Category: current events

Iowa Bill HF2676 Which Would Allow OTC Ivermectin in Iowa On its Way to Governor Reynolds Desk

Late yesterday, there was a story published in the Iowa Capital Dispatch announcing that the MAHA bill HF2676 is on its way to Governor Reynolds for her signature. A part of that bill “…also would allow ivermectin, a drug used to treat parasitic infections that some have claimed can be used in preventing or treating symptoms of COVID-19, to be distributed over the counter by pharmacies.”

She will probably sign it, making Iowa one of a handful of states in the U.S. which allows human-grade ivermectin available over-the-counter in pharmacies. I think saying it would be OTC is partly a misnomer because it would actually be more like “behind the counter” as it’s not packaged to be sold that way, for example, in places like Walgreens.

The language of the bill is permissive, though, which means that pharmacists “may” (not “shall”) make ivermectin available OTC. I’m surprised that she’s quoted in the story saying the bill “takes common sense steps to improve health and well-being for Iowans of all ages.” Nothing further from the truth could be said regarding the ivermectin piece. There’s no good evidence that it’s effective for treating Covid-19 infection.

That said, I’m not sure how this bill once it’s signed into law would be enforceable. Pharmacists and/or other health professionals are not required to unilaterally or collaboratively set up a standing order making ivermectin available OTC. I think you’d still need to have a prescription if you need it to treat parasite infections.

If you drive up to the window and request human-grade ivermectin, the law would not prevent a pharmacist from asking you why you want it. I’m aware of off-label indications for medications. The American College of Medical Toxicology (ACMT) published a paper in 2022 cautioning against off-label prescribing of ivermectin for treatment of Covid-19. I agree with their statement that “clinicians, not courts should direct medical care.” By extension, I think that you could substitute the word “legislatures” for “courts.”

Calello DP, Kazzi Z, Stolbach A. American College of Medical Toxicology (ACMT) Cautions Against Off-Label Prescribing of Ivermectin for the Prevention or Treatment of COVID-19. J Med Toxicol. 2022 Jan;18(1):69-70. doi: 10.1007/s13181-021-00866-z. Epub 2022 Jan 10. PMID: 35006547; PMCID: PMC8744041.

I realize there’s a lot of off-label prescribing of drugs going on out there. Ozempic is one of them. I have not read the news article warning about “Ozempic penis.” I have read the FDA’s announcement about off label use of ivermectin.

The push for ivermectin off-label use for Covid-19 looks politically motivated, in my opinion. Governor Reynolds will likely sign into law HF 2676 including the small part about ivermectin which really doesn’t seem to belong in the bill. It’ll be a pyrrhic victory. I think it makes the legislators who supported it and the governor look bad. Further, I think it makes Iowa look bad. I doubt Iowa pharmacists, one of whom refused to fill a prescription for ivermectin for Covid-19 a few years ago, will have any trouble declining to provide ivermectin to anyone who wants to use it to treat Covid-19.

OK, on the lighter side I’m going to pour a little cold water on ivermectin regarding its use as an antiparasitic agent. Does it work for ticks? The reason I bring this up is that last week, my wife Sena did not use OFF! Deep Woods insect repellent before going out into the backyard garden which borders on a woodsy outlot. When she came inside, she asked me to take a look at the back of her neck because she felt something crawling on her. I plucked a tick from her hair and flushed it down the sink.

Then, this morning I noticed a CDC article published last week about visits to emergency rooms for tick bites being higher than usual. Ticks can make you really sick. They cause several diseases including something I didn’t know much about which is alpha-gal syndrome. That’s not a term invented to compete with the alpha male syndrome. The “gal” is short for galactose and if a tick infects you with it, you can get allergic to red meat (tick bite meat allergy). Then you’d have to avoid eating red meat.

So, is ivermectin effective against ticks? There was a study published 12 years ago that said it was not. On the other hand, there’s a story that says ivermectin is protective against ticks—in deer, not in humans. Don’t forget the OFF!

