10 Things You Should Know About Trump & Cannabis Scheduling

According to a November 4, 2021, Congressional Research Service analysis, Does the President Have the Power to Legalize Marijuana?, the President cannot directly deschedule or reschedule marijuana by executive order. The Supreme Court has held that a president may issue an executive order only if authorized by statute or the Constitution. The Controlled Substances Act (CSA) assigns scheduling to the Attorney General (delegated to DEA) with scientific input from HHS/FDA, not the President.

Bottom line: The only way a president can affect scheduling is by directing agencies to use the CSA process already in motion — the same process that is currently in progress, the process President Biden initiated in October 2022. However, Trump cannot start a new rescheduling process until the current one is completed.

DEA Administrator Cole inherited a rescheduling process initiated under the Biden Administration.  The process had reached one of the last stages before a final ruling on the classification of cannabis by the DEA, an Administrative Law Judge hearing.  The hearing stalled days before it was scheduled to begin when one of the witnesses filed an interlocutory appeal. So the options in front of him include:

A. Resume the current ALJ track.

• • • Set a briefing schedule on the pending interlocutory appeal that paused the hearings in January.
    • Appoint a new ALJ to replace Judge Mulrooney

B. Scrap the current ALJ proceedings and issue a new “Notice of Hearing on Proposed Rulemaking.” (Under ALJ case law, any hearing would still center on HHS’s Schedule III recommendation) or

C. Skip an ALJ hearing and issue a final scheduling determination (Schedule I, II, or III), which would then be subject to judicial review

NOTE: House Republicans are attempting to choke off the DEA’s authority through the appropriations process. The current version of the  House FY2026 Commerce, Justice, Science (CJS) bill includes language that would block rescheduling activity:

Sec. 607: “None of the funds appropriated or otherwise made available by this Act may be used to reschedule marijuana… or remove marijuana from the schedules….”

If this passes in the FY2026 CJS before Cole has completed the process, it will come to a grinding halt.

The proposed rule change is not black and white, and the upcoming road ahead to a final ruling promises twists and turns. While patients have not been the focus of much of the news coverage on the rescheduling process, they are at the center of the journey to this groundbreaking end to 50+ years of prohibition of cannabis.

THE PROPOSED RULE:

1. AMEND § 1308.11 SCHEDULE I. -(d) Hallucinogenic substances. Unless specifically excepted or unless listed in another schedule, anymaterial, compound, mixture, or preparation, which contains any quantity of the following hallucinogenic substances, or which contains any of its salts, isomers, and salts of isomers whenever the existence of such salts, isomers, and salts of isomers is possible within the specific chemical designation (for purposes of this paragraph only, the term “isomer” includes the optical, position and geometric isomers).

BY REMOVING

paragraph(d)(23)-(23) Marihuana 7360

AND

paragraph (d)(58)-  (58) Marihuana Extract 7350 Meaning an extract containing one or more cannabinoids that has been derived from any plant of the genus Cannabis, containing greater than 0.3% delta-9-tetrahydrocannabinol on a dry weight basis, other than the separated resin (whether crude or purified) obtained from the plant.

CHANGING:

(redesignating paragraphs (d)(24) through (d)(104) as (d)(23) through (d)(102), respectively)

2. AMEND § 1308.11 BY REVISING THE RENUMBERED PARAGRAPH (D)(30) TO READ AS FOLLOWS:

(31) (30) Tetrahydrocannabinols 7370

(i) Meaning tetrahydrocannabinols, except as in paragraph (d)(31)(30)(ii) and (iii)  of this section, naturally contained in a plant of the genus Cannabis (cannabis plant), as well as synthetic equivalents of the substances contained in the cannabis plant, or in the resinous extractives extracts of such plant, and/or synthetic substances, derivatives, and their isomers with similar chemical structure and pharmacological activity to those substances contained in the plant, such as the following: 1 cis or trans tetrahydrocannabinol, and their optical isomers 6 cis or trans tetrahydrocannabinol, and their optical isomers 3, 4 cis or trans tetrahydrocannabinol, and its optical isomers

 (Since nomenclature of these substances is not internationally standardized, compounds of these structures, regardless of numerical designation of atomic positions covered.)

(ii) Tetrahydrocannabinols does not include any material, compound, mixture, or preparation that falls within the definition of hemp set forth in 7 U.S.C. 1639o.

(iii) Tetrahydrocannabinols does not include any substance that falls within the definition of marijuana set forth in 21 U.S.C. 802(16).

3. AMEND § 1308.13 BY ADDING NEW PARAGRAPHS (H), (I), AND (J) TO READ AS FOLLOWS:

1308.13 Schedule III.

(h) Marihuana Marijuana, as defined in 21 U.S.C. 802(16).

(i) Marihuana Marijuana Extract, meaning an extract containing one or more cannabinoids that has been derived from any plant of the genus Cannabis, containing greater than 0.3 percent delta-9- tetrahydrocannabinol on a dry weight basis, other than the separated resin (whether crude or purified) obtained from the plant.

(j) Naturally Derived Delta-9-Tetrahydrocannabinols.

