Rescheduling: A Cannabis Comedy of Errors
Navigating the Hazy Maze of Federal Cannabis Laws
Here's a fun and candid interview between Jack Thompson and me, where we tackle the quirks and chaos of rescheduling cannabis, sprinkled with a dash of humor. đ
Dr. C: Join me for an interview with Jack Thompson from CED Clinic, covering cannabis rescheduling. We discuss the benefits and challenges of current regulations, the future of cannabis research, and its economic and healthcare impacts. Our conversation touches on the chaotic regulatory landscape and the potential for federal rescheduling, all with a touch of humor. Hope you enjoy!
Table of Contents
Ideal federal handling of marijuana?
Does cannabis fit Schedule III criteria?
Will rescheduling simplify research?
Impact of rescheduling on state programs?
Is cannabis stronger now and does it matter?
Key research areas for cannabis scheduling?
Jack Thompson (JT): How do you think marijuana should be handled under federal law, ideally?
Dr. Caplan (Dr. C): If only thinking in the ideal didnât feel unfair these days. If I could wave a magic wand, Iâd say cannabis should be treated as a unique entity under federal law. Unlike any other natural medicine, cannabis has been a part of human history for as long as we have records. The U.S. government's historical stanceâholding a patent for cannabis while obstructing access for U.S. citizensâis problematic and calls for reparations.
I've personally seen the medical benefits of cannabis, from eliminating the need for other medications to increasing survival times and reducing suffering from various diseases. The current U.S. approach to cannabis regulation is, like her political puppeteering, chaotic, with different components of the same plant being regulated in wildly (and insanely) different ways. For instance, while the FDA oversees prescription cannabis-based medicines, the DEA classifies cannabis as a Schedule I controlled substance, and the USDA regulates hemp production, as the FTC monitors advertising and marketing claims. This fragmented regulatory landscape exists because no single body has taken control or leadership.
It doesn't seem reasonable for any one part of this disjointed system to assume complete control, as each has only partially addressed its own relevant charge as it is. With my magic wand, the federal government would establish a new framework to manage cannabis under one 7-pointed roof. This framework would address intellectual property needs, support expedited national-scale research, and ensure safeguards for regional production. Without such a system, in a U.S. economy where some sort of national structure is raised, to which all statesâ programs must adhere, I would expect federal legalization to be in the awkward position of bringing harm down onto local economies which rely on state-specific, vertically integrated systems. That seems like a steaming pile of⌠lawsuits⌠just waiting to happen.
JT: Ignoring how we might want cannabis to be handled in practice, do the risks and benefits of marijuana fit in with the criteria for Schedule III, scientifically speaking?
Dr. C: From a scientific POV, cannabis could fit the criteria for Schedule III. This category includes substances with a moderate to low potential for dependence and which have ârecognizedâ medical uses. Cannabis has a lower potential for dependence compared to Schedule I and II substances like heroin and cocaine, and substantial evidence supports (has always supported) its medical benefits for conditions such as chronic pain and epilepsy, appetite stimulation, and improvements in subjective reports of quality of life. While cannabis does carry a moderate risk of dependence, it is actually generally LESS habit-forming than substances already approved and in the marketplace, including Xanax and Valium, which are classified as Schedule IV.
Schedule V substances have an even lower potential for abuse and typically include limited quantities of certain narcotics in over-the-counter products. Cannabisâs higher THC content makes it unsuitable for Schedule V because it carries a higher risk of abuse in the wild world of unstructured (unguided/unsupervised) consumption. By placing cannabis in Schedule III, we have an opportunity to maintain tighter control over its distribution and use, with the idea that we can better ensure that it is managed responsibly while still acknowledging its medical benefits. This classification would also facilitate research and make it easier for patients to access cannabis under medical supervision. Realistically, rescheduling does make for far fewer hoops through which researchers must jump to do the critical work of studying more easily.
Essentially, Schedule III strikes the right balance between regulation and accessibility. Unlike Schedule IV and V, which would not provide sufficient controls, and Schedule I and II, which overly restrict its medical use and research potential, Schedule III offers a middle ground that recognizes both the medical benefits and the need for regulation.
JT: Many people say that rescheduling will make researching cannabis easier, but is this true? Will it be possible to study commercially-available cannabis products?
Dr. C: Rescheduling cannabis would simplify the research process immensely and across different angles of attack. Currently, researchers face exhausting hurdles because cannabis is classified as a Schedule I substance, which on paper presupposes a high potential for abuse and no accepted medical use. This classification imposes a complex web of regulations and administrative barriers, becauseâon paperâwhy would anyone care to study it if it has zero benefit use-cases?