Sheele JM, Ford LR, Tse A, Chidester B, Byers PA, Sonenshine DE. The use of ivermectin to kill ixodes scapularis ticks feeding on humans. Wilderness Environ Med. 2014 Mar;25(1):29-34. doi: 10.1016/j.wem.2013.09.008. Epub 2014 Jan 9. PMID: 24411976.

Cannabis Rescheduled from Schedule I to Schedule III Today

As of today, the US Dept. of Justice moved “…the classifications of products containing marijuana that are covered by the Food and Drug Administration or that have received a state medical-marijuana licence” from Schedule I to Schedule III.

This is not exactly the same as reclassifying all marijuana, although it looks like that is being considered as the next step. Marijuana itself is still illegal at the Federal level. And today’s current change in classification could also be legally challenged in the next 30 days.

It’s important to point out that today’s DOJ action is not the same as “full federal legislation” of marijuana. That would mean de-scheduling it altogether.

You can find out more about the legal consequences of today’s action at congress.gov. For example, “With respect to the manufacture, distribution, and possession of recreational marijuana, if marijuana were moved to Schedule III, such activities would remain illegal under federal law and potentially subject to federal prosecution regardless of their status under state law.”

Is Cannabis Reclassification Imminent?

I saw a couple of brief news alerts indicating that progress toward reclassification of marijuana from Schedule I to III could be happening as soon as today according to a Reuters report. I think that means we should pay attention to other stories and reports of cannabis use being associated with higher rates of psychosis in adolescents. That information is not new and it has been reported since at least since 2010.

The DEA is in charge of reclassification of substances.

Sena’s Out in the Garden on Earth Day!

Today is Earth Day and Sena is out in the garden working. She’s doing it not just because it’s Earth Day. She’s doing it because she cares a lot about the garden and not just that. She’s often way out in the outlot beyond our back yard.

We got a message in our mailbox from Forever Green in Coralville. Of course, it’s an ad about a sale to buy stuff at their store on Earth Day through Arbor Day (April 22-25). The great part of their message is:

Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not. 

Sena cares a whole awful lot. Happy Earth Day!

The Question of Ethical Principles Regarding the Ivermectin Portion of Governor Reynolds MAHA Bill HF 2676

I think the Iowa legislature bill HF 2676 (Governor Reynolds’ MAHA bill) has just been sent back to the Senate, maybe based on fiscal issues, according to the most recent information I could find on the web. The ivermectin piece probably isn’t in a section that bears heavily on fiscal matters, so if the Senate approves it this time, it might either go back to the House for more debate about budgetary issues—or it might go to Governor Reynolds’ desk to sign (if it even has to be signed by the governor).

The ivermectin part of this bill would allow pharmacists to decide (it’s not mandatory; it’s permissive) on whether or not to offer ivermectin over-the-counter—for whatever reason a patient wants it, which could be for treating Covid-19 infection for which there’s no evidence of its effectiveness.

Because the language of the bill states that pharmacists would be immune from civil and criminal liability for bad outcomes from using ivermectin for treating Covid-19 infection, it would be up to individual pharmacists to choose whether or not to provide it for that purpose, based on their ethical principles to act out of their sense of clinical duty to ensure patient safety.

The ivermectin part of the bill is in Section VII and, in my opinion, should be removed.

What’s Up with the Ivermectin Bill in Iowa?

I’m trying to find out what’s happening with Governor Reynolds’ MAHA bill (HF 2676) which includes allowing Iowa pharmacists to provide ivermectin without a prescription to those who prefer taking it, most likely for something else other than what’s indicated for, which is treating parasitic infections. The risk is that persons will try to use it to self-treat other diseases such as Covid 19 infections, for which there is no convincing evidence supporting ivermectin’s effectiveness.

There’s a list of bills signed into law by the governor as of April 16, 2026 which doesn’t include HF 2676. My understanding is that this year’s legislative session would be ending maybe as soon as tomorrow.

I found one source on the web which indicates the Iowa House passed it. It then went to the Senate, which passed the bill with the ivermectin part intact and it was returned to the House. It’s not clear whether Governor Reynolds actually needs to sign it into law.