Meaning those delta-9-tetrahydrocannabinols, except as in paragraphs (j)(ii) and (j)(iii) of this section, that are naturally contained in a plant of the genus Cannabis (cannabis plant).

Naturally derived delta-9-tetrahydrocannabinols do not include any material, compound, mixture, or preparation that falls within the definition of hemp set forth in 7 U.S.C. 1639o.

Naturally derived delta-9-tetrahydrocannabinols do not include any delta-9- tetrahydrocannabinols contained in substances excluded from the definition of marijuana as set forth in 21 U.S.C. 802(16)(B) (ii)

Referenced definitions:

7 U.S.C. §1639o. Definitions (1) Hemp- The term "hemp" means the plant Cannabis sativa L. and any part of that plant, including the seeds thereof and all derivatives, extracts, cannabinoids, isomers, acids, salts, and salts of isomers, whether growing or not, with a delta-9 tetrahydrocannabinol concentration of not more than 0.3 percent on a dry weight basis.

21 U.S.C. 802 (16)(A) Subject to subparagraph (B), the terms "marihuana" and "marijuana" mean all parts of the plant Cannabis sativa L., whether growing or not; the seeds thereof; the resin extracted from any part of such plant; and every compound, manufacture, salt, derivative, mixture, or preparation of such plant, its seeds or resin.

(B) The terms "marihuana" and "marijuana" do not include-

(i) hemp, as defined in section 1639o of title 7; or

(ii) the mature stalks of such plant, fiber produced from such stalks, oil or cake made from the seeds of such plant, any other compound, manufacture, salt, derivative, mixture, or preparation of such mature stalks (except the resin extracted there from), fiber, oil, or cake, or the sterilized seed of such plant which is incapable of germination.

When asked about rescheduling, Trump said:

“ I’ve heard great things having to do with medical [cannabis]…for pain and various things. I’ve heard some pretty good things. But for other things, I’ve heard some pretty bad things.”

This simple statement reflects the competing pressures shaping his decision: entrenched opposition in Congress, the persistence of anti-cannabis messaging, unexpected conservative support, strong demands from patients, and the backdrop of the opioid epidemic.

Anti-Cannabis Lobby

The anti-cannabis lobby is playing up the “big Marijuana” aspect of media coverage, amplifying cannabis business press releases, and focusing on how rescheduling impacts taxes for businesses. They gained steam during this rescheduling process, when speculations that President Biden had initiated the scheduling review as a strategic move for his re-election, driving a political wedge in a once-fading partisan line around medical cannabis policy.  Organizations like Smarter Approaches to Marijuana and, more recently, Project 2025 contributor, The Heritage Foundation, have been mounting public pressure campaigns on President Trump.

Project 2025:

While President Trump claims he hasn’t read Project 2025, it’s clear that his administration is operating in alignment with it. There are troubling signs that policies outlined in the Project could be used to crack down on medical cannabis under the guise of restoring the “rule of law.” Consider these excerpts:

“The DOJ can provide critical technical support for local law enforcement and play a critical agenda-setting role.” (p. 548)

“Use applicable federal laws to bring federal charges against criminals when local jurisdictions wrongfully allow them to evade responsibility.” (p. 553)

“Rigorously prosecute as much interstate drug activity as possible, including simple possession of distributable quantities.” (p. 554)

“Aggressively deploy the Racketeer Influenced and Corrupt Organizations Act (RICO)...” (p. 555)

In plain terms, this means that many of President Trump's advisors are not opposed to and potentially clearing the way for renewed raids, prosecutions, and interference in state-legal medical cannabis programs.

Current Leadership in Congress

The anti-cannabis lobby’s partisan wedge responded quickly to try to stop the rescheduling process. In 2024, the House Appropriations Committee passed a version of the Commerce, Justice, Science, and Related Agencies (CJS) appropriations bill that included language to block cannabis rescheduling efforts. The very next day, 25 Republican Senators and Congressmen sent a letter to Attorney General Merrick Garland, condemning the rescheduling process as politically motivated and unsupported by science.

Many of the signatories of that letter are now in leadership positions that the President must work to move his agenda in Congress, including  John Thune (R-SD), Shelley Moore Capito (R-WV)-GOP Policy Committee Chair, James Lankford (R-OK)- GOP Policy Committee Vice-Chair, Jerry Moran (R-KS), chair of CJS appropriations, and Hal Rogers, chair of House appropriations. 

On another letter was sent Attorney General Pam Bondi from House republicans: Congressman Pete Sessions (TX-17), Andy Harris (MD-01), Robert Aderholt (AL-04) , Chip Roy (TX-21), Paul Gosar (AZ-09), Blake Moore (UT-01), Gary Palmer (AL-06), David Rouzer (NC-07), and Mary Miller (IL-15) urging her to reject marijuana rescheduling on August 28^th.  

Unexpected Support from Conservative Circles

 Bob Barr, former Congressman (R-GA), authored an opinion piece, “Should marijuana be rescheduled?” While in Congress, Barr blocked the District of Columbia from implementing medical cannabis laws for almost a decade with the “Barr Amendment.”

