The Future of Medical Cannabis in America
As of November 4, 2020, there are thirty-five states and four territories in the United States that have legalized a medical cannabis program. A total of fifteen states and three territories have approved measures to regulate cannabis for adult-use. Approved measures in twelve states allow the use of “low THC, high cannabidiol” products for medical reasons in limited situations or as a legal defense. These low-THC programs are not counted as comprehensive medical cannabis programs. According to the National Conference of State Legislatures, a medical program is deemed comprehensive if it meets the following standards:
It provides protection from criminal penalties for using cannabis for a medical purpose.
It provides access to cannabis through home cultivation, dispensaries, or some other system that is likely to be implemented.
It allows a variety of strains or products, including those with more than “low THC.”
It allows either smoking or vaporization of cannabis product, plant material, or extract.
It is not a limited trial program.
Nebraska has a limited program that is not open to the public.[1]
At the federal level, cannabis remains classified as a Schedule I substance under the Controlled Substances Act. Schedule I substances are considered to have a high potential for dependency and no accepted medical use, therefore making distribution a federal offense. Medical cannabis prescriptions are more often called “recommendations” or “referrals” because of federal prescription prohibition.
There are many policy questions that bear asking as the nation moves forward in regards to medical cannabis. Primarily, how do we continue to regulate medical cannabis recommendations, dispensing, and registration of approved patients? Medical cannabis’ classification as a Schedule I substance is a liability for hospitals, insurance companies, and doctors. They are possibly risking their licenses by recommending a Schedule I substance.
The proposed STATES Act, CARERS Act, and MORE Act are intended to put pressure on the federal government to reschedule cannabis as a Schedule II or III substance. By rescheduling medical cannabis, would the federal government allow for more ease and flow in this ever-growing industry? According to a study conducted by the Pew Research Center, 91% of Americans support the legalization of medical cannabis.
What steps must be taken on the federal level to involve insurance companies, health care professionals, and doctors to create a more free-flowing industry? The federal government has many options in terms of restructuring banking regulations for industry professionals to make it easier to do business. So far, the federal government has given the states the authority to decide what laws to pass on medical cannabis. This has created an uneven playing field for constituents of these states. For example, the differing laws in each state make it difficult for other states to provide reciprocity and reimbursement for insurance, among other services. The inconsistent laws in each state make it difficult for insurance companies to dictate policies that could be implemented nationwide. Rescheduling cannabis would allow for research and testing of cannabis on the federal level, which this contemporary industry desperately needs. Federal rescheduling would give insurance companies the power to restructure their ideas on reimbursement for medical cannabis as part of each state’s workers’ compensation programs and also help employees navigate the healthcare field more easily. Privatized insurance companies could offer more generalized plans for hospitals and citizens if there was a federal understanding that cannabis was rescheduled to a schedule II substance.
What needs to happen on the federal level to make medical cannabis more accessible to all Americans?
One option is to reschedule cannabis and study the plant, then make conclusions based on research done at the federal level. The multitude of clinical data and research done at the federal level would allow for doctors to have a greater knowledge of the plant to help patients.
Another option is to leave the scheduling as is and to continue allowing each state to write its own rules on medical cannabis while having them operate at risk of federal prosecution. This tends to be a slippery slope; as more states create their own programs it is difficult for the federal government to have much oversight due to the illegality. As many states collect a great deal of tax revenue and help patients, the federal government continues to look at medical cannabis as a direct violation of the Controlled Substance Act.
A prime example of the changing viewpoint of medical cannabis in America was the vote of Proposition 207 in Arizona. Sixty percent of Arizonians voted in favor of adult-use cannabis. Additionally, the proposition will expunge the records of those convicted of cannabis felonies and it will grant social equity licenses for communities that were historically affected by these now-defunct cannabis laws. According to a Prison Policy Initiative report, the United States accounts for around twenty-two percent of the world’s prison population.[2] This number would dramatically decrease with the rescheduling of cannabis and the expungement of many cannabis prosecutions. The government can create a mutually beneficial situation by allowing many of these ex-convicts the chance to get jobs in the cannabis industry. Medical cannabis generates tax revenue and creates jobs; a program could be set up to assist ex-convicts in reacclimating to civilian life. This would be the ultimate full-circle experience.
