DEA May Have to Consider the Federal Scheduling of Cannabis
Seems like good news! But as always, things may not be as they appear...
The US Court of Appeals ruled last week that the schedule I classification (meaning cannabis, like heroin, has no medical value and a high risk of abuse and addiction) petitions to the DEA to reschedule cannabis must be acted on "with adequate dispatch." The DEA has a long history of delaying any such action and the court recognized this as a factor in the case brought by the plaintiffs. They "tabled" the case meaning they keep jurisdiction over this matter and could force the DEA in the future if they play their usual "ignore it" game.
Cannabis can not be studied as other medications are as it is illegal under federal law as an illegal schedule I drug. If it was rescheduled to a controlled drug II status (that of opioids, cocaine, amphetamines...) it could be studied, doctors could prescribe it, and insurance companies would pay for medical cannabis. Or so advocates for rescheduling say.
Have a look at a schedule II drug, oxycodone, for example. It is legal. It can be prescribed. Insurers often pay for this FDA approved medication. Any pain patient knows the hoops one must jump through to get such a medication: find a doctor willing to write such a prescription (fewer every day because of the professional and criminal risks in prescribing), the extensive rules and limits of how the medication may be prescribed and used and the suspicion and difficulties encountered when filling the prescription at a pharmacy. It is because it is a schedule II drug. Unlike with appeals for letting patients use a beneficial but prohibited medications, the DEA does move quite quickly when there is even a perceived transgression of the regulations...
The regulations are very difficult and expensive with which to comply. Schedule II drugs require much record keeping and data tracking, a prescription usually limited to thirty days with a visit to see the doctor whenever a refill is needed, they must be dispensed by a licensed pharmacist in an approved pharmacy to comply with the law... Such limitations will obviously raise the cost of and limit patient access to medical cannabis.
The answer for medical cannabis is not rescheduling, it is descheduling of the drug. Remove it completely from the federal controlled drug scheduling and then the states can, as they have been doing, develop their own laws for the residents of their state. Descheduling will take the control of cannabis away from the federal government and bring it to the states, while rescheduling may give the federal bureaucracies a different but perhaps even more effective means of control. We have seen how that goes.
Brian Nichol MD