“Rescheduling cannabis is not merely a bureaucratic reshuffling. Its Schedule I status creates major barriers for researchers and doctors wishing to study potential therapeutic uses. Further, it creates burdensome red tape that slows scientific progress.  

It demonstrably is not the case that no medical value can be had from marijuana. It has been used effectively to help patients with epilepsy, chronic pain, PTSD and chemotherapy-induced nausea. The notion that there is no known medical use for cannabis and cannabis-derived medication is clearly outdated. 

As a conservative, I have always believed that cutting regulatory red tape spurs economic growth. This would be the case for rescheduling cannabis; a straightforward change would support more than 440,000 existing jobs and open the door to future growth. It would lead to more American jobs in research and medicine, generating therapeutic breakthroughs and boosting the economy.”

The Opioid Crisis Connection

Rescheduling also intersects with one of Trump’s hallmark issues: the opioid epidemic, which he declared a public emergency during his first term. Cannabis-based therapies have shown efficacy in treating conditions where no other pharmaceutical options exist or where current treatments are ineffective or produce intolerable side effects. This is particularly important in cases of combination drug treatments that increase the likelihood of adverse events, side effects, tolerance and dependence, and drug resistance. Moreover, cannabis and cannabinoids have a robust safety profile compared to alternative treatments; unlike opioids, cannabinoid receptors do not regulate respiratory or cardiac functions, making lethal overdoses virtually impossible.

More than 68 million Americans live with chronic pain (CDC) and roughly 3 in 10 chronic pain patients report using cannabis to manage pain and improve function, often reducing or replacing opioids. 

There is a scientific consensus that medical cannabis is safe and treats pain:

“There is conclusive or substantial evidence that cannabis or cannabinoids are effective for the treatment of chronic pain in adults, as anti-emetics in the treatment of chemotherapy-induced nausea and vomiting, and for improving patient-reported multiple sclerosis spasticity symptoms.”- National Academies of Sciences, Engineering, and Medicine: The Health Effects of Cannabis & Cannabinoids, January 2017

“We find that, for purposes of the drug scheduling criteria in 21 U.S.C. 812(b), marijuana has a CAMU in the United States for: anorexia related to a medical condition; nausea and vomiting (e.g., chemotherapy-induced); and pain”. - Basis for the Recommendation to Reschedule Marijuana into Schedule III of the Controlled Substances Act

A recent Washington Post op‑ed by Julien Berman highlights county‑level data associating dispensary access with significantly lower opioid death rates over time.

“Turns out, when a county opens its first dispensary — giving residents easy access to marijuana — opioid death rates go down relative to counties that don’t yet have any dispensaries. The effects aren’t small, either. Ten years after that first dispensary opens, death rates in cannabis counties are, on average, about 30 percent lower than death rates in counties without a dispensary.”

According to the FDA’s Center for Drug Evaluation and Research (CDER):

“None of the evidence from the systematic reviews included in our analysis demonstrated substantial safety concerns that would argue against the use of marijuana in any of the indications where there exists some support for its benefit.”

(See: CDER’s “Considerations for Whether Marijuana Has a Currently Accepted Medical Use…”.)

 Patient Organizations

 A coalition of patient organizations representing millions of Americans weighed in on FY2026 CJS appropriations, calling for protections and greater reform:

“Medical cannabis programs have become a lifeline for millions of Americans, including many of the 30 million Americans living with one of 7,000 known rare diseases (95% of which have no FDA-approved treatment available) as well as the one-third of Americans who live with chronic pain and the 10% of Americans living with debilitating, intractable pain. 

You have the power to protect the health, safety, and dignity of millions of Americans. Until comprehensive, permanent federal legislation is enacted to align federal cannabis policy with state laws and integrate medical cannabis into mainstream healthcare, maintaining the Medical Cannabis CJS Amendment is essential.”

1937 Marijuana Tax Act

The Federal prohibition of Cannabis in the United States began with the 1937 Marijuana Tax Act. This legislation was passed despite opposition from the American Medical Association (AMA).

"American Medical Association knows of no evidence that marijuana is a dangerous drug," and warned that a prohibition "loses sight of the fact that future investigation may show that there are substantial medical uses for cannabis." -Dr. William C Woodward, AMA.

While the author and proponent of the bill Harry J. Anslinger, argued

“The primary reason to outlaw marijuana is its effect on the degenerate races,” “Reefer makes darkies think they're as good as white men,”​and  “Marihuana influences Negroes to look at white people in the eye, step on white men's shadows and look at a white woman twice.”

The Controlled Substances Act & the Shafer Commission 

The courts overturned the Marijuana Tax Act in 1968. That same year, the United States signed on to the United Nations Treaty on Narcotic Drugs, which required the U.S. to pass the Controlled Substances Act (CSA).   In 1970, cannabis was placed in Schedule I under the CSA as a placeholder, pending evaluation by a government-appointed commission known as the National Commission on Marihuana and Drug Abuse – also known as the Shafer Commission after the Commission's chairman, Raymond P. Shafer. Even though the Shafer Commission recommended the decriminalization of cannabis or at least a schedule to allow medical availability, these policy recommendations were rejected by President Nixon because they did not align with his desire to include “marijuana” in his war on drugs.

