"To rectify this state/federal conflict…cannabis must be removed from the Controlled Substances Act altogether."
By Paul Armentano, NORML
The Trump administration's decision to reclassify state-authorized medical cannabis and recognize state-licensed medical cannabis providers is a historic first step toward modernizing federal drug policy—but it stops far short of the comprehensive changes patients need, writes NORML Deputy Director Paul Armentano in an op-ed originally published by OtherWords.
For over 50 years, the federal government classified marijuana alongside heroin, denying it any legitimate medical utility and going so far as to threaten physicians who discussed cannabis options with patients. That position has grown impossible to defend.
Forty states have legalized physician-authorized medical cannabis access, beginning with California in 1996, and no jurisdiction has ever repealed its law. Sixty-nine percent of family physicians, nurse practitioners, and other health professionals now recognize cannabis as having well-established medical uses, and more than one-quarter have recommended it to patients. A 2023 Department of Health and Human Services 250-page review found that more than 6 million patients use medical cannabis under physician supervision, concluding: "No safety concerns were identified in our review that would indicate that the medical use of marijuana poses unacceptably high safety risks for the indications where there is some credible scientific evidence supporting its therapeutic use." Separately, researchers affiliated with the National Academy of Sciences had already established "conclusive evidence" that cannabis is "effective" for chronic pain.
Despite that progress, the rescheduling order leaves critical gaps. It offers nothing to patients in the 10 U.S. states that do not regulate medical cannabis, who still risk arrest and prosecution. It also provides no legal remedy for the thousands of businesses or millions of consumers in the 24 states that have legalized adult-use cannabis—those individuals remain technically in violation of federal law even when complying fully with state rules.
"To rectify this state/federal conflict…cannabis must be removed from the Controlled Substances Act altogether," Armentano writes, arguing that full descheduling would affirm America's federalism principles and grant states explicit authority to regulate adult cannabis use as they already do with alcohol.
Paul Armentano is the Deputy Director of NORML, the National Organization for the Reform of Marijuana Laws.
