The Department of Health and Human Services has recommended removing cannabis from the federal government’s list of drugs that have “no currently accepted medical use and a high potential for abuse.” Known as Schedule I, this group includes substances such as heroin and LSD, bad company in which cannabis, whose recreational and medicinal use is being legalized or decriminalized by many states, no longer belongs — if it ever did. This is a wise and overdue change, which, not incidentally, fulfills one of President Biden’s campaign promises.
The HHS recommendation now goes to the final decision-maker, the Drug Enforcement Administration, which has historically opposed rescheduling cannabis. But now there is an opportunity to recalibrate U.S. drug policy. The question is precisely how.
HHS’s suggestion was to move cannabis to Schedule III, which is for medically useful drugs with a middle-range potential for abuse; the current list includes ketamine and testosterone. Putting cannabis in that category would be a defensible judgment — albeit one whose detailed rationale HHS has not yet publicly described. Much has changed since the last formal review in 2016. There is evidence showing cannabis is effective at treating chronic pain, according to a 2017 report by the National Academies of Sciences, Engineering, and Medicine. Millions use it for that purpose, often with a doctor’s recommendation in the 38 states where medical marijuana is legal. The National Academies also reported that certain orally administered cannabis derivatives can help multiple sclerosis and cancer patients. A move to Schedule III would allow even more research to occur.
Public opinion has also shifted. A majority of the public no longer views weed usage as a problem. Nearly 70% of Americans support legalizing small amounts of marijuana for personal use, a dramatic shift from the late 1990s, when fewer than a quarter held that view. This is a key reason 23 states have legalized recreational marijuana use. There is a growing disconnect between state and federal policy. The DEA’s scheduling system technically does not address the legality of a drug, but the schedule number does impact federal policy on production, distribution and scientific research of the drug. Moving marijuana to Schedule III would effectively condone more widespread use.
And yet there is still much controversy about both the medical usefulness and the addictive potential of cannabis, which is today available in high concentrations of its psychoactive ingredient, THC. The Food and Drug Administration has never approved cannabis per se — as opposed to a few chemical derivatives — for medical use. The report by the National Academies also notes that heavy cannabis use might increase the risk of driving accidents and mental health disorders. A 2015 peer-reviewed study reported that nearly 30% of cannabis users develop a use disorder, defined as an inability to stop despite negative consequences.
In short, while cannabis doesn’t belong on Schedule I, incomplete information about it means it isn’t a slam dunk for Schedule III, either. Another strong option is a move to Schedule II alongside cocaine and Adderall. This would enable more research on marijuana and acknowledge its potential medical uses, but it would stop short of allowing cannabis companies to easily advertise across the nation and take advantage of tax breaks. Given the risks that remain with marijuana consumption, it seems preferable to be cautious. No one wants a repeat of the tobacco youth advertising fiasco.
Improved lawful access to the U.S. banking system is a more legitimate short-term priority for cannabis businesses, which could be accomplished by passage of a bipartisan bill pending in the Senate. Also, the entire subjective scheduling system is overdue for reform, as the ambiguities and conflict over rescheduling cannabis show.
HHS made its recommendation pursuant to instructions Biden gave last year; at the same time, he pardoned everyone with a federal conviction for simple possession of marijuana and asked governors to do the same at the state level. This message from the White House moved the United States toward a more rational and humane policy, albeit incrementally. Yet incrementally is how U.S. social policy has often advanced. Rescheduling marijuana would be another nudge in the right direction.