May 1, 2024 – One mustn’t draw any great conclusions in regards to the Marijuana Safety In light of the recent announcement that federal authorities may reclassify the drug, experts warn
But the move is predicted to make it easier for scientists to review questions on the protection and effectiveness of marijuana as a medical treatment, and one legal expert said it could change the federal government's view on marijuana use. medical marijuana by prescription in a state where medical use is legal under state law. Currently, this continues to be illegal under federal law.
“If you are a patient in a state that has a medical marijuana law, and your doctor writes you a prescription for medical marijuana and you possess it, you are no longer guilty of a federal crime,” said Robert Mikos, JD, the LaRoche Family Chair in Law at Vanderbilt University Law School in Nashville.
The Drug Enforcement Administration is proposing to vary the classification of marijuana from a Schedule I drug to a Schedule III drug. Schedule I also includes drugs equivalent to heroin, and the proposed change would downgrade marijuana to a lower-risk group that features drugs equivalent to Suboxone, which is used to treat heroin addiction.
“I don't think the intention of moving it from Schedule I to Schedule III was to send the message to the public that it is safe to use. I hope people don't misinterpret or overinterpret the meaning of the schedule change,” the psychiatrist said Deepak Cyril D’Souza, MD, Director of the Yale Center for the Science of Cannabis and Cannabinoids in New Haven, Connecticut.
The Justice Department confirmed the proposed change on Wednesday.
“Today, the Attorney General circulated a proposal to reclassify marijuana from Schedule I to Schedule III,” Xochitl Hinojosa, the department's public affairs director, said in an announcement. “After publication in the Federal Register, a formal legislative process will begin, as required by Congress in the Controlled Substances Act.”
The Federal Government defined Schedule I drugs have a high potential for abuse and no currently recognized medical use, while Schedule III drugs have a “moderate to low potential for physical and psychological dependence.” Other Schedule III drugs include steroids, testosterone, and certain combos of limited codeine with Tylenol. There are two more tiers – Schedules IV and V – with even lower risks of abuse or dependence.
“Some data suggest that cannabis can be used therapeutically,” said D'Souza, using the scientific term for marijuana. “So I think the reclassification makes sense.”
Andrew Esch, MD, a palliative care physician in Tampa, Florida, has already received calls from patients wanting to know what the proposed change might mean for them. Esch, who makes a speciality of treating patients with serious illnesses, meets the state of Florida's requirement to certify patients to buy medical marijuana at a dispensary. He praised the reclassification announcement.
“I think it's very important and a big step in the right direction to get information that helps our patients,” said Esch, who also serves as senior educational adviser on the Center to Advance Palliative Care on the Icahn School of Medicine at Mount Sinai in New York City.
Although he never uses marijuana as a first-line treatment, Esch says it's a crucial option because it could possibly relieve nausea, lack of appetite and sleep problems, in addition to pain and anxiety, that are common in individuals with serious illnesses. But sometimes his patients aren't willing to take marijuana.
“Patients are savvy and know how to work the internet. When I suggest medical marijuana, they look it up and see it's classified the same as heroin, and then they get very, very scared,” he said. “This reclassification, when they see it listed next to things like Tylenol with codeine, it's a lot less scary to them.”
Esch prescribes marijuana in the identical way he prescribes opioids.
“I think marijuana can be safe if used in the right patients and closely monitored,” he said. “There's just a lot more data on opioids than on marijuana, and I think both have their dangers and both have their benefits.”
In states where marijuana continues to be illegal under current law, not much will change.
“You still wouldn't be committing a federal crime, but you could be violating state law,” Mikos said. “That's a much more important consideration because when you look at who's going after people who are in possession of small amounts of drugs, the state is handling 99% of those cases.”
The known risks of marijuana
Currently, 38 states and Washington, DC allow using medical marijuana, and 24 states allow recreational use. Almost 1 in 5 people consume marijuana within the United States, in a posh legal landscape where it stays illegal on the federal level.
“There is very little scientific evidence to support what is actually happening,” D'Souza said. “The argument that has been made is that there is no good science because of the draconian regulations. So if those regulations are relaxed and marijuana is moved from Schedule I to Schedule III, researchers could answer some of these fundamental questions.”
Conducting research studies with Schedule I drugs involves high risks and liabilities and requires detailed inspections by the DEA.
D'Souza has been studying marijuana for 30 years and says the regulatory complexities deter many researchers. His latest project will examine marijuana as a treatment for nerve pain.
The lack of research and the increasing availability of the drug as states legalize it for recreational or medicinal use means that folks often look outside the scientific community for his or her information.
“People are interested in what Snoop Dogg and Willie Nelson have to say about cannabis,” D'Souza said. “It's hard for us in the scientific community to compete against that. I think we've done a very poor job of educating people.”
He identified that marijuana today is as much as 20 times stronger than the marijuana commonly utilized in the Nineteen Sixties to Eighties, and that marijuana addiction rates have increased from about 10% of users to as high as 30%.
Known risks of marijuana use include:
- Seeks
- Severe mental illnesses equivalent to schizophrenia or bipolar disorder
- Accidents while driving drunk
- Heart and lung problems
- Effects on brain development, particularly during fetal development and adolescence.
“As a physician, psychiatrist and someone who has been researching cannabis for 30 years, I continue to be concerned about the impact of cannabis on human health, much like I am concerned about the impact of alcohol and tobacco on human health. And as you know, these are among the top 10 causes of the global burden of disease,” D'Souza said. “The commercialization of these products was the critical turning point.”
Writer Kelli Whitlock Burton contributed to this report.