“Marijuana in its natural form is one of the safest therapeutically active substances known to man.” — Hon. Francis Young (deceased), DEA Administrative Law Judge, 1988
After nearly a century of “reefer-madness”-inspired paternalistic federal obstructionism, the Drug Enforcement Agency’s announcement that it won’t reschedule cannabis should come as no surprise. Predictably, the agency announced plans on Thursday to make research easier by ending the federal government’s monopoly on research-grade marijuana production.
The DEA, Food & Drug Administration, and Department of Health & Human Services (HHS) — “The Triad” — acknowledge cannabis contains constituents that, when used independently, or synergistically, can provide significant therapeutic benefits. However, they contend that a plant-based medicine of variable chemical composition that can be smoked (but, doesn’t have to be), can’t be medicine. (Millions of patients and their physicians, of course, disagree.)
How can the DEA justify its decision?
The DEA can classify a drug Schedule I if it meets (any of) the following criteria:
- No currently accepted medical use;
- Lack of accepted safety for use under medical supervision;
- High abuse potential
Common sense (and science) tell us none of these apply to cannabis. In fact, it wasn’t long ago — Sept. 6, 1988 — that one of the DEA’s own administrative judges concurred. In what should have been a landmark decision, the now deceased Hon. Francis Young, ruled (emphasis mine):
"[The evidence] clearly shows that marijuana has been accepted as capable of relieving the distress of great numbers of very ill people. … It would be unreasonable, arbitrary and capricious for DEA to continue to stand between those sufferers and the benefits of this substance.”
Young continued, “The record here establishes conclusively that at least 'a respectable minority' of physicians has 'accepted' marijuana as having a 'medical use in treatment in the United States.' That the others may not, makes no difference. … Nothing more can reasonably be required.”
The judge concluded that there’s “no lack of accepted safety for [the] use of [cannabis] under medical supervision and that it may lawfully be transferred from Schedule I to Schedule II."
After rejecting Young’s ruling, the DEA revised internal guidelines on what constitutes “accepted medical use,” implementing an eight-factor analysis.
What is “accepted medical use?”
The DEA narrowly defines “accepted medical use.” Among other requirements, the drug's chemistry must be known and reproducible, and have an “adequate” number of “gold standard,” human-controlled trials.
“Gold standard” research doesn’t exist because, ipso facto, government policy obstructs research. It took years for the first-ever whole-plant cannabis study — Dr. Sue Sisley and the MAPS Foundation’s PTSD study — to get approved.
(Notably, since 1999 the federal government has held a patent on cannabinoids as antioxidants and neuroprotectants, claiming, “cannabinoids [are] useful in the treatment…of a wide variety of oxidation associated diseases.”)
What is “accepted safety for use under medical supervision?”
The DEA points to the fact there aren't any FDA-approved botanical cannabis products and thus no accepted safety standards. Big surprise! The government has long impeded research — a point they’ve (indirectly) acknowledged with today’s announcement.
What constitutes “high potential for abuse?”
The litmus test: Are people using the substance for non-medicinal purposes? News flash: Numerous scheduled drugs are diverted to non-medicinal use (see below). Notably, only 9 percent of people who try marijuana develop a use disorder. Alcohol clocks in at 15 percent, while nicotine takes the cake at 33 percent.
Technically, the risk for psychological and physical dependence should decrease as you work your way down the schedules. But, the government applies this rule haphazardly, with more dangerous drugs appearing on lower schedules:
- Opioids appear on four out of five schedules. From 1999 to 2014, more than 165,000 people died in the U.S. from overdoses related to prescription opioids. During the same period, there were no reported fatal overdoses from cannabis.
- Schedule IV drugs, including Xanax, Soma, Klonopin, and Valium, were involved in 30 percent of fatal drug overdoses. To put that in perspective, at 3.07 deaths per 100,000 people, the rate of fatal benzodiazepine-related overdoses is 50 percent higher than the homicide rate of many large cities. (The eighth-largest city, San Diego, has a homicide rate of 2.4 / 100,000.)
And, I kid you not…
- “Crack,” “Crank,” “Ice,” “Meth,” and “Speed” (they literally list those names) are technically Schedule II drugs. And LSD precursor and hallucinogenic — LSA — is Schedule III.
Further, federal officials don’t consider that by expanding access to cannabis, we can reduce abuse of more dangerous drugs like opioids and alcohol. States passing medical marijuana laws experienced a 25-percent drop in fatal opioid overdoses. Similarly, studies suggest that when states enact medical marijuana laws, they experience a significant decline in alcohol consumption and suicide rates. On average, suicide rates for 20 to 29-year-old males decrease 11 percent, while rates for 30 to 39 year olds drop 9 percent.
We Need to Rethink Scheduling
Restricting cannabis as a Schedule I drug is morally indefensible. It’s time to rethink the lack of wisdom of our scheduling system. As I argue in my forthcoming book, Schedule ZERO: The Case for Rethinking Cannabis and Scheduling, we need to create a system that addresses the (legitimate) concerns of critics while recognizing the very real needs of patients.
Research and common sense suggest cannabis is safer than alcohol and many other drugs — while also providing tremendous therapeutic value. But our politically — not scientifically — driven scheduling scheme has failed.
Colorado attorney and inaugural member of the Marijuana Policy Advisory Committee Robert Hoban explains why: “The term 'medicinal' is problematic because it carries with it the connotation that is often confused with FDA approval or pharmacological recognition. This term has consumer, patient, and legal significance beyond cannabis. And it will be difficult for mainstream health care to grasp or recognize this accordingly.”
Hoban believes we should replace the word “medicinal” with a term that more accurately describes whole-plant cannabis — e.g. “herbal” or “botanical.” This, in turn, could inspire more intelligent policy while eliminating confusion among “mainstream health care, science, policymakers, and patients.”
The decades-long issues we’ve had accurately recognizing (and appreciating) cannabis for its impressive therapeutic versatility are not serving the public interest. Until we rethink our antiquated scheduling system, we will continue to impede scientific progress. At the end of the day, it’s patients who needlessly suffer.