Memo: Federal Guidance: AG Order No. 6754-2026: Rationale for Immediate Action
Prepared by Americans for Safe Access
Date: May 11, 2026
This memorandum provides rationale for the request delivered to President Trump and Acting Attorney General Blanche: Immediate Federal Guidance Needed to Protect Medical Cannabis Patients Regarding AG Order No. 6754-2026: Schedules of Controlled Substances: Rescheduling of Food and Drug Administration-Approved Products Containing Marijuana from Schedule I to Schedule III; Corresponding Change to Permit Requirements" on behalf of patients, disability, veterans, housing, healthcare, labor, and medical organizations and professionals.
I: BACKGROUND
Executive Order 14370, “Increasing Medical Marijuana and Cannabidiol Research,” signed on December 18, 2025, directed the Attorney General to take all necessary steps to complete the process of rescheduling marijuana to Schedule III of the Controlled Substances Act “in the most expeditious manner” consistent with federal law, including 21 U.S.C. § 811(d). On April 28, 2026, Acting Attorney General Blanche published final AG Order No. 6754-2026, placing FDA-approved marijuana products and marijuana products regulated by qualifying state medical cannabis licenses into Schedule III of the Controlled Substances Act and creating a federal registration structure.
21 U.S.C. § 811(d) authorizes the Attorney General to carry out scheduling actions necessary for the United States to meet obligations under the 1961 Single Convention on Narcotic Drugs and the 1971 Convention on Psychotropic Substances. In December 2020, the Commission on Narcotic Drugs voted to reclassify cannabis in recognition of its medical value, following the recommendation of the World Health Organization. Acknowledging this change, the International Narcotics Control Board’s 2022 annual report advised countries seeking to operate medical cannabis access programs must observe the specific control measures required for cannabis under Article 28 of the Single Convention to remain in compliance with international treaties. Those measures include licensing and controlling cannabis production for medical use, establishing a national cannabis agency, providing estimates of national medical cannabis requirements, and ensuring that medicinal cannabinoids are used in accordance with evidence on safety and effectiveness and under medical supervision.
The Attorney General asserted his authority, granted by Congress under 21 U.S.C. § 811(d), to place qualifying medical cannabis products into Schedule III and to establish a federal registration system for state-licensed medical cannabis manufacturers, distributors, and dispensers, relying on existing state medical cannabis licensing systems to support federal oversight. By reconciling cannabis scheduling and asserting control over medical access, AG Order No. 6754-2026 aligns U.S. federal cannabis policy with its international treaty obligations.
The Order recognizes state medical cannabis programs as part of the federal healthcare framework, noting that licensed medical professionals oversee patient qualification based on state-specific criteria and qualifying conditions. It confirms that state-authorized medical cannabis certifications or similar patient documents are to be treated as functionally equivalent to prescriptions. By amending 21 C.F.R. § 1301.13 to state that such documents “shall be sufficient to permit dispensing,” notwithstanding 21 C.F.R. Part 1306 or any other federal rule, the order gives state medical cannabis patient documentation federal legal effect.
For nearly thirty years, state medical cannabis programs have operated in conflict with federal law. Federal agencies and courts made no distinction between state-authorized medical cannabis and illegal use of a controlled substance, regardless of state medical authorization, due to Marijuana’s Schedule I status. For patients, caregivers, providers, cultivators, manufacturers, distributors, and dispensaries participating in state medical cannabis programs, this discrepancy has meant that they remain subject to federal criminal penalties and federal policy exclusions.
The Schedule I framework also shaped the application of federal civil rights protections. Section 12210 of the Americans with Disabilities Act provides that “the term ‘individual with a disability’ does not include an individual who is currently engaging in the illegal use of drugs”. Federal agencies, employers, landlords, healthcare entities, and federally funded programs actively deny medical cannabis patients accommodations and services based on that premise.
In practice, medical cannabis patients have faced loss of housing, employment, access to healthcare, eligibility for services, clinical support from federal providers, and participation in federally funded programs solely because they participate in state-approved medical cannabis programs. Federal agencies have also issued or maintained policies and guiding documents stating that, because medical cannabis has no accepted medical use, it should be treated as an illicit drug regardless of a patient's status under a state medical cannabis program. Those policies now require immediate review.
AG Order No. 6754-2026 includes instructions for state-licensed medical cannabis businesses to apply for Drug Enforcement Administration registration. The order states that state licensees seeking federal registration may submit state credentials as evidence of state-law authorization, and that registration must be granted unless doing so would be inconsistent with the public interest under 21 U.S.C. § 823 or with the requirements of the Single Convention. Because the public-interest factors include prior conviction records related to controlled substances, implementation must be handled carefully. Individuals and entities that participated in state medical cannabis systems during the Schedule I era should not be categorically excluded from the federal medical cannabis system because of prior cannabis-related convictions tied to outdated federal policy or state-authorized medical cannabis activity.
The order also recognizes the need for guidance from the Department of the Treasury and the Internal Revenue Service on tax issues affecting state-licensed medical cannabis businesses. To date, federal implementation has focused primarily on business registration and tax consequences. Comparable guidance has not yet been issued to protect patients from continued discrimination in housing, employment, healthcare, veterans’ services, disability accommodations, and federally funded programs.
That gap demonstrates the need for coordinated federal implementation. The Department of Health and Human Services should establish an Office of Medical Cannabis and Cannabinoid Control to oversee and coordinate implementation of federal medical cannabis policy following AG Order No. 6754-2026, the Medical Marijuana and Cannabidiol Research Expansion Act, and Executive Order 14370. Such an office would provide the federal infrastructure needed to translate rescheduling, research reforms, and state-program recognition into patient protections, healthcare integration, standardized data collection, product safety standards, civil rights coordination, and consistent federal guidance across agencies.