My usual go-to news source for Iowa lawmaker news is the Iowa Capital Dispatch, but it doesn’t seem to have any recent updates on this bill.

The language of the bill regarding so-called over-the-counter ivermectin is permissive, meaning pharmacists may (not must) provide ivermectin, not making it mandatory for Iowa pharmacists to hand over ivermectin to anyone who requests it. And pharmacists would be exempt from “…professional discipline or civil or criminal penalties for distributing ivermectin…”

It doesn’t look like anyone considered what recourse patients might have if they suffer injury as a result of taking ivermectin for a non-FDA approved (off label) condition.

AI Chatbots and Psychiatry: Embrace or Dislodge?

I’ve just finished reading a couple of online articles about Chatbot use by patients who then present either to psychiatrists or psychotherapists (not that they can’t be one and the same!) and I’m a little puzzled. The title of my blog post came partly from what my wife, Sena, always says about Artificial Intelligence—which is that it needs to be dislodged.

The first article, “Clinician Competence in the Age of Chatbots,” is part of a Psychiatric Times series, “AI Chatbots: The Good, The Bad, and the Ugly.” It’s a collaboration between a psychiatrist who I admire (Dr. Allen Frances, MD) and Jill Noorily (described as someone “who lives and writes at the boundary between AI and the humanities).

I’m far from an expert on AI and I tend to be opposed to it most of the time. The article by Dr. Frances and Jill Noorily sounds almost supportive of Chatbots in psychotherapy.

The other article is entitled “Patients Bring ChatGPT to Psychiatry Visits, With Richard Miller, MD.” The tone of Dr. Miller is more along the lines of “dislodge AI” than that of the article by Dr. Frances and Noorily.

They were both published about the same time. The difference in tone between the two articles is definitely noticeable, at least to me. I’m also more like Dr. Miller than the authors of the articles in the Psychiatric Times series “AI Chatbots: The Good, The Bad, and the Ugly.”

Many of them are co-written by Dr. Allen Frances and other co-authors. The first one in the series was “Preliminary Report on Chatbot Iatrogenic Dangers,” posted on August 15, 2025 by Dr. Frances, MD and Luciana Ramos.

I quickly read through about 5 of the articles, getting a deeper sense of the conflicts I have about AI in general. The first one on iatrogenic dangers mentions the lawsuit brought by a woman whose son was the victim of a Chatbot who told him he should commit suicide—which he did.

So far, I think I have the same mindset about AI as Dr. Miller. Your thoughts?

Earth Day 2026!

Hey, Earth Day 2026 is on April 22, 2026! If any of you are like me (and who isn’t?), you might have trouble figuring out just what you can do that would be meaningful on Earth Day.

Well, here’s a link to Earth Day Tips which gives you 50 easy ways to participate. You could volunteer, take a quiz, go to the park, or even eat kale! Try not to stand under a tree in which a bald eagle is pooping.

You can find Earth Day events in your area at this website.

How About Some Good News?

How about some good news for a change? See the Daily Iowan report on research being done at The University of Iowa examining how transcranial magnetic stimulation can help clinical neuropsychiatric conditions such as depression and Alzheimer’s disease. There’s also a link to the open access study which gives more detail about the process.

Reference:

Li, Z., Trapp, N.T., Bruss, J. et al. Multimodal evidence for hippocampal engagement and modulation by functional connectivity-guided parietal TMS. Nat Commun (2026). https://doi.org/10.1038/s41467-026-70346-x

Easter Monday Flowers

Today is Easter Monday, which is a part of Easter that we heard of for the first time today. That reminds me; we got some photos last week of daffodils and a purple flower we called a crocus—which is actually a hyacinth. So, I got another picture of the daffodils and hyacinths, which are popular flowers for Easter.

I’m not sure why we’ve never heard of Easter Monday before. I looked it up and it’s part of Eastertide, and it’s the second day of the resurrection of Jesus Christ. It’s also called Bright Monday.

In the U.S., Easter Monday is not a federal holiday, but it is in over 100 countries. I guess there’s a White House Easter egg roll, which I’ve never heard either. It’s observed in certain places in North Dakota.

Happy Easter Monday!