The significant gap between many U.S. states and the federal government on how to categorize cannabis will remain in place for now.
On Thursday, the Drug Enforcement Administration denied a petition to ease federal restrictions on the use of marijuana for the fourth consecutive time. While four states and the District of Columbia have legalized marijuana for recreational use and half the states in the Union now allow medical marijuana, the federal government will continue to treat cannabis as a schedule I controlled substance with “no currently accepted medical use” and a “high potential for abuse.”
The prohibitive federal approach makes comprehensive research of the actual medical properties of marijuana difficult and expensive. CNN’s chief medical correspondent Sanjay Gupta called the DEA decision a “missed opportunity” on medical marijuana.
Although the DEA is also relaxing the rules of cannabis research by making it easier for institutions to grow marijuana for scientific study, Dr. Gupta doesn’t think it will make any difference.
“While this will be hailed as a victory for research, it will largely be symbolic, because no matter how much marijuana is available, if access is still difficult, it hardly matters.”
Peter Grinspoon is a medical doctor and recovering addict who supports the complete legalization of cannabis. He had expected a rescheduling of marijuana which he considers non-addictive.
“It is very disappointing that the DEA declined to reclassify marijuana out of schedule I. The DEA is still in the dark ages about the safety and efficacy of marijuana as medicine for millions of patients across the country. Relaxing the rules for research is a step in the right direction, but is really only a drop in the bucket given the tremendous demand for research on the therapeutic benefits of cannabis.”
Grinspoon believes, the schedule I category presents a Catch-22 situation. You cannot do research because it is deemed to be a dangerous substance without medical use and you cannot establish any medical benefits without the required research. For him there’s already clear evidence that medical marijuana works.
“There is an overwhelming amount of anecdotal evidence from millions of patients that marijuana is really helpful for a broad variety of conditions,” Grinspoon told me. His list includes glaucoma, nausea, neurological disorders, multiple sclerosis, fibromyalgia, sciatica as well as most pain syndromes.
Other medical professionals are more sceptical. Addiction psychiatrist Kevin Hill writes in his book on marijuana that “for many illnesses mentioned in medical marijuana laws around the country, the data from scientific studies is weak or even nonexistent.” (Marijuana page 107)
For Dr. Hill, it is a case of policy being ahead of the science. “Medicine does not work that way—in medicine, we aim to establish the safety and effectiveness of treatments before we recommend them to large numbers of people.” (Marijuana page 107)
Hill does not rule out that cannabinoids could work as medication for some conditions if the benefits outweigh the risks. Different from Dr. Grinspoon, Hill believes marijuana can be harmful and sometimes lead to addiction.
Both agree that it should not be smoked—most physicians do not recommend smoking as a route of administration for any medicine since it is harmful to the lungs. No medication currently approved by the FDA is smoked. Hill and Grinspoon also agree that cannabis can have negative effects on brain development in adolescents and young adults.
A 2015 study published in the Journal of the American Medical Association found that cannabis may help alleviate muscle stiffness from multiple sclerosis and chronic pain but no convincing evidence for the claimed ability to treat other conditions.
Despite the currently weak evidence of medical benefits more states, including Arizona and Massachusetts, will vote on legalizing marijuana for recreational use in the fall while cannabis will remain a schedule I controlled substance for the federal government.