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.
Cannabis as a medicine seems quite new. With a majority of states now allowing its use, patients, many of their doctors, society at large and certainly to law enforcement and government are searching for information. The information available online is vast and often confusing. Much of it is incomplete, far too detailed and technical for most people to sort through, clever marketing or just plain wrong.
Medical cannabis patients are certified by a physician as having a qualifying condition. The patient is issued a card and then, too often is left to decide for themselves as to the best treatment. Dispensary employees are usually the cornerstone of giving patients advice on strains and how to use cannabis. Sometimes they are very good at giving recommendations. Sometimes, not so much.
Modern medicine treats disease with the drugs that are effective for the majority of patients, forgetting that we are all very different individuals. What is a good choice for one patient may be ineffective or cause side effects in another. Although most patients see some improvement in using cannabis, getting the best result is a bit more complicated...
I have seen patients without much knowledge or direction experience lukewarm results of medical marijuana. I have also seen those so-so results turn into remarkable improvement under the knowledgeable direction of a doctor that treats the individual patient using the correct combination/forms/amount of cannabis.
It is my hope to sift through all the noise, marketing, agenda driven studies, politics and stigmas encountered when one tries to be an informed medical cannabis patient. I want you to get the best result from medical cannabis you can.
Brian Nichol MD