This memorandum provides the rationale for the Department of Justice to issue nationwide guidance clarifying that medical cannabis patients may not be denied services, housing, healthcare, employment, benefits, or federal program participation solely because of their state-authorized medical cannabis patient status and are entitled to individualized assessment and reasonable accommodation. It also highlights the need for federal agencies to immediately identify, review, and update policies, guidance documents, forms, enforcement practices, funding conditions, and data systems that continue to treat medical cannabis patients as being engaged in disqualifying illegal drug use.
Medical cannabis patients are now protected from discrimination under the Americans with Disabilities Act, the Fair Housing Act, and Section 504 of the Rehabilitation Act. The Department of Justice must ensure that the public and private sectors align policies accordingly.
II. DEPARTMENT OF JUSTICE: CIVIL RIGHTS GUIDANCE
The Department of Justice is responsible for enforcing key provisions of the Americans with Disabilities Act and the Fair Housing Act and plays a central role in guiding federal civil rights compliance across agencies and regulated sectors. In light of AG Order No. 6754-2026, the Department should issue civil rights guidance clarifying how existing federal nondiscrimination laws apply following the federal government’s recognition of qualifying medical cannabis within Schedule III of the Controlled Substances Act.
The purpose of this guidance is not to create new rights, but to clarify how existing federal civil rights laws operate in this updated legal context. Federal agencies, regulated entities, private actors implementing federal programs, landlords, employers, businesses, healthcare providers, housing providers, service providers, and other covered entities must align their policies accordingly.
Qualifying medical cannabis patients are entitled to be evaluated under the following federal civil rights statutes. Failure to align policies with these laws may expose covered entities to federal enforcement, civil liability, loss of eligibility for federal funding, fines, and corrective actions.
Americans with Disabilities Act
The Americans with Disabilities Act prohibits covered employers from discriminating against qualified individuals on the basis of disability in job application procedures, hiring, advancement, discharge, compensation, training, and other terms, conditions, and privileges of employment. See 42 U.S.C. § 12112(a). The statute defines discrimination to include failure to provide reasonable accommodations to a qualified applicant or employee with a disability, unless the employer can demonstrate undue hardship. See 42 U.S.C. § 12112(b)(5)(A).
The Americans with Disabilities Act also limits when employers may conduct medical examinations or make disability-related inquiries. Under 42 U.S.C. § 12112(d)(2)(A), employers may not inquire into the existence, nature, or severity of a disability prior to a conditional offer of employment. The implementing regulation at 29 C.F.R. § 1630.13(a) similarly restricts medical examinations and disability-related inquiries except as specifically permitted.
These provisions establish a framework in which employment decisions must be based on qualifications, performance, and individualized assessment, rather than categorical assumptions about a medical condition or treatment. Policies that rely on status-based determinations, rather than evidence of impairment or job-related risk, must be evaluated within this framework.
The Fair Housing Act
The Fair Housing Act prohibits discrimination in the sale or rental of housing and in housing-related services on the basis of disability. Under 42 U.S.C. § 3604(f), discrimination includes the refusal to make reasonable accommodations in rules, policies, practices, or services when such accommodations may be necessary to afford a person with a disability equal opportunity to use and enjoy a dwelling.
This statutory framework applies across both public and private housing contexts covered by the Act. It requires that housing-related decisions involving individuals with disabilities be evaluated through an individualized reasonable-accommodation analysis, rather than categorical exclusions.
Following AG Order No. 6754-2026, policies that treat participation in a state-approved medical cannabis program as inherently disqualifying must be assessed against the Fair Housing Act’s requirements for individualized review and equal access to housing opportunities.
Rehabilitation Act and Federally Funded Programs
Section 504 of the Rehabilitation Act provides that no otherwise qualified individual with a disability shall, solely by reason of disability, be excluded from participation in, denied the benefits of, or subjected to discrimination under any program or activity receiving federal financial assistance or conducted by a federal executive agency. See 29 U.S.C. § 794.
This statute governs a wide range of federally funded and federally administered programs, including those involving healthcare, housing, employment, and federal contracting. It establishes that nondiscrimination obligations extend to entities that receive federal funds or operate federal programs, requiring compliance with disability rights protections in the delivery of services and benefits.
As with the Americans with Disabilities Act and the Fair Housing Act, Section 504 requires that determinations affecting individuals with disabilities be grounded in individualized assessment and program-specific considerations, rather than categorical exclusions.
Legal Framework for Implementation of Civil Protections
The Americans with Disabilities Act, the Fair Housing Act, and Section 504 of the Rehabilitation Act provide the Department of Justice with a clear basis for guiding implementation across federal agencies, federally funded programs, and covered private-sector settings. The statutes apply in different contexts, but they point in the same direction: medical cannabis policies must now be reviewed through the lens of disability nondiscrimination.
AG Order No. 6754-2026 does not answer every question for every setting. It does, however, change the central premise of patients’ rights. Federal agencies, regulated entities, private actors implementing federal programs, landlords, employers, businesses, healthcare providers, housing providers, service providers, and other covered entities must ensure that their policies align with this framework. Policies that deny housing, employment, healthcare, services, benefits, federal program participation, or reasonable accommodation solely because a patient’s medicine is cannabis must now be reviewed under federal nondiscrimination standards.
In light of this change, the Department of Justice should issue nationwide guidance making clear that discrimination against medical cannabis patients is a federal civil rights violation when it relies on policies that promote blanket exclusion rather than individualized assessment. The guidance should state that medical cannabis patients may not be denied services, housing, healthcare, employment, benefits, federal program participation, or reasonable accommodation solely because they participate in a state-approved medical cannabis program.
