In an interview with CBS news in 2015, U.S. Surgeon General Vivek Murthy suggested how cannabis can be helpful for some medical conditions, and that science should dictate the United States’ policy on the matter. In August of 2016, the Obama administration denied two petitions; the first by a New Mexico health provider and a second one by two Democratic governors, to reschedule cannabis and how it treats cannabis under federal drug control laws. The decision was based on a “scientific and medical evaluation” conducted by the US Food and Drug Administration at the request of the DEA, which declared cannabis has “no currently accepted medical use and a high potential for abuse.”
While both the Department of Health and Human Services (HHS) and DEA raised concerns about the abuse potential of cannabis, the critical basis for this decision remains the same, neither HHS nor DEA found that cannabis has a currently accepted medical use in the United States. Despite the fact that the U.S. Patent Office has issued patent #6630507 to the Health and Human Services, filed on February 2nd 2001. The patent lists the use of cannabinoids found within the cannabis sativa plant as useful in certain neurodegenerative diseases such as Alzheimer’s, Parkinson’s, and HIV dementia.
In a letter to the petitioners, Rhode Island Gov. Gina Raimondo, Washington Gov. Jay Inslee and New Mexico nurse practitioner Bryan Krumm, the DEA said doctors are responsible for treating patients, but the FDA makes decisions about drug safety: “Simply put, evaluating the safety and effectiveness of drugs is a highly specialized endeavor.” It’s worth noting that the DEA accepts Marinol (dronabinol) is an FDA-approved synthetic cannabinoid and it was placed in Schedule III in 1999.
What stands in the way of a broad role for medical science in cannabis policy is the Controlled Substances Act. Under this law, cannabis is listed as a Schedule I substance, meaning the government claims it has a high potential for abuse and no current accepted medical use. Substances classified in Schedules II-V are still subject to varying degrees of control, but have a recognized medical use and may be dispensed with a prescription under certain circumstances. They are also subject to robust research, testing, and manufacture. For cannabis to enjoy the same benefits, it would need to be rescheduled.
Critics of the DEA have pointed out that cannabis researchers are caught in a Catch-22. In order to have more research, scientists need to do more studies. But in order to do that, their studies must be approved by federal agencies, including the DEA, the FDA and occasionally the National Institute on Drug Abuse, the largest public funder of cannabis research.
The NIDA currently contracts with the University of Mississippi, which has held the sole license to grow research-grade cannabis in the entire country since 1968. Any US study that looks at cannabis needs to get its strains from the institute, whose mission isn’t to prove efficacy of the drug but rather its harm and abuse potential.
“Science has been shackled by politics for decades. Controlled trials couldn’t be done without begging NIDA,” said Dr. Sue Sisley, a psychiatrist formerly with the University of Arizona. Sisley says she was let go from the university because of her research into cannabis. In April 2016, the DEA approved Sisley’s proposal to study the effectiveness of cannabis to treat PTSD in veterans. It is the first such study in the country.
There are two ways by which the scheduling of cannabis can be changed: congressional action and administrative action.
Congress has the power to reschedule cannabis, either through new legislation specific to cannabis or through tailored amendments to the Controlled Substances Act. The first bill that proposed to move cannabis from Schedule I to Schedule II was introduced by republican Representative Stewart McKinney from Connecticut in 1981. Similar bills have been introduced perennially since then, most recently by republican Rep. H. Morgan Griffith of Virginia (H.R. 4498), all of which died in committee. In 2011, Reps. Ron Paul (R-TX) and Barney Frank (D-MA) introduced a bill to remove cannabis from the schedules entirely “de-scheduling” it, which also died in committee.
President Obama has contended that rescheduling cannabis is a job for Congress, while others rightly argue the administration has the authority to do so unilaterally. It is ironic that the president, who is so often criticized for overreaching his authority, is shrinking from the administrative power that Congress has granted him. Going back to 1961 to present day, 11 US Surgeons General were asked their views on medical cannabis and only two of them had a negative stance-David Satcher(appointed by President Clinton) and C. Everett Koop (appointed by President Reagan) .
The DEA received the petition from Bryan Krumm in 2009, a Provider in New Mexico who helped draft the state’s medical cannabis law, (“Krumm Petition”), and the second from the then-governors of Rhode Island and Washington in 2011 (“Governor’s Petition“).
The Krumm Petition requested DEA to remove cannabis from schedule I of the Controlled Substances Act (“CSA”), asserting that:
1) Cannabis has accepted medical use in the United States;
2) Studies have shown that smoked cannabis has proven safety and efficacy;
3) Cannabis is safe for use under medical supervision; and
4) Cannabis does not have the abuse potential for placement in schedule.
The Governor’s Petition requested removal of cannabis and “related items” from schedule I and reschedule as “medical cannabis” in schedule II because cannabis has an accepted medical use in the United States; is safe for use under medical supervision; and for medical purposes has a relatively low potential for abuse, especially in comparison with other schedule II drugs.
Prior to initiating rescheduling proceedings both petitions require DEA to seek an opinion from Health and Human Services Dept. and determine whether the scheduling recommendation, scientific and medical evaluation and ‘all other relevant data’ constitute substantial evidence that the drug should be rescheduled as proposed. This review is commonly known as the “eight factor analysis.” The eight factors include:
1) The drug’s actual or relative potential for abuse;
2) The drug’s scientific evidence of its pharmacologic effect, if known;
3) The state of current scientific knowledge regarding the drug;
4) The drug’s history and current pattern of abuse;
5) The drug’s scope, duration, and significance of abuse;
6) The risk, if any, to public health;
7) The drug’s psychic or physiological dependence liability and
8) Whether the drug is an immediate precursor of a controlled substance.
Schedule II drugs that the US Government has concluded to be safer than cannabis, that can induce “severe psychological or physiological dependency,” include opioids and barbiturates such as adderall, cocaine, methamphetamine, oxycodone, ritalin and vicodin. From 2000 to 2014 Schedule II drugs have killed over a million Americans from drug overdoses and yet cannabis has zero deaths associated with it. The DEA must be held accountable for the deaths they have caused by prohibiting access to this life saving medication. By continuing the total prohibition of cannabis, the DEA has demonstrated a complete disregard for human life and is violating fundamental rights guaranteed by the US Constitution.
For now, there remain two ways to change the federal government’s classification of cannabis: for a host of federal agencies including the DEA and FDA to sign off on doing so; or for Congress to pass a law, and for the president to sign it. Bryan Krumm has appealed the DEA’s decision on his petition, review of this order has been docketed in the US Court of Appeals for the 10’th Circuit as 16-9557 Krumm v Drug Enforcement Administration.
Lifting the prohibition of medical cannabis will help to alleviate the suffering of millions of Americans and save countless lives. It will allow much needed research to be conducted to determine which strains of cannabis are the best for treating psychiatric illnesses, curing cancer, treating chronic pain, preventing Alzheimer’s and treating scores of other illnesses. It will end the workplace discrimination of cannabis that has led to to job loss and denial of job opportunities to millions of Americans.