Rescheduling Cannabis in America: Celebration or disappointment? It is in the eye of the beholder.

On April 30th, 2024, the DEA accepted the recommendation of the U.S. Health and Human Services and FDA that cannabis should be reclassified as a Schedule 3 drug along with Ketamine, Codeine, steroids, and Marinol, synthetic THC. It does not mean that cannabis is legalized for adult use but does end the 53 years that cannabis was wrongly entered into the CSA as a Schedule 1 drug with no medical benefits and as much danger as heroin, PCP, and LSD. This is the most monumental drug policy reform since the War on Drugs began.

Now we await the White House Office of Management and Budget to markup legislation that will begin the process of rescheduling and create the public comment period for Americans to voice our sentiments on it. Many are dissatisfied because they want cannabis descheduled and completely removed from the CSA. Others oppose because they believe cannabis to be the gateway drug demonized by prohibitionists and the Just Say No Campaign. Others are celebrating that we have begun the process, understand incremental reforms, and that something is better than nothing. In my opinion, the pros outweigh the cons.

Many things will stay the same because cannabis has not been decriminalized, people will still be arrested for it, and no one will be let out of prison due to rescheduling. But many things will change for the better, starting with our ability to change the conversation. Some of the benefits to unfold over time will include:

  • Research will become easier to conduct, and that’s a very good thing. We have been stalled in a Catch-22 of no randomized double-blind placebo-controlled trials to study the efficacy of cannabis for the various disease states we believe it helps. Not only will we be able to study it, but we will be able to use cannabinoids grown by professionals and not the NIDA / DEA controlled cannabis that does not represent the products on the private market. We will be able to study the modern routes of use like tinctures, FECO extracts, edibles, and various topical products. Complex chemical profiles of whole plant formulations will be studied, and not just isolates or synthetic molecules. Finally, we will be able to compare cannabis medicines with the standards of care for pain, cancer, insomnia, mental health, autoimmune, and neurodegenerative conditions like Alzheimer’s, Parkinson’s, and MS. We will even be able to safely trial cannabinoids for pediatrics and other sensitive populations.
  • FDA Approved formulations that emerge from this new research will be stocked on local pharmacy shelves, even in non-legal cannabis states. This will provide access to residents across the country, and insurance companies will reimburse the cost for needed medicines breaking the affordability barrier that exists for so many today. New science will fuel a different side of the industry, where GMP formulations will bring standardized, consistent, reliable, tested plant medicines like Sativex and innovative products that combine multiple cannabinoids with other botanicals that offer new hope for millions not served by traditional pharmaceuticals. We will have alternatives to opioids and NSAIDs which kill or injure millions of patients who suffer with chronic pain syndromes.
  • The Cannabis Industry will benefit from tax relief once 280E is repealed, allowing deductions for regular business expenses. Enhanced profitability will stabilize the industry for growth, and that will prompt Congress to pass banking reforms to end the unsafe cash-based system. These measures will free up capital to invest in people, staff training, and educational systems for patients. Tracking Apps will emerge to help people adjust, optimize, and retain cannabis products, and online marketplaces will steer people towards more suitable options for care.
  • Professional guidance from clinicians, nurses, and multidisciplinary teams will become the norm to steer medical patient care. Budtenders will more easily focus on the recreational consumer and not attempt to practice medicine by telling sick patients what their last customer used successfully. Regulatory compliance will be easier because natural lanes of professional conduct will emerge as licensed personnel enter the field currently dominated by connoisseurs and enthusiasts.
  • Finally, medical and nursing schools will begin teaching on the endocannabinoid system, and how modulating it may affect all human diseases. Cannabis will begin to be seen as a first line therapy instead of a last resort option. Well trained doctors, nurses, and researchers will work to implement new cannabinoid care pathways, and products will be balanced formulations and away from the high THC domination we have seen as medical programs are replaced by adult use programs. Modern dispensaries will build a Medical Door for cannabis that value patient care. Eventually we will have evidence-based guidelines to know what formulations, routes, doses, and times will best treat specific conditions and we will create targeted learning to accompany these new products. Botanical cannabis products may be allowed in healthcare facilities as we move to expand Ryan’s Law and the compassionate use laws for needs not met by Sch. 3 medicines, or when a patient does not have access to insurance reimbursements.
  • All these points are my own analysis from reading several commentaries and my decade in this business. I admit this is decidedly a glass half full assessment, and I invite other comments and dialogue as we move forward together. We are all on the same side as Americans who admit our healthcare and pharmaceutical system is failing most of us, and that any progress at the end of the day is a good day.

By Elisabeth Mack RN, BSN, BA, MBA
Elisabeth founded Holistic Caring in 2016 to bridge the gap between traditional and cannabis medicine through education, guidance, and supportive care for patients. An educational provider for the California Board of Registered Nursing, she professionalizes medical cannabis by equipping healthcare providers to have necessary conversations with patients and to approach cannabis by emphasizing holistic and functional medicine.