"I am against legalizing marijuana. Even if the Commission does recommend that it be legalized, I will not follow that recommendation...”

“The President's News Conference," The American Presidency Project website, May 1, 1971

The Compassionate Investigational New Drug Program

In 1976, patient Bob Randall fought a cannabis charge based on “medical necessity,” resulting in FDA  creating the Compassionate Investigational New Drug (IND) program, the federal government growing and providing cannabis for a small number of patients.

In 1992, President Bush Sr.'s administration shut down the program to new applicants, citing concerns that the program undermined the “WAR ON DRUGS.”

Ignoring & Changing the Rules of Engagement 

After a 15-year-long battle to have the DEA follow the rescheduling process in the CSA, a rescheduling petition advanced to a DEA Administrative Law Judge hearing. In 1988, DEA's Chief Administrative Law Judge, Francis L. Young, ruled

 "Marijuana, in its natural form, is one of the safest therapeutically active substances known... It would be unreasonable, arbitrary, and capricious for the DEA to continue to stand between those sufferers and the benefits of this substance.”

In 1998, the DEA rejected the ALJ opinion and published its denial in the Federal Register. This was after creating a new criteria for determining whether a drug has a “currently accepted medical use”, now referred to as the five-element test.

Many have argued that the added layer to the process of determining medical value (“five-element test)” for Schedule I substances to enter less restrictive schedules would never allow cannabis to be rescheduled. In practice, only substances that fall under FDA oversight, Schedule II-V substances, successfully move between schedules based on evaluating their abuse potential (ultimately determined by the DEA). These substances have already established their medical value through other processes.

The “5 element test” standard is equivalent to the federal regulations for an FDA-approved drug, i.e., the medical value assigned to cannabis does not meet their definition of “medicine,” not that cannabis has no medical value.

In 2024, the DOJ’s OLC found that:

“Congress’s decision to explicitly invoke the FDCA’s standards with respect to some parts of the CSA, but not with respect to whether a drug has a CAMU, strongly suggests that it did not mean to equate CAMU with the standards necessary for FDA approval.”

CONGRESS CREATED THIS PROBLEM. THEY CAN FIX IT.

The current rescheduling process could drag on for years. While POTUS can’t interrupt this process, Congress can utilize the data from HHS’s findings and the experiences of their constituents to pass legislation not only recognizing the medical benefits of cannabis but also facilitating safe access at any time. 

While Schedule III may seem like a large deviation from the recommendations provided by HHS and DEA in 2016, outright dismissing the finding of HHS and DOJ, “currently accepted medical use” does not take into account the enormity of the scientific and medical discoveries that have happened in the time since they were issued as well as the vast societal call for an updated approach to cannabis policy.

12 YEARS OF SCIENTIFIC & MEDICAL DISCOVERIES ESTABLISHED “CURRENTLY ACCEPTED MEDICAL USE” IN THE U.S. 

In 2011, at the time of the filing of the last rescheduling petition, while sixteen states had passed medical cannabis laws, only thirteen of the programs were operating, and only five had operating distribution programs, accounting for 286,243[5] registered medical cannabis patients (excluding WA, CA, HI no data available and DC, DE, NJ not online yet) and estimated 600,000[6] non-registered patients. Today, there are over 6 million patients utilizing the state medical cannabis programs.

 [T]he Office of the Assistant Secretary for Health found that more than 30,000 HCPs [Healthcare Providers] are authorized to recommend the use of marijuana for more than six million registered patients, constituting widespread clinical experience associated with various medical conditions recognized by a substantial number of jurisdictions across the United States. For several jurisdictions, these programs have been in place for several years and include features that actively monitor medical use and product quality characteristics of marijuana dispensed.

DEA, DOJ: Notice of Proposed Rulemaking: Schedules of Controlled Substances: Rescheduling of Marijuana May 21, 2024[7].

First Product Safety Protocols for the Cannabis Supply Chain

2012-The American Herbal Pharmacopoeia (AHP) issued the Cannabis Inflorescence Monograph, a comprehensive description of the plant’s botany, constituent components, analysis, and quality control. This monograph, authored by the world’s leading experts on the plant, provides scientifically valid methods of testing the identity, purity, potency, and quality of cannabis products.

2013-The American Herbal Products Association (AHPA), the principal U.S. trade association and voice of the herbal products industry, created supply-chain-wide product safety protocols for commercial cultivation, manufacturing, distribution, and laboratory testing of medical cannabis products for human consumption.

2015- 2022 States Add Qualifying Conditions to Medical Cannabis Programs Through Formal Review Process

Twenty-one state medical cannabis programs included a process to add qualifying medical conditions through a designated expert committee appointed by the State’s Department of Health. The first state to add a qualifying condition through this process happened in 2015, after the HHS review of the petition had been completed.