Many wonder what the federal government will do in regards to cannabis rescheduling and legalization. John Fetterman, the lieutenant governor of Pennsylvania, says the President should think about how legalization could raise tax revenue in the post-pandemic economy of state budget deficits.[3] This is a valid point, but more is at stake besides an increase in economic revenue. International trade deals that require both sides to keep cannabis illegal would have to be rewritten. For over half a century, the American government has put pressure on other countries about its drug policies; those stances would need to be reversed.
Rescheduling would require some police unions to readjust their mindsets in terms of policing around the country. Restructuring police departments and other various drug enforcement agencies to help educate citizens on drugs, instead of continuing to prosecute and continue a cycle of incarceration. A citizen convicted of a cannabis crime faces the possibility of a loss of food stamp privileges, the denial of bank loans, loss of public housing, and difficulty in securing a job with a criminal cannabis record. Restructuring the laws would protect states and citizens from unfair prosecution at the federal level.
The end of the war on drugs can help communities that were repressed by the laws flourish in a new time of economic prosperity and inventiveness. The reversal of these laws could help alleviate some of the hardships these communities face, and the economic revenue generated by tax revenue could help with education systems, libraries, job training, and treatment programs. The war on drugs has wasted billions of U.S dollars and affected billions of people, however, if these laws are reversed, we can truly use the plant to our advantage. Time spent on prosecuting cannabis could be dedicated to teaching people about the properties of medical cannabis.
One of the main arguments against medical cannabis rescheduling is that it is a gateway drug that will lead to serious mental or physical problems in teens and adults. More research can be conducted regarding this claim if the federal government obtains legal access to the plant to properly test and perform due diligence on the effects on the population. We can gain more knowledge and insight into the cannabis plant by rescheduling it as a Schedule II substance. The Drug Enforcement Administration could repurpose a large amount of their annual funding to educate the American public on the effects of cannabis. A more educated and informed public would be able to better assess the value of adding medical cannabis to their supplement routines.
Progress over perfection is the name of the game if you are any politician trying to move the ball forward in terms of reclassification of medical cannabis. Rescheduling cannabis to a Schedule II drug would allow for clinical trials, research studies, and a more free-flowing industry that would not have to operate in the shadows of federal illegality. Federal rescheduling could allow for the expungement of past cannabis records as well as more scientific studies. More jobs, healthier people, and happier constituents could be the byproduct of rescheduling medical cannabis. Regulation and education need to be the main intentions when reclassifying medical cannabis. Step by step, we can learn more about medical cannabis and help people who are suffering. By bringing public health into the center of this debate, we can clearly identify what parts of the system we need to modify and rationalize. Putting health and community safety first requires a fundamental reorientation of policy priorities and resources.
Reach out to your local political offices and ask about their current stance on medical cannabis and about current legislation that could make a difference.
Works Cited
Karmen Hanson, A. G. (2020, November 04). State Medical Marijuana Laws. Retrieved from https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx
Wagner, Wendy Sawyer and Peter. “Mass Incarceration: The Whole Pie 2020.” Mass Incarceration: The Whole Pie 2020 | Prison Policy Initiative, Prison Policy Initiative, 24 Mar. 2020, www.prisonpolicy.org/reports/pie2020.html.
Dovere, Edward-Isaac. “The Marijuana Superweapon Biden Refuses to Use.” The Atlantic, Atlantic Media Company, 6 July 2020, www.theatlantic.com/politics/archive/2020/07/biden-marijuana-pot-legalize/613777/.