U.S. government forced to publish cannabis re-evaluation recommendation

Last August, the Department of Health and Human Services (HHS), along with the Food and Drug Administration (FDA) have recommended reclassifying cannabis from Schedule I to Schedule III of the list of controlled substances. However, the report has not yet been made public.

Publication 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 conclusions. According to Zorn's analysis, the FDA identified three key criteria for re-evaluating the list:

• Low abuse potential: The FDA has determined that cannabis has a lower abuse potential than Schedule I and II drugs and substances.
• Recognized medical use : After reviewing a large number of data, studies, expert opinions and statements from professional organizations, the FDA affirmed that marijuana has a currently accepted medical use in the U.S. for specific conditions, including anorexia, nausea and vomiting (chemotherapy-induced) and pain
• Low physical and psychological dependence: The FDA concluded that while cannabis can lead to 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's analysis compared the prevalence and adverse effects of cannabis against Schedule I, II and III substances. The agency found that the public health risks of cannabis are low compared to other drugs such as heroin, cocaine and benzodiazepines. The report points out that «when it comes to overdose deaths, cannabis still ranks near the bottom of comparison 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 highlighted strong evidence for the efficacy of cannabis, particularly in the treatment of anorexia linked to medical conditions, nausea and pain.

Implications for the classification of controlled substances

The publication of the FDA report fuelled expectations of imminent action on the part of the Drug Enforcement Administration (DEA) to move cannabis from Schedule I to Schedule III. President Joe Biden's October 2022 directive for an expedited review of cannabis classification has given the process a boost. Legal experts anticipate a proposed regulation in the near future, with final regulations expected by mid-summer.

While the FDA report has been hailed as a thorough and scientifically sound document, some quarters are opposed to it. Republican members of Congress, asserting an «irresponsible pro-marijuana agenda», have expressed reservations about the FDA's recommendation.

The DEA recently issued a reminder that it alone had the power to reclassify, or not, cannabis.