(CNN) — Cannabis, or marijuana, has come a long way on the road back to legitimacy in the United States, and it soon may pass an important milestone: rescheduling. That’s the technical term for reclassifying it as a less dangerous drug, which would loosen some restrictions around it at the federal level.
Cannabis was widely used as medicine in the 1800s and early 1900s. But Congress effectively criminalized it in 1937 with passage of the Marihuana Tax Act. However, starting in 1996, marijuana has since become accessible in most states for adult medical or recreational use.
But it’s a different story at the federal level. Currently, cannabis is a Schedule I drug, under the Controlled Substance Act, alongside drugs such as heroin and LSD. By definition, Schedule I drugs have a high potential for abuse and no currently accepted medicinal use. The US Department of Justice is in the process of considering moving marijuana from a Schedule I to a less-restricted Schedule III drug.
Rescheduling cannabis is a complicated process. President Joe Biden officially requested the shift in 2022, and it involves multiple agencies, including the US Drug Enforcement Administration and the US Department of Health and Human Services. The latter agency found “credible scientific support” for the use of cannabis in the treatment of certain conditions, including chronic pain.
That cannabis can potentially be used safely and effectively in a medical context is not a new concept to Dr. Staci Gruber, an associate professor of psychiatry at Harvard Medical School in Boston who has dedicated her career to understanding the effects of cannabis on the brain.
“At this point, there is an awful lot of evidence suggesting that for some people with some types of pain, certain cannabinoids work relatively effectively,” Gruber told CNN Chief Medical Correspondent Dr. Sanjay Gupta recently on his podcast, Chasing Life. “We have certainly seen in our observational studies, individuals cut down on their use of opioids on their own after initiating a course of cannabinoids.”
You can listen to the podcast’s full episode here.
So, what would the rescheduling of cannabis mean for the average American? Gruber shares five things you need to know about cannabis’ possible reclassification.
Don’t expect huge changes at the consumer level
As the next step in the process, the DEA has scheduled a public hearing on December 2; experts and stakeholders will be allowed to speak about the proposed change.
If the rescheduling occurs, to a large degree, cannabis would still be regulated.
“One letter makes all the difference: REscheduling is not DEscheduling,” Gruber wrote in an email. “While rescheduling will have significant tax implications for industry and change the administrative burden for researchers, it likely won’t change much for consumers and patients.”
She said that you still wouldn’t be able to buy cannabis as a Schedule III substance over the counter or at a general retail store, for example.
Do your homework
Be honest about what you want and then select a product in line with those goals.
“Know before you go: Make sure you know what you’re looking to accomplish with cannabis/cannabinoids before you buy something, and be honest with yourself,” said Gruber, who is also director of the Cognitive and Clinical Neuroimaging Core and the Marijuana Investigation for Neuroscientific Discovery Program, both at McLean Hospital in Belmont, Massachusetts.
For example, she asked, would you want to use cannabis for medical reasons, recreation or a mix of the two?
Carefully picking the right product with a goal in mind will affect the experience you have — whether it’s a clinical benefit or a side effect.
Trust but verify
Make sure you know exactly what is in the product you are buying.
“Buyer be aware,” Gruber said. “Know what you’re looking for in a product, and don’t rely only on the product label — ask for certificates of analysis (COAs) for the products you’re interested in to confirm exactly what is contained in the product and in what amount.”
She said independent laboratory analyses are best.
Are you reelin’ in the years?
Consider your age — it matters, Gruber said.
“Cannabis carries higher potential risks for children/adolescents and emerging adults especially when exposed to larger amounts of THC and higher potency products as they are in the midst of critical brain development,” she said.
On the other hand, she pointed out, older adults with slower metabolism may also be sensitive to cannabinoid products. “But many adults experience unique benefits from cannabinoids,” she noted.
Regardless of age, cannabis use has been linked to potential health risks.
Know yourself
Take into account your personal and medical history.
“We are not all created equally,” Gruber said. “Each person is likely to respond to cannabis and cannabinoid products differently.”
She said individual responses are based on a number of factors, including what compounds are in the product, how the product is used, previous experience with cannabinoids, the consumer’s age, metabolism, use of other substances, genetics and family history of certain conditions.
Another important factor is the use of conventional medications. “Drug-drug interactions are a potential concern as cannabinoids; particularly CBD, when used orally, can interact with liver enzymes and increase or decrease serum levels of other drugs,” she said.
As a final point, Gruber said, “Remember — using cannabis for medical purposes does not mean you need to get high or feel altered — be mindful of THC content, and make sure to start low and go slow.”
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