To begin with, researchers must obtain a Schedule I research license from the Drug Enforcement Administration (DEA). This is not a straightforward task; the application process requires detailed information about the research project, security protocols, and the qualifications of the research team. The approval process can extend over several months, sometimes a year or more.
In addition to the DEA license, Institutional Review Board (IRB) approval is also required. The IRB ensures that the study meets ethical standards and safeguards the rights and welfare of participants. This approval process can also be time-consuming, often taking several months.
Moreover, researchers are restricted to sourcing cannabis from federally-approved suppliers, such as the National Institute on Drug Abuse (NIDA). Acquiring cannabis from NIDA involves additional applications and wait times, further complicating the research process.
More still, research that involves human subjects often requires an Investigational New Drug (IND) application to the U.S. Food and Drug Administration (FDA), to investigate the safety and efficacy of cannabis or cannabis-derived products.
And donât forget about the governing bodies with stipulations beyond the federal requirements; researchers also need to comply with state-specific regulations regarding cannabis research, and some states donât exactly open their hearts and minds to different ways of thinking these days.
Rescheduling cannabis to Schedule III would alleviate some of these challenges. It would streamline some of the licensing processes, reduce some of the number of regulatory approvals required, and potentially shorten wait times, making it more feasible for researchers to study cannabis and its effects. Will it be so tremendous? Probably not, for the motivated researchers, many of whom may actually be enticed by the strict walls and hoops to climb as it is. All the more special and unique, no?
As for studying commercially-available cannabis products, rescheduling would probably facilitate this as well. It would likely lead to more standardized testing and quality controls, ensuring that these products are consistent and reliable for research purposes. While some states have already implemented regulations to allow the study of commercially available products, federal rescheduling would provide a more uniform framework.
However, the categorization of cannabisâwhether as a medicine, a food product, or otherwiseâcan influence the regulatory landscape and research opportunities. This categorization affects how regulations are applied and what types of research can be conducted. Therefore, a clear and consistent federal framework is essential to support comprehensive cannabis research.
JT: Will rescheduling have any impact on state-legal medical marijuana programs?
Dr. C: Perhaps unreasonably so, Iâm usually optimistic, so, yes, Iâd say that rescheduling cannabis at the federal level would likely have a significant positive impact on state-legal medical marijuana programs. It would help harmonize state and federal laws, lending greater legitimacy to state programs and offering legal protections to patients and providers. This alignment would mitigate the legal risks that currently exist due to the discrepancy between state and federal regulations. Even if the alignment is just in its public perception, this will still go a long way. Even in cases where state legal activity is NOT violating federal law, today, such as when physicians recommend cannabis as a therapeutic to medical patients and counsel them accordingly, the public perception of alignment with the federally illegal cannabis product trade (products different from verbal and intangible clinical counseling by a licensed healthcare provider) has all but locked physiciansâ medical practices out of the banking system nationwide.
Furthermore, rescheduling could eliminate the barriers that prevent medical schools and professional organizations from educating future healthcare providers about the benefits of cannabis and the human endocannabinoid system (ECS). This would enhance the medical community's understanding and acceptance of cannabis as a therapeutic option and would surely help future generations avoid the mistakes of the misinformation passed on to us by our predecessors.
Additionally, federal rescheduling could serve as a catalyst for states without medical cannabis programs to establish them. This would expand access to medical cannabis for individuals in those states who could benefit from its therapeutic properties. Overall, rescheduling would promote a more cohesive and supportive environment for medical cannabis across the United States.
JT: People often argue that cannabis is much stronger now than it was in the past. Is this true? And does this affect the conversation around rescheduling and decriminalization when it comes to risks?
Dr. C: Yes, it's true that today's cannabis is generally bred to have higher THC content compared to the past. The stores these days make good money from those experienced with cannabis, many of whom have developed a taste for higher THC over the years. However, it's important to consider whether people are consuming the same amounts or using it for the same lengths of time as they did in days gone by. Many individuals smoke cannabis, which burns off a significant portion of the THC, meaning the actual consumption might not be as high as lab tests would suggest. Without taking these factors into account, it's difficult to argue that the increased potency seen in lab tests translates directly to higher risks in real-life use. And, there are concentrate products that have flooded markets globally that seem to have raised the threshold for THC quantity by an entire frame shift. Some products, to my continual surprise, are as dense as 90% THC.
