The regulatory framework in Iowa is extremely restrictive; only patients with severe medical conditions, such as cancer and terminal illness, can participate in this market.

In January 2022, Iowa Democratic senators released the text of a joint resolution to put the question of cannabis legalization before voters on the state's ballot.

The proposed constitutional amendment states, "the possession, growth, cultivation, processing, manufacture, preparation, packaging, transferal, consumption, and retail sale and purchase of cannabis, or products created from or including cannabis, by persons 21 years of age or older, shall be lawful."

The General Assembly will need to pass the proposal twice during two separate sessions to get the constitutional amendment on the ballot, meaning the soonest voters will get to weigh in will be during the November 2024 election. It also means the Republican-controlled legislature will need to get on board with the idea of a referendum on the issue.

There is no notable market activity at this time.

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Watch for this market to evolve slowly. As with all nascent medical markets, conditions such as chronic pain and anxiety will likely be the catalysts for this market to become relevant.

Regulators also announced that applications would be accepted for a second cultivator/processor license after Acreage Holdings dropped out of the market. But questions remain about whether the current program is viable, given the low-THC content allowed and the limited number of licenses.