The Department should further clarify that federal agencies must immediately review policies that deny benefits, services, accommodations, housing, employment, healthcare, veterans’ services, or program participation to medical cannabis patients solely because of state-authorized medical cannabis use. The legal standard must shift toward individualized review, reasonable accommodation, actual impairment, documented safety risks, and program-specific necessity.
Without clear direction, patients will continue to face avoidable discrimination, and covered entities will be left guessing how to reconcile outdated cannabis policies with current federal civil rights obligations.
III. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT: HOUSING
The Department of Housing and Urban Development’s current marijuana-related housing policies were developed under the former federal Schedule I framework and continue to rely on the premise that marijuana use is disqualifying illegal drug use, including when used for medical purposes under state law. HUD’s 2014 guidance, “Use of Marijuana in Multifamily Assisted Properties,” states that owners of federally assisted housing must deny admission to applicants determined to be illegally using a controlled substance, including marijuana, and may not establish lease provisions or policies that affirmatively permit occupancy by a household member who uses marijuana. HUD’s public reasonable-accommodation guidance also states that public housing agencies may not make reasonable accommodations for medical marijuana, even when the individual is using cannabis for medical purposes under state law.
Earlier HUD guidance for public housing and Housing Choice Voucher programs likewise stated that new admissions of medical marijuana users are prohibited in these programs, while public housing agencies retain discretion to determine, on a case-by-case basis, whether to terminate assistance for existing residents. HUD regulations at 24 C.F.R. § 960.204 also require public housing agencies to establish standards prohibiting admission of a household member who is currently engaging in illegal drug use, or where the agency has reasonable cause to believe illegal drug use may threaten the health, safety, or peaceful enjoyment of other residents.
That framework now requires immediate review. For patients, HUD’s current approach creates a direct conflict between medical treatment and housing stability. Patients in federally assisted housing include seniors, veterans, people with disabilities, low-income families, and individuals with serious or chronic conditions. These patients should not be forced to choose between remaining housed and continuing a state-authorized medical treatment. Nor should a caregiver’s administration of medical cannabis automatically place a household at risk of eviction or termination of assistance.
Continued denial of admission, eviction, termination of assistance, or refusal of accommodation based solely on state-authorized medical cannabis use are now in conflict with the Fair Housing Act’s reasonable-accommodation requirements and Section 504 of the Rehabilitation Act obligations in federally assisted housing programs. HUD may still allow housing providers to address actual lease violations, but medical cannabis patient status shall not, standing alone, constitute grounds for disqualification.
Required Action:
1. HUD must withdraw and replace its 2014 “Use of Marijuana in Multifamily Assisted Properties” guidance, its HUD Exchange reasonable-accommodation FAQ, prior public housing and Housing Choice Voucher guidance on medical marijuana, and any related handbooks, lease requirements, admissions standards, occupancy policies, notices, FAQs, and program instructions that require or permit denial of admission, eviction, termination of assistance, or refusal of reasonable accommodation based solely on state-authorized medical cannabis use.
Suggested Guidance:
Notice to all Housing Providers: Implementation of AG Order No. 6754-2026
Participation in a state-approved medical cannabis program, or the use, possession, or caregiver administration of medical cannabis in accordance with state law, shall not, standing alone, constitute grounds for denial of admission, eviction, termination of assistance, or refusal of reasonable accommodation in federally assisted housing.
Requests involving medical cannabis shall be evaluated through the same individualized reasonable-accommodation framework that applies to other disability-related needs, including consideration of legitimate health, safety, lease, and program requirements.
This policy supersedes the 2014 “Use of Marijuana in Multifamily Assisted Properties” guidance, the HUD Exchange reasonable-accommodation FAQ, any prior public housing and Housing Choice Voucher guidance on medical marijuana, and any related handbooks, lease requirements, admissions standards, occupancy policies, notices, FAQs, and program instructions. Housing providers shall update their internal policies, including, but not limited to, leases, admissions standards, and occupancy policies, to reflect this change in federal law.
2. HUD should also issue immediate interpretive guidance regarding 24 C.F.R. § 960.204 and initiate rulemaking if necessary to conform its regulations to AG Order No. 6754-2026, the Fair Housing Act, and Section 504 of the Rehabilitation Act.
IV. THE DEPARTMENT OF HEALTH & HUMAN SERVICES & THE CENTERS FOR MEDICARE & MEDICAID SERVICES
Healthcare providers and federally funded healthcare entities need clear federal direction following AG Order No. 6754-2026. Many hospitals, hospices, nursing homes, assisted living facilities, federally qualified health centers, transplant programs, pain clinics, and other care settings have restricted or prohibited patient access to medical cannabis because they fear federal licensing, certification, reimbursement, or funding consequences.
That uncertainty has left patients vulnerable at moments when continuity of care matters most. Patients entering hospice, long-term care, assisted living, hospital care, or transplant evaluation may be told to discontinue medical cannabis, even when it is part of an established treatment plan. Others have their medical cannabis use inaccurately documented as non-medical use or substance-use-related conduct rather than as part of their healthcare profile. Refusing accommodations for state-authorized medical cannabis patients violates the Americans with Disabilities Act.
Many of these providers receive federal financial assistance or participate in Medicare, Medicaid, the Children’s Health Insurance Program, or other federal healthcare programs. Blanket exclusion of medical cannabis patients may also violate Section 504 of the Rehabilitation Act when it denies access to care, reasonable accommodation, or program participation solely because of state-authorized medical cannabis use. Policies must now be evaluated under disability nondiscrimination, reasonable accommodation, patient safety, clinical judgment, and continuity-of-care standards.
The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) must inform healthcare providers and federally funded healthcare entities that they may not deny care to medical cannabis patients. They should also ensure that medical cannabis use can be documented accurately as therapeutic medication use when a patient participates in a state medical cannabis program or uses cannabis under the recommendation, certification, authorization, or supervision of a licensed healthcare professional.