That said, the higher potency does add complexity to the conversation around rescheduling and decriminalization. Stronger cannabis products can increase the risk of dependence and other adverse effects, which means that we should take a more cautious approach to regulation and devote much greater resources to public education. Proper regulation and comprehensive public education are essential to ensure that these more potent cannabis products are used safely and responsibly. This includes clear guidelines on dosage, potential risks, and safe consumption practices to mitigate any adverse effects associated with higher THC levels.
JT: Are there any particular areas of research we should prioritize to address these issues around the appropriate schedule (or lack of) for marijuana? For example, do we know enough about its potential for dependence and abuse?
Dr. C: There are countless areas of research that deserve a sharpened focus to help us all make more informed decisions about the appropriate scheduling and regulation of cannabis. Prioritizing these areas will not only aid policymakers but also help the public feel more comfortable exploring cannabis:
Long-term Health Effects: We need more studies on the long-term clinical impacts of chronic cannabis use, particularly with high-THC products. While public health data suggests that cannabis is relatively benign compared to other treatments, and the cultures around the world that have enmeshed cannabis into their daily lives (for generations) offer us a very reassuring view of the long-term impacts of cannabis, the public deserves concrete data on long-term effects. The reality is, though, that we donât have much data on the long-term health effects of any medicine. So, is it right, just, or fair that we judge cannabis by a different ruler?
Dependence and Abuse Potential: More research is necessary to compare cannabis with other substances regarding dependence and abuse potential. From my experience overseeing data collection from hundreds of thousands of cases, cannabis has a relatively low risk of dependence, comparable to benzos, opiates, even caffeine, exercise, or binge-watching TV. However, the definitions of overuse, misuse, and abuse need a complete overhaul, as they are based on outdated measurement tools and a fundamental misunderstanding of cannabis. So, we need to understand that there are benefits, there are certainly risks, and we need to know who is likely to fit into which bucket.
Medical Efficacy: Rigorous clinical trials are essential to better understand the full range of medical benefits cannabis can offer. A recent study (JAMA) indicates that at least 17% of all primary care patients use cannabis regularly for some form of symptom management. That is an astronomical number that has so far completely escaped the medical profession. That is a HUGE number of people issuing their own self-care, regularly. We need to better understand what and how the public is using their cannabis and the associated risks and benefits for individuals, both short-term and long-term.
Public Health Impacts: It's very important to study how widespread cannabis use affects public health, including mental health and driving safety. We need better methods to measure intoxication, functional alteration, and how individual differences in genetics, consumption, experience, recovery, and metabolism influence these factors. To a great extent, the true impact (for better or for worse) of the impact on adolescent brains, pediatric populations, and special populations, will come out in public health data. Are we, as a culture, ready to consider the possibility that cannabis might actually be a good thing? Imagine a study that shows recreational marijuana legalization increased enrollment by 9%, without compromising degree completion or graduation rate, and boosts college competitiveness? Yikes. Iâd wager weâre not going to see that discussed openly in Nebraska, Tennessee, Florida, or Texas anytime soon.
Product Safety and Quality: Research is needed to ensure that commercially available cannabis products are safe and of high quality. Different states have different testing parameters, providing a natural experiment we can learn from to improve safety standards nationwide.
With a sharpened focus on these areas, we can address the embarrassing knowledge gaps that currently exist and make more informed decisions about the appropriate scheduling and regulation of cannabis. This will help ensure that cannabis is used safely and effectively, which benefits both the medical community and the general public.
For more information on me, visit my websites:
BenjaminCaplan.com | CEDclinic.com | EO.care
DoctorApprovedCannabisHandbook.com | CaplanCannabis.com |
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Dr. C: Thank you, Jack, for the engaging conversation and the thoughtful questions. It's been a pleasure discussing these important topics!
To listeners and readers, if there are any interesting individuals or topics you'd like us to include here, please share your suggestions in the comments section! Join us next time for more unfiltered conversations. Until then, be safe and make informed choices!
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www.television.si absolutely agrees. Cannabis is and should be sui generis, tax free, treated as outside the regular economy as a safety net for all those who do not neet the bureaucratic criteria for human rights e.g. people who don't even speak the Slovene of their village. There should be at least one thing left standing as a monument to remind us we are human and not robots for money. Free quality testing could be made available using all the money not wasted on healthcare and bureaucracy. But they don't think like that, do they?