The implications of President Trump's recent executive order on marijuana are significant, particularly for the realm of medical research. This week, he took a bold step by signing an order that reclassifies marijuana, thereby altering its legal status in a way that could have far-reaching effects.
Marijuana has been moved from being classified as a Schedule I drug—alongside some of the most dangerous substances like heroin and LSD—to a less restrictive Schedule III category. This new classification includes drugs such as ketamine, Tylenol with codeine, and certain steroids.
However, it is crucial to note that this executive order does not legalize marijuana on a federal level. Currently, cannabis is permitted for medical use in 40 states and for recreational use in 24 states, showcasing a growing acceptance at the state level.
Experts from the pharmaceutical field and addiction specialists have expressed their views to ABC News, suggesting that this reclassification could diminish the stigma surrounding marijuana and facilitate more extensive scientific inquiry into its effects and uses. Just before the order was signed, Trump mentioned that he believed this change would unlock "tremendous amounts of research."
Understanding the Context of Marijuana Research
Under the current Schedule I classification, marijuana is regarded as a substance without any accepted medical use according to federal law, coupled with a high potential for abuse and dependency. Conversely, Schedule III recognizes that a drug has valid medical applications and typically possesses moderate to low abuse potential, requiring a doctor’s prescription for use.
Chad Johnson, who serves as an assistant professor in pharmaceutical sciences and is the director of graduate studies in medical cannabis at the University of Maryland, highlighted the significant challenges researchers face when dealing with Schedule I substances. Many academic researchers tend to avoid studying these substances due to the considerable obstacles involved. Obtaining a license from the U.S. Drug Enforcement Administration (DEA) is a lengthy and costly process. Johnson pointed out that the DEA must conduct comprehensive screenings and implement numerous security measures before allowing researchers access to these substances in their laboratories.
Furthermore, the DEA imposes strict regulations on how much of a Schedule I substance can be produced annually for medical, scientific, or industrial purposes, which limits the quantities available to researchers. "Many researchers avoid these Schedule I substances simply because it’s too cumbersome. You have to meticulously track every milligram used and report this to the DEA," Johnson remarked.
By reclassifying marijuana to Schedule III, many of these hurdles are removed. Johnson believes this will encourage a wave of new researchers and attract seasoned professionals who previously hesitated to engage with marijuana research due to its former classification.
Caution from Addiction Experts
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Yasmin Hurd, the director of the Addiction Institute at Mount Sinai in New York, shared her mixed feelings regarding the executive order. While she agrees that easing regulations could promote research into marijuana, she also raises concerns about the potential increase in addiction risks associated with easier access to cannabis.
The Centers for Disease Control and Prevention (CDC) estimates that around 30% of individuals who use cannabis may develop cannabis use disorder, which can disrupt their daily activities. "My main concern regarding the reclassification is that it might be interpreted as an endorsement of cannabis as medicine, which is not the case," Hurd expressed to ABC News. "It’s important to clarify that cannabis has not yet been proven to have any universally accepted medical uses."
Hurd noted that there are FDA-approved medications that utilize cannabidiol (CBD), the non-psychoactive component of marijuana, particularly for treating epilepsy. Additionally, synthetic tetrahydrocannabinol (THC), the primary psychoactive compound in marijuana, can be prescribed to alleviate nausea and vomiting in certain patients. However, she emphasized that no cannabis products have definitively shown medicinal benefits, and ongoing research is necessary.
A recent review published in the medical journal JAMA concluded that there is "insufficient" evidence supporting the use of cannabis or CBD for medical or therapeutic purposes. Despite the current limitations in research—largely stemming from marijuana's previous Schedule I status—there is a wealth of patient experience data that documents the usage of marijuana both medically and recreationally. Johnson emphasized the importance of this patient data, stating that it provides insights into why individuals choose specific products and how frequently they use them.
Johnson disagrees with the notion that there are no medicinal benefits of cannabis. He pointed out that patient data indicates otherwise, noting, "While we might not fully understand the mechanisms behind its effects, we do have evidence suggesting that cannabis can offer medicinal advantages." He concluded that Trump's executive order may play a pivotal role in diminishing the stigma surrounding cannabis use and enabling researchers to gather valuable data on the substance.