Medical cannabis documentation should be distinct from non-medical use or substance-use-disorder-related fields. Federal healthcare programs should develop standardized intake and electronic medical record fields that allow clinicians to document the route of administration, cannabinoid content (where known), dose, frequency, patient-reported outcomes, potential drug interactions, and state program participation.
Required Action:
1. HHS and CMS must issue clear guidance requiring federally funded healthcare entities to evaluate requests from state-authorized medical cannabis patients under the same individualized reasonable-accommodation framework used for other disability-related healthcare needs.
Suggested guidance language:
Notice: Implementation of AG Order No. 6754-2026
Healthcare providers and federally funded healthcare entities, including hospitals, hospices, nursing homes, assisted living facilities, federally qualified health centers, Medicare- and Medicaid-participating providers, transplant programs, and pain clinics, must evaluate requests from state-authorized medical cannabis patients through the same individualized reasonable-accommodation framework that applies to other disability-related healthcare needs.
Reasonable accommodations may include, but are not limited to, discussing medical cannabis use with patients, documenting therapeutic use, coordinating care, evaluating potential drug interactions, recommending medical cannabis where authorized, completing state medical cannabis program forms, and the use of cannabis medicines on-site. Categorical refusal to reasonably accommodate state-authorized medical cannabis patients may violate the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, and could place participation in Medicare and Medicaid, federal grant funding, certification, accreditation, licensing, or program participation at risk.
Facilities that dispense medications should seek guidance from the Drug Enforcement Administration on whether additional registration or permitting is required to dispense medical cannabis, or whether existing Drug Enforcement Administration registration is sufficient.
2. HHS and CMS must issue directives on the documentation of therapeutic cannabis use.
HHS and CMS should direct federally funded healthcare programs and Medicare- and Medicaid-participating providers to update electronic health record systems and patient intake forms to include a distinct field for medical cannabis use. This field must be separate from non-medical cannabis use, illicit drug use, or substance-use-disorder-related documentation.
Medical cannabis use should be documented as therapeutic medication use when a patient participates in a state medical cannabis program or uses cannabis under the recommendation, certification, authorization, or supervision of a licensed healthcare professional. Documentation should not automatically classify state-authorized medical cannabis use as substance misuse, illicit drug use, or non-medical cannabis use.
3. HHS and CMS must standardize intake and clinical documentation.
HHS and CMS should develop standardized intake and documentation standards for federally funded healthcare settings, including hospitals, hospices, nursing homes, assisted living facilities, federally qualified health centers, Medicare- and Medicaid-participating providers, transplant programs, pain clinics, and other federally funded healthcare entities. These standards should allow clinicians to document the route of administration, cannabinoid content where known, dose, frequency of use, participation in state medical cannabis programs, the certifying healthcare professional where applicable, patient-reported outcomes, possible drug interactions, contraindications, and relevant care-coordination needs.
4. HHS and CMS must provide system-wide implementation guidance.
HHS and CMS should issue guidance for federally funded healthcare programs and Medicare- and Medicaid-participating providers on implementing standards for medical cannabis documentation, intake, patient safety, and care coordination. This guidance should direct healthcare providers to ask patients whether cannabis use has been inaccurately documented in their medical records and, where appropriate, take steps to correct the record so that state-authorized medical cannabis use is documented as therapeutic medication use rather than non-medical use, illicit drug use, or substance-use-disorder-related history.
V. DEPARTMENT OF VETERANS AFFAIRS POLICY: VETERANS HEALTHCARE
Veterans continue to face a conflict between state medical cannabis laws and Department of Veterans Affairs policy. The Department of Veterans Affairs currently states that veterans will not be denied Department benefits because of marijuana use, encourages veterans to discuss marijuana use with Department providers, and allows Department providers to record marijuana use in the veteran’s medical record for treatment planning. That policy recognizes the importance of communication but falls short of allowing Department clinicians to provide meaningful support for participation.
Veterans Health Administration Directive 1315 governs access to Veterans Health Administration clinical programs for veterans participating in state-approved marijuana programs. Under the current policy, veterans who rely on the Department of Veterans Affairs as their primary healthcare provider remain unable to receive medical cannabis recommendations, referrals, state forms, or registration assistance from Department clinicians, even when they live in a state with a lawful medical cannabis program.
That gap fragments care. Veterans must seek medical cannabis guidance outside the Department system, often from clinicians who do not have access to their full medical history, medication list, disability profile, or treatment plan. This undermines care coordination, discourages honest disclosure, and prevents Department clinicians from fully evaluating drug interactions, contraindications, symptom control, and continuity of care.
In light of AG Order No. 6754-2026, the continued prohibition on Department clinicians assisting veterans with state medical cannabis programs is no longer aligned with federal recognition of qualifying medical cannabis. Veterans should not be placed at a disadvantage within the federal healthcare system simply because their medicine is cannabis.
The Department of Veterans Affairs must also update its electronic medical record systems. Medical cannabis use should be documented through a distinct code or field separate from non-medical use or substance misuse. Veterans Health Administration intake and documentation standards should include route of administration, chemical composition where known, dose, frequency of use, state medical cannabis program participation, certifying healthcare professional where applicable, and potential interactions with prescribed medications.
Required Action:
The Department of Veterans Affairs must issue guidance and protocols that allow Department healthcare providers to support veterans participating in state-approved medical cannabis programs.
1. Replace Veterans Health Administration Directive 1315 with a directive permitting clinical support for state medical cannabis program participation.
Suggested Language:
Department of Veterans Affairs healthcare providers may discuss medical cannabis openly with veterans and, where consistent with state law and clinical judgment, may recommend medical cannabis, make referrals, complete state medical cannabis forms, or assist veterans in registering for state-approved medical cannabis programs. Department clinicians may document medical cannabis use as therapeutic medication use, evaluate potential drug interactions, coordinate care, and support continuity of care for veterans participating in state medical cannabis programs.
