Keypoint: The proposed change acknowledges the medical applications of marijuana.
The Associated Press has reported that the US Drug Enforcement Administration (DEA) is planning to reclassify marijuana to a less dangerous drug category. The proposed change acknowledges the medical applications of marijuana and suggests that the drug poses a lower risk of abuse compared with certain other controlled substances.
Pending review by the White House Office of Management and Budget, the suggested reclassification would shift marijuana from its current Schedule I classification, alongside substances like heroin and lysergic acid diethylamide (LSD), to Schedule III, placing it alongside medications such as ketamine and certain anabolic steroids. However, this reclassification would not entail full legalization for recreational use.
“In a long overdue policy change, the DEA has announced its plan to reclassify marijuana as a lower-risk drug,” John J. Miller, MD, told Psychiatric Times®. “The next required step is approval of this change by the White House Office of Management and Budget. Unfortunately, if approved, this policy change does not go far enough. It will not legalize marijuana federally—rather, improve access and parameters of use in states where it is already legal.”
Miller is medical director at Brain Health in Exeter, New Hampshire; editor in chief of Psychiatric Times; a staff psychiatrist at Seacoast Mental Health Center in Exeter; and a consulting psychiatrist at Insight Meditation Society in Barre, Massachusetts.
Marijuana is currently legal for recreational use in 24 US states and for medical use in 14 US states.2 Georgia will also soon become the first state to allow the sale of medical marijuana products in independent pharmacies, with more than 100 more pharmacies applying to participate.3 Public opinion toward legalization of marijuana, for both medical and recreational purposes, has also shifted, with a recent Gallup poll indicating that a record 70% of adults are in favor of legalization.4
Part of this shift has to do with the significant amount of information publicly available claiming the efficacy of marijuana for a wide variety of uses.3
“With so much circulating information available to the public, it is important to emphasize the facts about medical marijuana, especially the distinction between qualifying conditions and US Food and Drug Administration (FDA)-approved indications, its limited evidence, and the poorly regulated products available in marijuana dispensaries,” Yi-lang Tang, MD, PhD; Elizabeth McCord, MD; and Karen Drexler, MD, recently wrote in Psychiatric Times.3
The authors—who are all affiliated with the Department of Psychiatry and Behavioral Sciences at Emory University in Atlanta, Georgia—emphasized that medical marijuana and medicine are not the same thing. Variations in state laws regarding qualifying conditions, a lack of scientific consensus on efficacy and safety due to a lack of controlled trials, and inconsistent quality control in the production of marijuana all suggest a need for clinicians to educate the public about medical marijuana and its potential risks and benefits.3
According to Miller, further distinction in the proposed reclassification of marijuana announced today may also help with these efforts.
“As we have opined in Psychiatric Times over the years, it would be more beneficial and scientifically accurate to redefine this policy for tetrahydrocannabinol (THC), as cannabidiol (CBD) is already a legal and unscheduled drug federally,” Miller told Psychiatric Times. “The terms marijuana and cannabis are vague, and they include plant products that contain over 100 different cannabinoids, most of which are not well characterized. THC and CBD are the best studied and have dramatically different clinical effects and pharmacologies.”
Note: This article originally appeared on Psychiatric Times
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