Marijuana rescheduling looked like it would be completed before the end of 2024. It didn’t happen. Now rescheduling is stuck in administrative court with no timeline for moving forward. But let us assume that marijuana is ultimately moved from Schedule I of the Controlled Substances Act (CSA) to Schedule III. What then?
Rescheduling opens the door to marijuana being treated like other drugs in the same class. Think of ketamine. It is the perfect example. Rescheduling will also create more opportunities to expand medical cannabis by Developing specific medications for targeted medical conditions.
Despite the advantages of rescheduling, it doesn’t come without its own set of issues. So to make it work, we would need Congress to build five specific things into the system:
1. Evidence-Based Regulations
Lawmaker comments over the past few years suggest that rescheduling could lead to Washington regulating marijuana much the same way other prescription drugs are regulated. If Congress were to legalize rather than reschedule, regulations would take a form more like how we currently regulate alcohol. Regardless, we will need evidence-based regulations, nut rules rooted in politics.
Right now, persistent and acute pain are the two biggest reasons medical cannabis card holders visit the Beehive Farmacy in Salt Lake City, Utah. In fact, more than 85% of Utah’s card holders cite pain as their primary medical condition. It is pretty much the same throughout the country.
Any future regulations involving medical cannabis as a pain treatment need to be supported by science. The science can include both clinical and anecdotal evidence, as long as the evidence drives regulatory decisions.
2. Robust Public Health Surveillance
Rescheduling will open a floodgate unlike anything else we have ever seen in healthcare. Therefore, we are going to need robust public health surveillance to monitor how cannabis is being prescribed, who is using it, its efficacy, and any potential negative impacts it creates. We cannot just reschedule and hope for the best.
3. Enforced Quality Control
The point of rescheduling marijuana rather than decriminalizing it is to improve access to medical cannabis. That being the case, we also need quality control standards established by either federal or state regulations, followed by strict enforcement. We don’t play games with other types of painkillers; we definitely should not with marijuana. Most importantly, we do not want a new medical cannabis problem to replace the current opioid crisis.
4. Limited Industry Influence
Since I brought up the opioid crisis, let’s talk about industry influence. The pharmaceutical industry bears a large portion of the blame for the current opioid crisis due to heavily pushing opioids in the previous decade. We cannot allow the medical cannabis industry to do the same thing.
Lobbying and marketing need to be controlled. Industry desires should never be allowed to trump public healthcare. Our current healthcare mess exemplifies what happens when healthcare companies have too much influence. Let us not repeat those mistakes with medical cannabis.
5. Limitations on Taxation
Again, the point of rescheduling is to increase access to medical cannabis. With that being the case, taxation should be significantly limited. We have seen thus far that state governments cannot wait to get their hands on cannabis tax dollars. We also know that taxation drives up prices. So if medical cannabis is really about healthcare and we want healthcare to remain affordable, medical cannabis taxes should be intentionally limited.
No one knows if marijuana will ever be rescheduled. And if it is, there is no way to know if the five things mentioned in this post will be built into the system. Here’s hoping both become reality at some point.