2. Update electronic medical record systems. The Department of Veterans Affairs must update electronic medical record systems to include a distinct code or field for medical cannabis use. This field must be separate from non-medical cannabis use, illicit drug use, or substance-use-disorder-related documentation.
3. Standardize intake and documentation. Veterans’ Health Administration intake and documentation standards should include the route of administration, chemical composition, where known, dose, frequency of use, participation in a state medical cannabis program, and the certifying healthcare professional, where applicable.
4. Provide system-wide implementation guidance. The Department of Veterans Affairs must issue Veterans Health Administration-wide guidance on implementing these documentation, intake, clinical support, and care-coordination standards in patient care. This guidance should instruct VHA healthcare staff to proactively ask patients whether cannabis use has been inaccurately documented in their medical records and, where appropriate, take steps to correct the record so that state-authorized medical cannabis use is documented as therapeutic medication use rather than non-medical use, illicit drug use, or substance-use-disorder-related history.
VI. THE OFFICE OF PERSONNEL MANAGEMENT, SUBSTANCE ABUSE & MENTAL HEALTH SERVICES ADMINISTRATION, & DEPARTMENT OF HEALTH & HUMAN SERVICES: WORKPLACE POLICY
Federal employees and contractors remain subject to cannabis testing and employment consequences even when they use medical cannabis in accordance with state law and without workplace impairment. Executive Order 12564 initiated the federal Drug-Free Workplace Program and continues to require federal employees to refrain from illegal drug use on and off duty. The Department of Health and Human Services’ Mandatory Guidelines for Federal Workplace Drug Testing Programs continue to require federal agencies to test for marijuana and state that only prescription medications may be offered as a legitimate medical explanation for a positive drug test.
This framework does not reflect the legal context created by AG Order No. 6754-2026. A state-authorized medical cannabis patient may be denied federal employment, lose a federal job, lose a federal contract opportunity, or face discipline based on a positive test that does not establish impairment, on-duty use, unsafe conduct, or poor job performance. To explain the result, the patient may be forced to disclose a disability, medical condition, or treatment plan.
Drug testing itself is generally not considered a prohibited medical inquiry under the Americans with Disabilities Act. However, when a cannabis-positive test automatically triggers adverse action, the policy may pressure an applicant or employee to reveal disability-related medical information to avoid punishment. That creates a compliance problem that federal agencies should not ignore.
Federal workplace policy must distinguish medical use from impairment. Employment decisions should focus on actual job performance, individualized assessment, and demonstrable safety risks. For safety-sensitive duties, agencies may maintain restrictions where necessary, but off-duty, state-authorized, physician-guided medical cannabis use should not be treated as misconduct absent evidence of impairment, unsafe conduct, or a specific job-related safety risk.
Required Action:
1. The Office of Personnel Management (OPM), HHS, the Substance Abuse and Mental Health Services Administration (SAMHSA), and the DOJ must replace outdated federal workplace guidance with standards that distinguish state-authorized medical cannabis use from impairment, misconduct, deficient performance, or job-related safety risk.
Suggested replacement language:
State-authorized medical cannabis use shall not be treated as disqualifying misconduct for federal employment or federal contracting solely on the basis of a cannabis-positive test. A positive cannabis test, standing alone, does not establish impairment, misconduct, or lack of fitness for duty for a qualified medical cannabis patient absent evidence of on-duty impairment, unsafe conduct, deficient performance, or a demonstrable job-related safety risk. Federal agencies shall evaluate medical cannabis-related employment issues through individualized assessment, applicable disability law, and legitimate safety requirements.
For safety-sensitive duties, federal workplace policy may continue to impose restrictions where necessary, but it should not punish off-duty, lawful, physician-guided medical cannabis use absent evidence of impairment, misconduct, or a specific safety risk.
2. The agencies should also review whether pre-employment and random cannabis testing policies operate as de facto disability-related inquiries when applicants or employees must disclose a medical condition to explain state-authorized medical cannabis use.
VII. DEPARTMENT OF DEFENSE: MILITARY POLICY & SERVICE MEMBERS
Active-duty service members remain subject to the Uniform Code of Military Justice, including Article 112a, which criminalizes knowing wrongful use, possession, manufacture, distribution, importation, exportation, or introduction of controlled substances. Current Department of Defense and branch-specific policies leave no meaningful medical cannabis pathway for service members. There is no exception for a doctor’s recommendation, no exception for state-authorized medical cannabis use, and no exception for service members stationed in jurisdictions where medical cannabis is legal.
Branch-specific rules, including Army Regulation 600-85, Department of the Air Force Manual 44-197, Navy and Marine Corps ALNAV 057/19, and Coast Guard ALCOAST 308/20, prohibit cannabis, hemp-derived cannabinoid products, cannabidiol products, or related substances in a manner that treats medical use, non-medical use, and potential misconduct as the same category of prohibited conduct.
The military has unique readiness, discipline, deployment, and safety requirements. Those requirements must be respected. However, AG Order No. 6754-2026 requires the Department of Defense to revisit whether a zero-exception framework remains appropriate for all circumstances involving therapeutic medical cannabis use. A policy that treats medical disclosure as misconduct may deter service members from asking clinical questions, planning continuity of care, or seeking medical guidance before separation, retirement, disability evaluation, or transition into Department of Veterans Affairs healthcare.
The Department of Defense does not need to treat medical cannabis like any ordinary medication in every military setting. Certain duty assignments, deployment contexts, weapons-related duties, aviation roles, and safety-sensitive activities may require strict limitations. But those limits should be grounded in readiness, safety, impairment, deployment needs, and military necessity—not the outdated assumption that all medical cannabis use is indistinguishable from misconduct.
