Cannabidiol Act" to the more encompassing "Iowa Medical Cannabis Act."

Cannabidiol, commonly known as CBD, one of over a hundred and twenty cannabinoids found in the marijuana plant, was originally the primary product available when the program started.

However, a 2020 law removed a THC (a complimentary cannabinoid to CBD) limit on products and allowed the sale of high-THC products — but with a cap of 4.5 grams of THC per 90-day purchase in most cases. THC is the primary compound in a marijuana plant that causes the "cerebral effect ."

The report said that the name creates confusion around the program because some law enforcement officers and other officials are unaware that high-THC medical cannabis products are legal and readily available in the state.

The bulk of dispensary sales is high-THC products making up 78 percent, followed by 13.2 percent of a one-to-one ratio of THC and CBD and 8.9 percent solely CBD products.

According to Nelson, the higher percentage of sales of THC products can be attributed to its effectiveness in treating chronic pain and the availability of CBD over the counter in Iowa and online. With CBD readily available without a medical card, people joining the program generally seek higher THC formulas or CBD-THC combinations.

The report also states the name state law and the program name change would "reflect scientific reality via the encompassing of all cannabinoids, improve program education, and mitigate confusion with program stakeholders."