Last August, the Department of Health and Human Services (HHS), along with the Food and Drug Administration (FDA) of the United States recommended reclassifying cannabis from Schedule I to Schedule III of the list of controlled substances. However, the report had not been made public until now.
The release of the report follows a request under the Freedom of Information Act (Freedom of Information Act) of a lawyer, Matt Zorn. The report is 252 pages long and highlights the FDA's findings. According to Mr. Zorn's analysis, the FDA has defined three key criteria for reevaluation of the list:
- Low potential for abuse: The FDA has determined that cannabis has a lower potential for abuse than List I and II drugs or substances.
- Recognized medical use: After reviewing a large body of data, studies, expert opinions, and statements from professional organizations, the FDA affirmed that marijuana has a currently accepted medical use in the United States for specific conditions, including anorexia, nausea and vomiting (chemotherapy-induced), and pain
- Low physical and psychological dependence: The FDA concluded that while cannabis may cause moderate or mild physical dependence, the likelihood of serious consequences is low, indicating that strong psychological dependence does not occur in the majority of users.
Comparative risk assessment
The FDA analysis compared the prevalence and harms of cannabis versus List I, II, and III substances. The agency found that the public health risks of cannabis are low compared to other drugs like heroin, cocaine and benzodiazepines. The report highlights that “when it comes to overdose deaths, cannabis still ranks near the bottom of comparator drugs.”
The FDA report confirms the credible medical use of cannabis in the treatment of anorexia, nausea and pain. The agency evaluated the potential benefits of cannabis for seven indications, including anxiety, epilepsy, inflammatory bowel disease and post-traumatic stress disorder. The conclusion found strong evidence for the effectiveness of cannabis, particularly in the treatment of anorexia linked to medical conditions, nausea and pain.
Implications for the classification of controlled substances
The release of the FDA report fueled expectations of imminent action by the Drug Enforcement Administration (DEA) to move cannabis from Schedule I to Schedule III. President Joe Biden's October 2022 directive, which calls for an expedited review of the classification of cannabis, has given a boost to the process. Legal experts anticipate a proposed settlement in the near future, with the final settlement expected by mid-summer.
While the FDA report has been hailed as a thorough and scientifically sound document, it is opposed in some quarters. Republican members of Congress, claiming an “irresponsible pro-marijuana agenda,” expressed reservations about the FDA's recommendation.
The DEA recently recalled that it alone had the power to reclassify, or not, cannabis.