Required Action:
1. The Department of Defense must review and revise or replace Department-wide and branch-specific policies governing cannabis, hemp-derived cannabinoids, cannabidiol products, and state-authorized medical cannabis use.
Suggested language:
Department of Defense and branch-specific cannabis policies shall distinguish therapeutic medical cannabis use from recreational use, diversion, impairment, and misconduct. Service members with qualifying medical conditions should have access to a medically supervised review process consistent with readiness, discipline, deployment requirements, and safety. No service member shall be subject to punitive action solely for disclosing state-authorized medical cannabis use for purposes of seeking medical guidance, transition planning, disability evaluation, or veteran healthcare continuity.
2. The Department should identify duty assignments, deployment contexts, and safety-sensitive activities in which use must remain restricted, while establishing a responsible pathway for medical disclosure, clinical review, and continuity-of-care planning.
VIII. DEPARTMENT OF JUSTICE & DRUG ENFORCEMENT ADMINISTRATION: REGISTRATION
The Department of Justice order creates a federal registration process for state-licensed medical cannabis manufacturers, distributors, and dispensers. The order states that state licensees seeking federal registration may submit state credentials as evidence of state-law authorization, and the Federal Register notice describes the placement of state-licensed marijuana in Schedule III and related regulatory treatment.
The order also states that the Administrator must grant registration unless doing so would be inconsistent with the public interest under 21 U.S.C. § 823 or with the requirements of the Single Convention. Under 21 U.S.C. § 823, the public-interest factors include the applicant’s prior conviction record under federal or state laws relating to the manufacture, distribution, or dispensing of controlled substances.
The Department of Justice’s medicinal cannabis regulations also include public-interest factors for registration, including prior conviction records under federal and state laws relating to the manufacture, distribution, or dispensing of controlled substances. See 21 C.F.R. § 1318.05.
This provision requires careful implementation. For decades, medical cannabis patients, caregivers, providers, workers, cultivators, and operators lived under a federal framework that treated cannabis as Schedule I, even when they were acting under state medical cannabis laws or helping build regulated state medical cannabis systems. Many people with prior cannabis convictions were criminalized because federal and state laws failed to recognize medical cannabis. Those convictions should not now be used to exclude them from the very federal medical cannabis system that finally recognizes the legitimacy of this work.
A blanket denial policy based on prior cannabis convictions would disrupt state medical cannabis programs, penalize people who helped create patient access before federal law caught up, and recreate the harms caused by decades of outdated cannabis prohibition.
Required Action:
The White House should instruct DOJ and DEA to remove or revise any implementation policy that treats prior cannabis-related convictions as a categorical basis to deny Drug Enforcement Administration registration for state-licensed medical cannabis manufacturers, distributors, or dispensers.
Guidance should require individualized public-interest review and make clear that a prior cannabis-related conviction, standing alone, should not disqualify a state-licensed applicant absent a current, documented risk to public health or safety.
IX. DEPARTMENT OF HEALTH & HUMAN SERVICES: ESTABLISH THE OFFICE OF MEDICAL CANNABIS & CANNABINOID CONTROL
The Secretary of Health and Human Services should establish an Office of Medical Cannabis and Cannabinoid Control within the Department of Health and Human Services to oversee and coordinate interagency implementation of federal medical cannabis policy following AG Order No. 6754-2026, the Medical Marijuana and Cannabidiol Research Expansion Act, Pub. L. No. 117-215 (2022), and Executive Order 14370, “Increasing Medical Marijuana and Cannabidiol Research” (Dec. 18, 2025).
The Office would serve as the federal government’s primary medical cannabis and cannabinoid coordination body. Its purpose would be to translate federal recognition into patient protections, healthcare integration, research advancement, product safety standards, civil rights guidance, and consistent implementation across agencies. The Office should function as an operational bridge between research, regulation, healthcare delivery, civil rights, product safety, and patient access.
Congress enacted the Medical Marijuana and Cannabidiol Research Expansion Act to expand research on cannabis and cannabidiol by reducing barriers to research and improving federal processes for studying these substances. Executive Order 14370 then directed federal agencies to accelerate research, improve federal research frameworks, and support policy changes, including rescheduling, necessary to advance medical cannabis science. AG Order No. 6754-2026 was issued in accordance with that Executive Order, but rescheduling alone does not fulfill either Congress’s directive or the Executive Order’s intent. Without coordinated federal implementation, research reforms will remain fragmented, clinical data will remain underused, and patients will continue to face barriers in healthcare, housing, employment, veterans’ services, disability accommodations, and federal programs.
The Office should coordinate across the CMS, FDA, NIH, DOJ, HHS, VA, DoD, OPM, SAMHSA, Treasury, IRS, Financial Crimes Enforcement Network, the Domestic Policy Council, state medical cannabis regulatory programs, and Tribal governments, where appropriate. It should also include ongoing consultation with patients, caregivers, veterans, disability-rights advocates, clinicians, researchers, healthcare systems, state regulators, and product safety experts.
The Office should oversee federal medical cannabis and cannabinoid implementation in the following core areas:
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- Patient data, medical records, and clinical evidence, including standardized medical cannabis intake questions, electronic health record fields, product terminology, route of administration, cannabinoid profile, dose, frequency, patient-reported outcomes, and documentation practices across federal healthcare programs.
- Healthcare integration and coverage research, including Centers for Medicare & Medicaid Services studies on cost savings, coverage models, patient outcomes, opioid reduction impacts, healthcare utilization, and potential Medicare and Medicaid pathways.
- Product safety, labeling, and stability standards, including standards for contaminants, pesticides, residual solvents, heavy metals, microbial impurities, labeling accuracy, product consistency, packaging, storage, shelf life, expiration dating, and recall procedures.
