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Why the federal government still rejects marijuana as medicine

Modes of thought

The drug enforcement arm of the federal government has reiterated its steadfast rejection of marijuana for medical use, even as more states continue to move toward legalizing the drug for medical and recreational use alike.  

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    Medical marijuana is displayed in Los Angeles, California, August 6, 2007. The drug enforcement arm of the federal government has reiterated its steadfast rejection of marijuana for medical use, even as more states continue to move toward legalizing the drug for medical and recreational use alike.
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The federal Drug Enforcement Agency (DEA) announced Thursday that the drug classification for marijuana will remain a Schedule 1, the same as cocaine or heroin. 

The DEA also said cannabis has “no current accepted medical use in treatment in the United States.”

The announcement disappointed advocates for marijuana legalization, who point to both public opinion polls and state referendums as evidence that federal law is behind the times: Societal views of marijuana are shifting, why hasn't the federal government's outlook?

But for those who study drug policy and the complex process of approving new drugs for medicine, it was no surprise.

"It is not standard practice for either state legislators, let alone citizen votes, to decide what is or is not a medicine," says Jonathan Caulkins, a public policy professor at Carnegie Mellon University in Pittsburgh, Penn. "If Massachusetts passed a law tomorrow that said Twinkies were medicine, that would not make them medicine, nor would it bind in any way federal actions." 

Federal agencies are bound by laws that require more rigorous scientific research than they have yet seen, which is why the government included in its Thursday announcement a promise to open up marijuana research to universities as never before.

"Much of the research on the health effects of marijuana is based on those who smoked low-potency product," says Beau Kilmer, a co-director for the RAND Drug Policy Research Center. "We need much more research on the consequences – both good and bad – associated with different modes of consumption, like vaping, and higher-potency products."

If the FDA finds evidence from the resulting research that marijuana has medical value, then the DEA will be empowered to change its classification.

What is new, then, about an announcement that the federal government will continue its official policy against marijuana? On a practical level, almost nothing.

Federal law enforcement will continue to focus its resources on America's opioid epidemic, taking on weed cases only for inter-city gangs or Mexican drug cartels, says Russ Baer of the Drug Enforcement Administration (DEA). 

"The FDA process has been in existence for over 50 years, so why should marijuana get a free pass?" Mr. Baer asks. "If one day the FDA comes to us and says ... there is a medically accepted use for marijuana, for epilepsy, for example, then our narrative and our discussion changes drastically."  

Those advocating for increased access to the drug say this attitude is behind the times and rejects the experience of many Americans. 

"In order for it to be a Schedule 1 [drug] it's supposed to have no medical value and a potential for abuse, but half the states disagree with that," says Evan Nison, a board member for the Washington, D.C.-based National Organization for the Reform of Marijuana Laws (NORML). "It’s a fact now that marijuana has medical value." 

Granting any substance the distinction of "medicine" is a complex process, and the FDA does not approve entire plants for use by the American medical community. What is more likely is that, after the newly opened research runs its course, scientists with the FDA would allow doctors to prescribe strains and compounds derived from the plant to treat specific conditions.

"The FDA is not going to approve cannibis generically. That would be silly," says Mark Kleiman, a professor at the University of California-Los Angeles who specializes in drug abuse policy. " 'Blow some weed' is not medicine."

Legalization advocates say the medical argument has already been decided, and public opinion now rests on whether the drug will be available recreationally to all adults, a point 58 percent of Americans support, according to Gallup, and which five more states will vote on next November. 

"The DEA has been left behind," says Tom Angell from the activist group Marijuana Majority. "They’re still opposing medical marijuana while the rest of the country is supporting full legalization of marijuana."

In terms of gaining FDA medical approval, the legalization movement has hurt its own case by trying to market marijuana as both a medicine and a recreational drug simultaneously, rather than lobbying Congress for another exemption like the one granted to alcohol and tobacco. 

"If we're going to have an honest discussion about this, then let’s all agree to follow the science and not public opinion," Baer says. "That’s the difference right now between the federal government and the states."

Marijuana advocates will continue to point to state referendums and interest from elected officials and presidential candidates as evidence that history has spoken in favor of legalization, but federal agencies insist that without a pot-specific exemption from Congress, they cannot allow the drug into the nation's medical system. They are, for their part, frustrated by legalization advocates who they say regularly switch between science and public opinion as their tactics, while they are bound to laws made decades ago by a now-stagnant Congressional act. 

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