65 Qualifying Conditions Added to Medical Cannabis Programs Through Expert Reviews

• • ADHD
  • Age-Related Macular Degeneration
  • ALS
  • Alzheimer’s Disease
  • Amyotrophic Lateral Sclerosis
  • Anorexia Nervosa
  • Anxiety Disorder
  • Arthritis
  • Autism
  • Cachexia Or Wasting Syndrome
  • Cancer, Including Remission Therapy
  • Cerebral Palsy
  • Chronic Hepatitis C
  • Chronic Vocal
  • Motor Tic Disorder Colitis
  • Complex Regional Pain Syndrome
  • Degenerative Neurological Disorder
  • Depression
  • Dyskinetic
  • Dystonia
  • Ehler’s Danlos Syndrome
  • Fibromyalgia
  • Huntington Disease
  • Hydrocephalus
  • Interstitial Cystitis
  • Intractable Headache Syndrome
  • Irritable Bowel Syndrome (IBS)
  • Mal Syndrome
  • Migraines
  • Muscular Dystrophy
  • Neuro-Bechet’s Autoimmune Disease
  • Neurodegenerative Diseases
  • Nystagmus
  • Obsessive Compulsive Disorder (OCD)
  • Obstructive Sleep Apnea
  • Opioid Use Disorder
  • Osteoarthritis
  • Pain; Chronic, Of Visceral Origin
  • Pain: Any Condition Opioids Prescribed
  • Pain: Chronic. Chronic Related to Musculoskeletal Disorder. Neuropathic, & Severe Debilitating & Intractable
  • Pancreatitis: Acute & Chronic
  • Parkinson's
  • Polycystic Kidney Disease (PKD)
  • Post Laminectomy Syndrome with Chronic Radiculopathy
  • Post-Herpetic Neuralgia, Peripheral Neuropathy & Allodynia from Shingles
  • Post-Traumatic Stress Disorder (PTSD)
  • Progressive Degenerative Disc Disease of The Spine
  • Sickle Cell
  • Spastic Movement Disorders
  • Spasticity
  • Spinal Cord Injury
  • Substance Use Disorder
  • Superior Canal Dehiscence Syndrome
  • Terminal Illness
  • Tourette Syndrome
  • Trigeminal Neuralgia
  • Ulcerative Colitis
  • Vulvar Lichen Sclerosis
  • Vulvodynia & Vulvar Burning

Agencies That Led the Process for Expert Reviews of Adding Qualifying Conditions Above:

• • Connecticut Department of Consumer Protection/Board of Physicians
  • Delaware Department of Health & Social Services
  • Hawaii Department of Health
  • Illinois Department of Public Health
  • State of Michigan Department of Licensing & Regulatory Affairs
  • Minnesota Department of Health
  • New Jersey Department of Health
  • New Mexico Department of Health/Medical Advisory Board
  • New York Commissioner of Health
  • State Medical Board of Ohio
  • Pennsylvania Department of Health
  • Rhode Island Department of Health

HHS noted this in its findings which was highlighted by the Office of Legal Counsel (OLC) in defense of HHS approach to CAMU:

“Several states have also established processes through which experts can recommend additions to, or removals from, the list of conditions that marijuana may be used to treat—indeed, HHS has informed us that 17 jurisdictions have added conditions that may be treated with marijuana using such processes; see HHS Part 1 Analysis Memo at 4. In short, it is simply not the case that state practice concerning medical marijuana is completely divorced from scientific and medical assessment.” [8]

In 2015, HHS indicated that “medical practitioners who are not experts in evaluating drugs cannot be considered qualified experts” (HHS, 2015; 57 FR 10499,10505).

HHS also highlighted that state-level “medical marijuana laws do not provide evidence of such a consensus among qualified experts.”

April 2016- Institutional Guidance for Medical Cannabis on Recommending Medical Cannabis 

The Federation of State Medical Boards (FSMB) adopted “Model Guidelines for the Recommendation of Marijuana in Patient Care”[9], and several state medical boards have issued guidelines for physicians to incorporate cannabis into their patients’ treatment regimen for example: “Medical Board of California’s Guidelines for the Recommendation of Cannabis for Medical Purposes.”[10]

2016-CDC Recognizes Cannabis’ Role in Treating Pain & Mitigating Opioid Deaths

The CDC published guidelines for opioid prescribers: stop testing for Cannabis.

“Clinicians should not test for substances for which results would not affect patient management or for which implications for patient management are unclear. For example, experts noted that there might be uncertainty about the clinical implications of a positive urine drug test for tetrahydrocannabinol (THC).”

January 2017- The National Academies of Sciences, Engineering, and Medicine published The Health Effects of Cannabis and Cannabinoids [11],

The report concluded:

"There is conclusive or substantial evidence that cannabis or cannabinoids are effective for the treatment of chronic pain in adults, as anti-emetics in the treatment of chemotherapy-induced nausea and vomiting, and for improving patient-reported multiple sclerosis spasticity symptoms."

February 2017: “Gateway Theory” Debunked 

DEA removed “Gateway Theory” references from its website and several publications. The change came after ASA filed a legal request citing violations of the Information Quality Act (IQA), which requires that administrative agencies not provide false information to the public. Ironically, ASA used data from the DEA’s “Denial of Petition to Initiate Proceedings to Reschedule Marijuana” to challenge  their references to “Gateway Theory.”