- Research infrastructure and provider education, including standardized data sets for National Institutes of Health-funded research, study of real-world medical cannabis products used by patients in state programs, and training materials for healthcare providers on cannabinoid therapeutics, dosing, drug interactions, contraindications, routes of administration, and patient counseling.
- Civil rights and federal policy alignment, including coordination with the Department of Justice and relevant civil rights offices to ensure that federal recognition of medical cannabis is reflected in guidance under the Americans with Disabilities Act, the Fair Housing Act, Section 504 of the Rehabilitation Act, and other nondiscrimination laws.
- State-federal coordination and patient access, including coordination on state licensing, patient registries, adverse-event reporting, data sharing, patient access in states without functioning medical cannabis programs, supply disruptions, DEA registration implementation, hemp-law changes, and state-federal transition issues.
- Hemp-derived cannabinoid regulation and financial coordination, including coordination with the Food and Drug Administration, Department of the Treasury, Internal Revenue Service, Financial Crimes Enforcement Network, and financial regulators to ensure that federal hemp, tax, banking, and financial policies do not undermine patient access or the stability of state medical cannabis programs.
The Secretary should ensure that the Office is staffed with individuals possessing expertise in clinical, regulatory, scientific, public health, patient safety, healthcare delivery, health data, product safety, cannabinoid therapeutics, cannabis testing, healthcare integration, and civil rights.
The Office should issue an initial interagency implementation plan within 90 days addressing patient protections, healthcare integration, standardized data collection, product safety, hemp-derived cannabinoid regulation, state-federal coordination, research implementation, and the steps necessary to ensure that federal recognition of medical cannabis translates into meaningful access for patients.
X. CONCLUSION
The Administration has taken an important step by recognizing FDA-approved marijuana products and products regulated by qualifying state medical cannabis licenses within Schedule III. That recognition must now have practical meaning for patients.
Patients should no longer lose housing, employment, healthcare access, veterans’ services, federal program participation, or be denied reasonable accommodation solely because their medicine is cannabis. Federal agencies must now align outdated policies with the legal framework established by AG Order No. 6754-2026 and existing civil rights laws.
It should be the policy of the United States that medical cannabis patients are medical cannabis patients are now protected from discrimination under the Americans with Disabilities Act, the Fair Housing Act, and Section 504 of the Rehabilitation Act. They are entitled to be evaluated accordingly. Failure to align policies with these laws may expose covered entities to federal enforcement, civil liability, loss of eligibility for federal funding, fines, and corrective actions.
REFERENCES
Americans with Disabilities Act: Employment Discrimination. 42 U.S.C. § 12112. uscode.house.gov/view.xhtml?req=(title:42+section:12112+edition:prelim)
Americans with Disabilities Act — Illegal Use of Drugs: 42 U.S.C. § 12210. uscode.house.gov/view.xhtml?edition=prelim&num=0&req=granuleid:USC-prelim-title42-section12210
AG Order No. 6754-2026 / Schedule III Final Rule: Department of Justice and Drug Enforcement Administration, “Schedules of Controlled Substances: Rescheduling of Food and Drug Administration Approved Products Containing Marijuana From Schedule I to Schedule III; Corresponding Change to Permit Requirements,” 91 Fed. Reg. 22714, April 28, 2026.
www.federalregister.gov/documents/2026/04/28/2026-08176/schedules-of-controlled-substances-rescheduling-of-food-and-drug-administration-approved-products
Application for Registration; Time for Application; Registration for Independent Activities.
21 C.F.R. § 1301.13.
www.ecfr.gov/current/title-21/chapter-II/part-1301/section-1301.13
Army Regulation 600-85: The Army Substance Abuse Program.
Department of the Army, July 23, 2020.
home.army.mil/ansbach/application/files/3616/0162/2625/AR_600-85-The_Army_Substance_Abuse_Program_23_JUL_20.pdf
Coast Guard ALCOAST 308/20: The Use of Hemp and Cannabidiol Products Is Prohibited.
U.S. Coast Guard, August 13, 2020. content.govdelivery.com/accounts/USDHSCG/bulletins/29a24a1
Controlled Substances Act: Registration Requirements: 21 U.S.C. § 823. uscode.house.gov/view.xhtml?edition=prelim&num=0&req=granuleid:USC-prelim-title21-section823
Controlled Substances Act — Treaty-Based Scheduling Authority: 21 U.S.C. § 811(d). uscode.house.gov/view.xhtml?edition=prelim&num=0&req=granuleid:USC-prelim-title21-section811
Controlled Substances Regulations: Prescriptions: 21 C.F.R. Part 1306.
www.ecfr.gov/current/title-21/chapter-II/part-1306
Convention on Psychotropic Substances, 1971: Article 2: United Nations, Convention on Psychotropic Substances, 1971.
www.unodc.org/pdf/convention_1971_en.pdf
Denial of Admission for Drug-Related Criminal Activity or Illegal Drug Use: 24 C.F.R. § 5.854.
www.ecfr.gov/current/title-24/subtitle-A/part-5/subpart-I/section-5.854.
Department of Defense Instruction 1010.16: Technical Procedures for the Military Personnel Drug Abuse Testing Program: Department of Defense.
www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/101016p.pdf
Department of Housing and Urban Development: Use of Marijuana in Multifamily Assisted Properties.
U.S. Department of Housing and Urban Development, December 29, 2014.
www.hud.gov/sites/documents/useofmarijinmfassistpropty.pdf
Department of Housing and Urban Development Exchange FAQ: Medical Marijuana Reasonable Accommodation. HUD Exchange.
www.hudexchange.info/faqs/4167/can-a-pha-make-a-reasonable-accommodation-for-medical-marijuana/
Department of Housing and Urban Development: “Medical Marijuana Use in Public Housing and Housing Choice Voucher Programs,” February 10, 2011. Archived copy.
www.fairhousingnc.org/wp-content/uploads/2015/01/HUD-Medical-Marijuana-Use-in-Public-Housing-and-HCVP-2-10-11.pdf
Department of Justice Press Release: Schedule III Order.
U.S. Department of Justice, April 23, 2026.
www.justice.gov/opa/pr/justice-department-places-fda-approved-marijuana-products-and-products-containing-marijuana
Department of Justice Press Release: Implementing Executive Order 14370: U.S. Department of Justice, April 23, 2026.
www.justice.gov/opa/pr/justice-department-places-fda-approved-marijuana-products-and-products-containing-marijuana
Department of the Air Force Manual 44-197: Military Drug Demand Reduction Program.
Department of the Air Force, February 4, 2026.
static.e-publishing.af.mil/production/1/af_sg/publication/dafman44-197/dafman44-197.pdf
Drug-Free Workplace Act of 1988: 41 U.S.C. §§ 8101–8106. uscode.house.gov/view.xhtml?edition=prelim&path=%2Fprelim@title41%2Fsubtitle4%2Fchapter81
Equal Employment Opportunity Commission Regulation — Prohibited Medical Examinations and Inquiries: 29 C.F.R. § 1630.13.
www.ecfr.gov/current/title-29/subtitle-B/chapter-XIV/part-1630/section-1630.13
Equal Employment Opportunity Commission — Enforcement Guidance on Disability-Related Inquiries and Medical Examinations of Employees: U.S. Equal Employment Opportunity Commission, July 26, 2000.
www.eeoc.gov/laws/guidance/enforcement-guidance-disability-related-inquiries-and-medical-examinations-employees
Executive Order 12564 — Drug-Free Federal Workplace: President Ronald Reagan, September 15, 1986. National Archives.
www.archives.gov/federal-register/codification/executive-order/12564.html
Executive Order 14370: Increasing Medical Marijuana and Cannabidiol Research. President Donald J. Trump, December 18, 2025.
www.govinfo.gov/app/details/DCPD-202501206
Fair Housing Act: Discrimination in Sale or Rental of Housing. 42 U.S.C. § 3604.
uscode.house.gov/view.xhtml?edition=prelim&num=0&req=granuleid:USC-prelim-title42-section3604
Federal Register: Schedule III Final Rule. Department of Justice, April 28, 2026.
www.federalregister.gov/documents/2026/04/28/2026-08176/schedules-of-controlled-substances-rescheduling-of-food-and-drug-administration-approved-products
International Narcotics Control Board — Report for 2022.
International Narcotics Control Board, Report of the International Narcotics Control Board for 2022, United Nations, 2023.
www.incb.org/incb/en/publications/annual-reports/annual-report-2022.html
Mandatory Guidelines for Federal Workplace Drug Testing Programs.
Substance Abuse and Mental Health Services Administration (SAMHSA), Department of Health and Human Services (HHS). February 1, 2024 www.federalregister.gov/documents/2023/10/12/2023-21734/mandatory-guidelines-for-federal-workplace-drug-testing-programs
Medical Marijuana and Cannabidiol Research Expansion Act. Pub. L. No. 117-215, December 2, 2022.
www.govinfo.gov/app/details/PLAW-117publ215
Medicinal Cannabis Regulations: Application of Public Interest Factors. 21 C.F.R. § 1318.05.
www.ecfr.gov/current/title-21/chapter-II/part-1318/section-1318.05
Medicare Advantage Supplemental Benefits Regulation. 42 C.F.R. § 422.102.
www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-422/subpart-B/section-422.102
Navy and Marine Corps ALNAV 057/19: Department of the Navy Hemp Policy. Department of the Navy, August 7, 2019.
www.mynavyhr.navy.mil/Portals/55/Messages/ALNAV/ALN2019/ALN19057.txt
Public Housing Lease and Grievance Procedures. 24 C.F.R. § 966.4.
www.ecfr.gov/current/title-24/subtitle-B/chapter-IX/part-966/subpart-A/section-966.4
Public Housing Regulations — Denial of Admission for Criminal Activity or Drug Abuse by Household Members. 24 C.F.R. § 960.204.
www.ecfr.gov/current/title-24/subtitle-B/chapter-IX/part-960/subpart-B/section-960.204
Rehabilitation Act of 1973: Nondiscrimination Under Federal Grants and Programs. 29 U.S.C. § 794. www.govinfo.gov/app/details/USCODE-2018-title29/USCODE-2018-title29-chap16-subchapV-sec794
Single Convention on Narcotic Drugs, 1961: Article 28: Control of Cannabis.
United Nations, Single Convention on Narcotic Drugs, 1961, as amended by the 1972 Protocol.
www.unodc.org/pdf/convention_1961_en.pdf
Substance Abuse and Mental Health Services Administration: Federal Drug-Free Workplace Program.
SAMHSA.
www.samhsa.gov/substance-use/drug-free-workplace/about/background
Termination of Assistance for Criminal Activity or Alcohol Abuse: Housing Choice Voucher Program.
24 C.F.R. § 982.553.
www.ecfr.gov/current/title-24/subtitle-B/chapter-IX/part-982/subpart-L/section-982.553.
Uniform Code of Military Justice: Article 112a: Wrongful Use, Possession, etc., of Controlled Substances. 10 U.S.C. § 912a. uscode.house.gov/view.xhtml?edition=prelim&num=0&req=granuleid%3AUSC-prelim-title10-section912a
Veterans Affairs: Marijuana Use and VA. U.S. Department of Veterans Affairs.
www.publichealth.va.gov/marijuana.asp
Veterans Health Administration Directive 1315. U.S. Department of Veterans Affairs.
www.va.gov/vhapublications/ViewPublication.asp?pub_ID=11394
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