Iowa is home to a medicinal marijuana program, but the state’s program prohibits the use of flower cannabis as a medicine. Prior to the passage of HF2589, Iowa limited the amount of THC concentrations in extracts to 3%. HF2589, which was signed into law by Governor Kim Reynolds on June 29, 2020, removed this limitation, but reduced the combined total of THC that can be purchased to 4.5 g per patient per 90-day period. The law does allow health care practitioners to certify that certain patients should be allowed to procure more than 4.5 g within the 90-day period, particularly if the patient has "a terminal illness with a life expectancy of less than one year" or the amount "is insufficient to treat the patient's debilitating medical condition."
For non-medical patients, use of marijuana is a misdemeanor. First-time offenders can receive a maximum sentence of up to 6 months imprisonment and a fine of $1,000. Second-time offenders can receive a maximum sentence of up to 1 year of imprisonment and a fine of $1,875. Subsequent offenders can receive a maximum sentence of up to 2 years imprisonment and a fine of $6,250.
The unlicensed cultivation of marijuana is a felony. The maximum penalties are as follows:
• 50 kg or less: 5 years of incarceration and up to $7,500 in fines.
• 50-100 kg: 10 years of incarceration and up to $50,000 in fines.
• 100-1000 kg: 25 years of incarceration and up to $100,000 in fines.
• More than 1000 kg: 50 years of incarceration and up to $1,000,000 in fines.
For physicians, there are no specific training courses that must be completed to recommend cannabis to patients. Physicians must only be properly licensed MDs and DOs and provide information to the patient about the risks/benefits of cannabis use. HF2589 modified Iowa law and allows physician assistants licensed under chapter 148C, advanced registered nurse practitioners licensed under chapter 152, advanced practice registered nurses under 152E, and podiatrists licensed under chapter 149 to recommend cannabis. These physicians may only recommend cannabis to patients with the following qualifying conditions:
• Amyotrophic lateral sclerosis
• Autism spectrum disorder
• Chronic pain
• Crohn’s disease
• Multiple sclerosis
• Cancer-related nausea
• Parkinson’s disease
• Post-traumatic stress disorder (as of 06/29/2020)
• Terminal illnesses
• Ulcerative colitis.
For more information, please see the medical cannabidiol page for physicians on the Iowa Department of Public Health’s website:
Residents of other states who have enrolled in their home state’s cannabis program may not procure cannabis from dispensaries in Iowa; they are merely allowed to possess cannabis preparations containing less than 3% THC obtained through their state’s program. Patients and caregivers are both allowed to register with Iowa’s medicinal cannabis program and in the state of Minnesota as a visiting qualified patient or primary caregiver.
For patients interested in learning more about the state’s program, direct them to the Department’s site for the public: