ASA Policy Positions
Deschedule Cannabis and Recognize It as Medicine
While the U.S. federal government recognizes the medical value of tetrahydrocannabinol (THC) and cannabidiol (CBD), two constituents of cannabis, and permits the sale of pharmaceutical drugs made by synthesizing or isolating these compounds, such as dronabinol or Epidiolex, it classifies cannabis as a Schedule I substance under the Controlled Substances Act. This makes it federally illegal to prescribe, dispense, or administer cannabis for medical use. However, many patients find that whole-plant cannabis, cannabis extracts with a broad range of the plant’s constituent chemicals, and other cannabis-containing products more effectively address their symptoms than the aforementioned pharmaceutical products.
Clinical research affirms that cannabis can be used safely and effectively to alleviate the symptoms of serious and chronic medical conditions. Retaining cannabis in Schedule I prevents robust research into maximizing the therapeutic benefit that can be derived from cannabis, precludes health insurance coverage for the cost of medical cannabis, and makes federal criminals of people who rely on cannabis to treat debilitating illness and the people who produce or provide medical cannabis to these patients. Therefore, cannabis should be federally descheduled and recognized as medicine.
Make Medical Cannabis Available to Anyone Who Could Benefit from It
No matter the condition requiring medical attention, patients and their healthcare providers must weigh the potential benefits and risks of any treatment they may pursue. The potential benefits and risks of the medical use of cannabis should be weighed against those of all other treatment options under consideration in light of each individual patient’s medical history and circumstances. Unfortunately, many of the states and territories that have legalized the medical use of cannabis have also created restrictive lists of qualifying conditions that preclude access to it by many of the people who could benefit from it.
No enumerated list of conditions is expansive enough to cover every condition for which cannabis may produce medicinal benefit, so writing restricted lists of qualifying conditions into law inevitably results in needless suffering. Additionally, for some individuals with acute injuries, cannabis may be a more appropriate first-line treatment than the alternatives, such as opioid medication, which carries significant risk of addiction and can prove fatal in the case of overdose. To ensure that patients and healthcare providers have as many effective options available to them as possible to combat pain and illness, healthcare providers’ ability to recommend (and eventually prescribe) medical cannabis should be unrestricted, and medical cannabis should be available to anyone who could benefit from it.
Enable and Facilitate Comprehensive Medical Cannabis Research
Cannabis has been used medicinally for millenia, but modern cannabis research in the United States has been stymied by decades of prohibition. The federal government has repeatedly acknowledged that cannabis’ Schedule I status prevents research that would provide more information about both the potential benefits and potential harms of cannabis. Researchers must complete a lengthy and onerous application process to obtain permission to conduct research, and if approved, the only cannabis they can study is that produced at the University of Mississippi for the National Institute on Drug Abuse, which pales in quality and chemotypic diversity when compared to the cannabis available to patients and consumers in dispensaries nationwide.
While research has been conducted and is ongoing in other countries, dozens of which have legalized medical cannabis at the national level, the United States has tremendous resources that could be brought to bear to more quickly unlock cannabis’ full medical potential. The federal government should eliminate barriers to research, immediately let researchers use commercially available cannabis to get a comprehensive picture of cannabis’ medical advantages and drawbacks, authorize producers of medical cannabis for scientific research other than the University of Mississippi, fund high-quality scientific studies, and take any other action necessary to enable and facilitate comprehensive medical cannabis research.
License and Regulate Cannabis Dispensaries
Regulated medical cannabis distribution systems enhance patient access to different cannabis chemotypes and to a variety of cannabis products. Additionally, they offer a means by which to ensure that the cannabis and cannabis products made available for sale to patients pass safety testing and are accurately labeled. However, some jurisdictions do not allow dispensaries, and some of the jurisdictions that do allow dispensaries also allow cities or counties to ban dispensaries within their borders.
The jurisdictions that permit the medical use of cannabis should license dispensaries and should pass sensible regulations to ensure that they are responsibly operated and provide patients with safe and effective products. Regulations should not be unreasonable or onerous, or they may act to reduce patient access to medical cannabis. To ensure that it is feasible for patients to obtain cannabis for which they legally qualify, cities and counties should not be permitted to impose bans on medical cannabis dispensaries.
Allow Home Cultivation for Patients
There are myriad varieties of cannabis, and it is important that patients have the ability to grow the most effective cultivar(s) for their particular condition at home. Otherwise, they must hope that the needs of the broader market sync up with theirs or risk finding that the cannabis they find most effective is no longer commercially produced. Allowing home cultivation would also reduce the cost of medical cannabis, and affordability is a key concern for many patients. While the existence of a centralized production and distribution system is important, patients should not have to rely on it exclusively. To ensure access to effective and affordable cannabis, medical cannabis jurisdictions should allow home cultivation for patients.
Test Medical Cannabis Prior to Sale
In 2014, Americans for Safe Access worked with the American Herbal Pharmacopoeia and American Herbal Products Association to create industry standards for testing laboratory analysis of cannabis and cannabis products. To inform and educate patients, protect patient health, ensure product quality and safety, and promote accuracy in labeling, jurisdictions that allow medical cannabis should require that representative samples of commercially produced cannabis and cannabis products be analyzed by cannabis testing laboratories and pass all required testing before those products may be distributed to dispensaries for sale to patients.
End the Taxation of Medical Cannabis
Many medical cannabis patients experience financial hardship. It’s expensive to be sick in America, especially for those who are very sick or sick for a long time. Those suffering from severe or chronic disease may find their employment opportunities and financial well-being threatened by illness. The lack of insurance coverage for medical cannabis and associated costs compounds this problem, and the imposition of unreasonable taxes further exacerbates it.
Sales tax is regressive and disproportionately impacts financially vulnerable populations, such as medical cannabis patients. Were it not for cannabis’ Schedule I status, healthcare providers would be able to prescribe it rather than recommend it, which would render medical cannabis exempt from taxation. While not opposed to low-impact fee structures that are designed to offset the costs of administering medical cannabis programs, ASA does call for an end to the taxation of medical cannabis.
Create an Office of Medical Cannabis Control
Nearly a dozen federal agencies now play a role in decision-making processes relating to the scheduling of cannabis. These agencies differ from one another in their aims, methods, and missions. For example, the Department of Health and Human Services exists to enhance the health and well-being of all Americans, while the Drug Enforcement Administration exists to enforce the controlled substances laws and regulations of the United States. This promotes competition for funding among the various agencies involved and impedes progress on important research and federal recognition of cannabis as medicine - a feat dozens of other countries have managed to accomplish at the national level.
It is time to transfer regulatory authority for cannabis to a new agency that will prioritize conducting research, producing a wide range of cannabis products for medical use, and ensuring nationwide access to cannabis-based and cannabis-containing medicines. This new federal agency would have centralized regulatory authority, which would result in a consistent and predictable regulatory environment nationwide. ASA has drafted the legislation to transfer these authorities to a new agency, which is available at safeaccessnow.org/omcc, and we are currently seeking a Congressional champion to bring forward this legislation to create an Office of Medical Cannabis Control.