Marijuana reclassification ‘gives us hope’ for more treatments, doctor says. What to know

For more than 50 years, marijuana has been ranked as a Schedule I drug — a category for substances with “no currently accepted medical use in treatment” in the U.S.

But now, cannabis, the most common “illicit” drug used by Americans, is headed closer toward medical acceptance following the Justice Department’s recent proposal for reclassification.

“I don’t know where this will go, but the reclassification gives us hope for more treatment options,” Dr. Sulagna Misra, a Los Angeles-based physician and founder of direct primary care practice Misra Wellness, said in an interview with McClatchy News.

With marijuana’s popularity and use in the U.S., the plant’s potential health benefits are no mystery, she explained. However, more research is needed to demonstrate cannabis’ medicinal purposes.

“It’s kind of distributed to the masses already… but we need the proper studies,” Misra said.

Reclassifying marijuana will make it easier for researchers to study the plant’s effects on people, as there’s less barriers to studying lower scheduled drugs, Misra explained.

Currently, cannabis is categorized next to heroin, methaqualone (Quaaludes), LSD and other substances in the Schedule I category, which also means the substances have a high abuse potential. Below this are drugs like cocaine, fentanyl, morphine and PCP, all considered Schedule II substances under the Controlled Substances Act.

On April 30, Attorney General Merrick Garland shared a proposal to reclassify marijuana as a Schedule III drug, according to a statement provided to McClatchy News by the Justice Department.

Schedule III drugs have “less potential for abuse” than the substances in the higher categories and have “a currently accepted medical use in treatment” in the U.S., according to the Drug Enforcement Administration.

When the reclassification proposal is published in the the Federal Register, “it will initiate a formal rulemaking process as prescribed by Congress in the Controlled Substances Act,” the Justice Department said.

Where marijuana stands in medicine

Misra told McClatchy News that education surrounding marijuana is lacking, as it is a complex plant with a variety of properties.

“Some doctors don’t know the difference between CBD and THC,” Misra said.

Marijuana leaves, flowers, stems and seeds come from the naturally occurring Cannabis sativa or Cannabis indica plant. The plant’s main psychoactive element, THC, produces feelings of euphoria for users.

Another well-known cannabis ingredient is CBD. It differs from THC in that it doesn’t produce a “high” when consumed, and is used in several different products, including food, drinks as well as beauty products, according to Brent A. Bauer, M.D. a doctor at the Mayo Clinic.

Marijuana has more than 480 “constituents” or ingredients, including THC and CBD, according to the DEA.

Despite marijuana’s Schedule I status, the Food and Drug Administration has approved one ”cannabis-derived drug” containing CBD as a prescription: Epidiolex, an anti-seizure medication, according to a congressional report published May 2.

The FDA has also approved two prescription drugs with synthetic THC, and another that has a “synthetic substance that is structurally similar to THC,” the report says. These medications are used to treat nausea and vomiting in cancer patients undergoing chemotherapy, as well as appetite loss for patients who have HIV.

The medications with synthetic THC are called Marinol and Syndros, and the medication with an ingredient similar to THC is Cesamet, according to the report.

“Additional drugs containing marijuana-derived THC and CBD are reportedly being developed,” the report says.

Marijuana’s potential health benefits

For Misra, one of the most exciting parts about marijuana reclassification is how it can advance research and possibly lead to more treatment options.

“We want as many treatment options as we can get,” she said.

“We need to do the studies so we know what we can give this for,” Misra continued. “If we’re talking about (how marijuana) helps insomnia, we need studies for insomnia. If we’re talking about (how) it helps for anxiety, we need studies for anxiety.”

In states where recreational marijuana is legal, sometimes the packaging of recreational cannabis touts the plant’s benefits, with words like “calm,” “elevate” or “sleep,” she said.

“They’re already saying the recreational stuff does medicinal stuff,” Misra added.

“We need to prove that,” she said.

For some people, marijuana can be beneficial for pain management, particularly as an alternative and less-addictive substance compared to opioids, Misra explained.

Marijuana also has potential health benefits when it comes to anxiety, sleep, stress, libido — and the potential to kill certain viruses and bacteria, Misra said.

While she’s excited to see new research that can potentially highlight marijuana’s benefits, she said “I also want to see the negative studies.”

“We wanna prove that a negative study is just as powerful as a positive study,” Misra explained.

She has seen how marijuana may cause excessive eating because it’s known to increase appetite, and that THC may suppress testosterone production in men.

“I want to see: what does it do for these hormones? What does it do for metabolism? What does it do for bacteria and viruses? What are the doses that we need? What are the derivatives of marijuana that we need?” she said.

What comes next?

The Justice Department’s proposal needs to be reviewed by the White House Office of Management and Budget in order for marijuana reclassification to move forward, according to The Associated Press, which first reported on the proposal.

If approved, then the DEA will hear public commentary on a plan to reschedule cannabis, the outlet reports.

While no changes are immediately happening now, Misra said this “gives us hope for research” and “scientific changes.”

She said that though there’s going to be “a lot of opposition” to reclassification, she urges to “stay curious” and “keep an open mind.”

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