“Each of the DEA’s statements about medical cannabis set forth below have been directly refuted by the DEA’s own statements in the DPR. Given its own recent contradiction of these statements, the DEA cannot credibly maintain that they are “accurate,” “reliable,” “unbiased,” or “reproducible.” Moreover, the statements are based on scientifically inaccurate data and result in denying patients access to vital medicine. Accordingly, each of these statements violate the IQA’s utility and objectivity standards and should be corrected.[12}”

Today, NIDA’s webpage “Research Topics:  Cannabis (Marijuana)” answers the question  “Is cannabis a “gateway” drug?” in accordance with this change:

 “Cannabis products are among the first substances along with alcohol and tobacco that a person will likely encounter in their life (MTF, 2023), and people who use substances commonly use these before trying others. Still, most people who use or have used cannabis do not go on to use other substances later in life[13].”

October 2017- The United States declares the opioid crisis a “public health emergency” after reaching an average of “91 deaths a day.”[14]

2017-2018- Several States Amend Medical Cannabis Programs to Include Pain Patients 

Connecticut, Washington DC, Florida, Illinois, New Jersey, and New York add pain as a qualifying condition to their medical cannabis program following ASA report, “Medical Cannabis as a Tool to Combat Pain and Opioid Crisis: A Blueprint for State Policy.”[15]

2018-Cannabis Research Centers Receive Funds for Research Outside NIDA

University & Cannabis Research Centers begin receiving regular funding from state cannabis programs. For example, the Center for Medicinal Cannabis Research was established in 2000, at UC San Diego, but it wasn’t until 2018 that CMCR began receiving annual funds from revenue cannabis programs.

• • The Yale Center for the Science of Cannabis and Cannabinoids (YC-SCAN2)
  • Systematically Testing the Evidence on Marijuana (STEM)
  • Oregon Health & Science University (OHSU)
  • Institute of Cannabis Research (Colorado State University Pueblo)
  • Center for Cannabis Policy, Research, and Outreach, (Washington State University)
  • Cannabis Education & Research Program, University of Washington
  • Global Hemp Innovation Center, Oregon State University
  • Consortium for Medical Marijuana Clinical Outcomes Research, University of Florida
  • The Johns Hopkins University Cannabis Science Lab
  • Medical Cannabis Research Center, Drexel University
  • Medical Marijuana Academic Clinical Research Center, Pennsylvania State University
  • Center for Medical Cannabis Research (University of Utah Health)
  • Cannabis Research Center (University of Minnesota)
  • Michael G. DeGroote Centre for Medicinal Cannabis Research (McMaster University)
  • UC San Diego, Center for Medicinal Cannabis Research
  • UC Irvine Center for the Study of Cannabis
  • UC Riverside Center for Cannabinoid Research
  • UCLA Center for Cannabis and Cannabinoids
  • UC Berkeley Cannabis Research Center
  • UC Davis Cannabis and Hemp Research Center

January 2019-WHO Recognizes Medical Benefits of Cannabis 

The World Health Organization recommends that the United Nations Committee on Narcotic Drugs reschedule cannabis based on “a multi-year review process conducted by the Expert Committee on Drug Dependence (ECDD), an independent scientific advisory body to the WHO. Based on scientific assessment, potential health risk and therapeutic benefit.”[16]

2019- Universities & Colleges Cannabis Specialty Degrees

Thousands of Americans have degrees in cannabis studies including Cannabis Biology and Chemistry, Cannabis Studies, Pharmaceutical Sciences, Agriculture and Horticulture, Cultivation, Policy, Medical Plant Sciences, Business, Commerce, and Administration from over 40 Universities and colleges

Associate and Bachelor Degrees: Beal University, California State Polytechnic University, Humboldt, City College of San Francisco, Colorado State University-Pueblo, Community College of Denver, Eastern Gateway Community College, Johnson & Wales University, Lake Superior State University, Little Priest Tribal College, Medgar Evers College, Minot State University, Naugatuck Valley Community College, Northern Michigan University, Pennsylvania Institute of Technology, Saint Louis University, St. Cloud State University Stockton University, SUNY, University of California Riverside, University of Connecticut, University of Denver, University of Maine, University of Rhode Island, University of San Diego, University of Vermont, University of Wisconsin Plattville, University of Wisconsin-Madison School of Pharmacy, Western Illinois University, Western Washington University, and York College of Pennsylvania

Master’s Degrees: American International College, University of Maryland, University of Maryland School of Pharmacy, Thomas Jefferson University, University of Colorado, Rowan University, Pacific College of Health and Science, and Cornell College of Agriculture and Life Sciences

December 2020- UNCND Changes Scheduling of Cannabis in International Drug Treaties 

