As the debate over whether marijuana should be completely legalized continues, a compromise offer has been placed on the table: moving marijuana from Schedule I to Schedule III of the Controlled Substances Act (CSA). In fact, HHS has already made a formal recommendation to the DEA to that effect. But caution is warranted. Rescheduling marijuana would have significant consequences.

The compromise is seen as a way to unshackle medical cannabis without giving the green light to full legality for recreational use. Rescheduling would ostensibly lead to legitimate medications, more medical cannabis research, and even lower costs for patients. But all such benefits are theoretical. On the other hand, the consequences of rescheduling are quite real.

The Lack of Compliance Would Remain

Rescheduling marijuana would open the door for treating it like any other prescription medication. But it would not automatically bring states into compliance with respect to their medical and recreational marijuana programs. And in fact, the Congressional Research Service (CRS) maintains that states would still be out of compliance if marijuana were rescheduled without any other changes to the law.

Moving it to Schedule III does not legalize recreational consumption. It also doesn’t legalize state licensed medical cannabis pharmacies that currently dispense the drug with little more than a state-issued medical cannabis card.

Right now, a Utah patient can visit the Beehive Farmacy medical dispensary in Brigham City with card in hand. He can purchase whatever medical cannabis products he likes and then medicate as he sees fit. None of that would change with rescheduling unless Congress made some additional changes to the law. Purchasing medical cannabis under the same system would still be out of compliance.

Moving to a Prescription Model

Bringing things into compliance would require moving to a prescription model. But that would mean getting the FDA involved. Before doctors could prescribe medical cannabis, the drug itself would have to be approved by the FDA. And in order for that to happen, medical cannabis would have to be put through a long and strict process that involves multiple rounds of clinical testing.

As things currently stand, pharmaceutical companies spend years getting approval for new drugs. A new drug could take a decade or longer to make its way through the process. In addition, completing that process could cost millions of dollars. Is anyone prepared to bring medical cannabis into the same costly, convoluted system?

Unfortunately, this is not where the bad news ends. Moving to a prescription model would also force manufacturers and distributors to register with the DEA. They would have to follow all regulatory requirements pertaining to Schedule III substances in order to remain in business.

Finally, moving to the prescription model would put medical cannabis under the purview of the federal government, thereby stripping the states of any authority they currently think they have.

It Might Be the Only Option

All things considered, rescheduling marijuana isn’t in the short term interests of medical cannabis patients. It is in their long-term interests, but it would cause some headaches for a few years. But might be the only option.

The Senate has been trying for years to find a way to legalize marijuana across the board. They have been unsuccessful at every attempt. Furthermore, there does not appear to be a lot of enthusiasm about finding ways to overcome disagreements among senators. Thus, the compromise.

At this point it seems that the compromise is the only way to move medical cannabis forward. Do not be surprised if a compromise bill is passed and signed this year. But be prepared for the consequences as well.