“the UN Commission on Narcotic Drugs (CND), the drug policy making body of the UN re-classified cannabis and cannabis resin under an international listing that recognizes its medical value. The CND voted on recommendations made by the WHO’s 41st Expert Committee on Drug Dependence (ECDD), which suggested that cannabis and cannabis resin should be reclassified from its current listing alongside heroin, fentanyl analogues and other opioids considered to be exceptionally harmful to the public health.”[17]

May 2022-State Medical Cannabis Programs Provide Medical Professionals with Dosage Tools 

The Minnesota Department of Health issues “Dosing and Chemical Composition Report: A Review of Medical Cannabis Studies Relating to Chemical Compositions and Dosages for Qualifying Medical Conditions."[18]

January 2023-INCB Issues Guidance for Drug Treaty Signatories to Oversee Federal Medical Cannabis Programs 

International Narcotics Control Board (INCB) Report of the International Narcotics Control Board for 2022:

“In 2018, WHO carried out a critical review of cannabis and cannabis-related substances and came to the conclusion that these substances can have a therapeutic value. Following the recommendation of the WHO, the Commission on Narcotic Drugs decided in December 2020 to remove cannabis and cannabis resin from Schedule IV of the 1961 Convention as amended, but to keep it in Schedule I. The 1961 Convention (in its article 28) allows State signatories to cultivate and use cannabis for medical purposes under certain conditions. The Convention requires that States license and control cannabis production for medical use, establish a national cannabis agency, provide estimates of the national requirements for cannabis for medical purposes, and ensure that medicinal cannabinoids are used in accordance with evidence on their safety and effectiveness and under medical supervision. As far as the specific control measures for cannabis are observed, these medical cannabis programmes are in compliance with the conventions. However, in some States “medical cannabis programmes” are operated without the necessary I. control required by the conventions or by the standards recommended by WHO in relation to good manufacturing and good prescribing guidelines.”[12]

2023- Over 60 Countries Have Medical Cannabis Access

In 2011, only two countries had laws allowing for the medical use of cannabis: Canada and the Netherlands. In 2023, that number rose to over 60 countries with explicit laws and dozens more debating legislation. Patients in the European Union (EU) can petition their government to receive medical cannabis from EU countries that have medical cannabis programs.

Countries with Medical Cannabis Access:

Albania, Argentina, Australia, Barbados, Brazil, Cayman Islands, Canada, Channel Islands, Chile, Colombia, Costa Rica, Croatia, Cyprus, Czech Republic, Denmark, Ecuador, Estonia, Faeroe Islands, Finland, Georgia, Germany, Gibraltar, Greece, Iceland, Isle of Man, Ireland, Israel, Italy, Jamaica, Lebanon, Lesotho, Luxembourg, Malawi, Malta, Mexico, Morocco, the Netherlands, New Zealand, North Macedonia, Norway, Panama, Paraguay, Peru, Poland, Portugal, Romania, Rwanda, Saint Kitts and Nevis, Saint Lucia, San Marino, Saint Vincent and the Grenadines, San Marino, South Africa, Spain, Sri Lanka, Switzerland, Thailand, Ukraine, the United Kingdom, Uruguay, Vanuatu, Zambia, and Zimbabwe.

March 2023- Cannabis Care Recognized as a Healthcare Specialty Practice

American Nurses Association (ANA) Officially Recognizes Cannabis Nursing as a Specialty Nursing Practice

August 2023- HHS Finds Cannabis has “Currently Accepted Medical Use”

HHS’s Schedule III recommendation follows the evidence—and the real-world practice already happening in regulated state systems.

1. 1. Statement from President Biden on Marijuana Reform
   2. Basis for the Recommendation to Reschedule Marijuana into Schedule III of the Controlled Substances Act.
   3. Notice of Proposed Rule Making: Docket No. DEA-1362; A.G. Order No. 5931-2024
   4.  OLC memo: Questions Related to the Potential Rescheduling of Marijuana
   5. Bowles, Daniel W. (2012). "Persons Registered for Medical Marijuana in the United States." Journal of Palliative Medicine, Volume 15, No. 1.
   6. Americans for Safe Access (2013, June 13). "What's the Cost?"
   7. Page 24, Basis for the Recommendation to Reschedule Marijuana into Schedule III of the Controlled Substances Act.
   8. Page 20, OLC memo: Questions Related to the Potential Rescheduling of Marijuana
   9. Federation of State Medical Boards. "Model Guidelines for the Recommendation of Marijuana in Patient Care."
   10. Medical Board of California. "Guidelines for the Recommendation of Cannabis for Medical Purposes."
   11. National Academies of Sciences, Engineering, and Medicine (2017). The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research.
   12. “Request For Correction of Information Disseminated by DEA Regarding Marijuana (Cannabis)” Information Quality Act Request for Correction, December 5, 2016, Submitted by Americans for Safe Access Foundation
   13. Is cannabis a "gateway" drug?” NIDA. 2024, September 24. Cannabis (Marijuana). Retrieved from https://nida.nih.gov/research-topics/cannabis-marijuana on 2025, July 24 “
   14. S. Government Accountability Office (2018). "Opioid Crisis: Status of Public Health Emergency Authorities."
   15. Americans for Safe Access (2017). "Medical Cannabis as a Tool to Combat Pain and Opioid Crisis: A Blueprint for State Policy."
   16. World Health Organization. "Extract from the Report of the 41st ECDD: Cannabis and Cannabis-Related Substances."
   17. World Health Organization (2020, December 4). "UN Commission on Narcotic Drugs Reclassifies Cannabis to Recognize Its Therapeutic Uses."
   18. International Narcotics Control Board (2022). Report of the International Narcotics Control Board for 2022, Chapter I.
   19. Minnesota Department of Health (2023). "Dosing and Chemical Composition Report: A Review of Medical Cannabis Studies Relating to Chemical Compositions and Dosages for Qualifying Medical Conditions."

The good news: It would acknowledge CAMU, validating patients and clinicians who’ve been ahead of federal policy for years.

Rescheduling cannabis has the potential to positively shift social attitudes, reduce stigma, and foster greater acceptance among medical professionals, employers, and policymakers. These changes could help normalize medical cannabis use and create a more supportive environment for patients.

 One of the few definitive outcomes of rescheduling—especially to Schedule III—is its potential to advance cannabis research. Schedule III would ease the costs and regulatory burdens associated with handling, storage, and security under Schedule I could make research more accessible, expanding scientific knowledge about cannabis’ effects, safety, and therapeutic applications.

Not So Good News: Status Quo Remains for State Cannabis Stakeholders

Rescheduling will not automatically integrate state medical cannabis programs into federally regulated frameworks. State program products would remain outside legal protocols unless Congress provides clear guidance and establishes a formal registration process. Patients in state programs would not require prescriptions, and these products would remain ineligible for federally approved clinical trials focused on efficacy.

Unregulated Schedule II or III substances would remain federally illegal. While simple possession charges are rarely enforced, activities such as cultivation, manufacturing, and distribution outside federal regulations would still be classified as trafficking, with severe penalties. For instance, trafficking Schedule III substances could result in penalties ranging from 10 years in prison and a $500,000 fine for individuals (first offense) to 20 years and a $1 million fine for subsequent offenses.

State medical cannabis programs are protected from federal interference under the CJS amendment. However, the enforcement of federal laws on adult use is ultimately determined by presidential directives. Rescheduling is also unlikely to alleviate tax burdens for cannabis businesses. While 280E would no longer apply under a Schedule III status, it is improbable that unregulated Schedule III cannabis products would qualify for business expense deductions, as federal law still considers manufacturing and distribution drug trafficking. Historically, the IRS has denied deductions for illegal business activities (Internal Revenue Code 162 (c)(2)), including racketeering, sports betting, and other activities violating federal or state law. Without changes to the tax code or federal legalization—both requiring Congressional action—cannabis businesses claiming deductions prematurely would likely find themselves in legal battles with the IRS.

Impacts on Patients

Rescheduling is undeniably a victory for medical cannabis patients and advocates. By recognizing cannabis’ “currently accepted medical use in treatment in the United States,” the federal government has validated decades of patient-led advocacy and the role of state programs as “laboratories of democracy.” These programs, built with compassionate use in mind, were essential in overcoming barriers raised by HHS, DEA, and DOJ denials of rescheduling petitions over the past 50 years.

However, while rescheduling marks progress, it is not the comprehensive solution patients need. Schedule III does not legalize medical cannabis, improve state medical cannabis programs, or restore federal rights for patients. Instead, it shifts the conversation from debating cannabis’ medical value to exploring how patients can safely access it. However, this shift does little to address the structural barriers limiting patient access today.

More on Schedule III

Then it’s status quo: research bottlenecks, no federal integration for state programs, persistent stigma, and patients stuck in a patchwork. After HHS’s CAMU finding, maintaining Schedule I would deepen the perception that politics—not science—controls the scoreboard.

The CSA schedules were built to classify drugs, not whole-plant medicines with dozens of active constituents and entourage effects. Cannabis isn’t one molecule; it’s a therapeutically rich botanical. For single-compound pharmaceuticals, the schedules work like neat drawers. For cannabis, they’re a junk closet. That’s why every “move it up or down” debate leaves unmet needs on one side or another—patient access, product safety, insurance coverage, research scale, or diversion control. A bespoke federal medical-cannabis framework is the adult solution.

Congress can end the loop. Use HHS’s findings and the lived reality of millions of patients to pass comprehensive medical cannabis legislation. That means:

• Codify medical recognition and establish a national framework that respects state experience while setting federal baselines for product safety, labeling, testing, and pharmacovigilance.
• Create a federal office with clear authority to coordinate HHS/FDA/NIH/VA/DoD/CMS and state regulators—so patients, clinicians, and researchers aren’t navigating a maze.
• Enable coverage pathways (public and private) for physician-directed medical use, especially for conditions with poor alternatives.
• Preserve and modernize appropriations protections (the Medical Cannabis CJS Amendment) until permanent law takes hold.
• Fund research and data infrastructure to keep benefits, risks, dosing, and interactions grounded in evidence—not anecdotes.

Learn more about the Medical Cannabis & Cannabinoid Act (MCCA).