OPINION:
For too long, outdated federal drug policy has set back scientific progress, restricted access to potentially beneficial therapies and prevented medical professionals from obtaining clear guidance on standardized dosing and safety through research.
Cannabis, criticized for decades at the federal level, has been placed in Schedule I of the Controlled Substances Act. This is the most restrictive category, alongside heroin, and is defined as having no accepted medical use and high potential for abuse.
In a historic step on Dec. 18, President Trump signed an executive order directing federal agencies to reschedule cannabis to Schedule III, signaling a long-overdue shift toward evidence-based health care policy.
Although this executive order does not itself automatically reclassify cannabis, it instructs the attorney general and Department of Justice to expedite the formal federal rulemaking process required to officially reschedule the drug.
The Schedule I classification has long been at odds with the reality of clinical practice. Millions of patients use cannabinoid therapies for pain, multiple sclerosis, epilepsy, post-traumatic stress disorder, chemotherapy side effects and other conditions, yet researchers and clinicians have struggled under federal barriers to rigorous investigation and clinical guidance.
The Association of Cannabinoid Specialists highlights that reclassification would provide much-needed clarity for medical practice and allow doctors to integrate cannabis-based care with confidence.
The American Nurses Association similarly emphasizes that Schedule I status, which stigmatizes cannabis and limits research, complicates nursing care rather than enhances it. Rescheduling to Schedule III would better align federal policy with accepted therapeutic use and allow health care professionals to support patients based on sound evidence.
The formal change to Schedule III would dramatically reduce obstacles to cannabis research and, ultimately, mitigate the risk of clinicians relying on untested information.
Under current law, researchers must navigate burdensome Drug Enforcement Administration licensing and complex bureaucratic hurdles to study cannabis. This slows scientific progress and limits understanding of therapeutic risks and benefits.
As noted by the American Epilepsy Society, cannabis’ Schedule I classification has made research difficult.
Reclassification would facilitate more inclusive research into the benefits and risks of cannabis use by reducing regulatory restrictions and enabling a wider variety of research studies. Moving it to Schedule III would make research easier and help doctors better understand its potential for treating epilepsy and other neurological conditions.
These positions have only strengthened in recent months. After the executive order in December, the American Nurses Association and the American Association of Nurse Anesthesiology publicly endorsed moving cannabis to Schedule III, citing the need for clearer federal guidance and expanded research.
Nursing leaders emphasized that reclassification would help nurses better document use, communicate risks, and deliver care grounded in clinical evidence, rather than operate in a gray area created by outdated law.
Mr. Trump’s executive order represents important momentum for medical science and patient care. Directing federal agencies to complete rulemaking quickly moves federal policy closer to recognizing what leading health care professionals and millions of patients already know: Cannabis has accepted medical use and a lower risk profile than previously acknowledged.
Yet it’s equally vital to recognize that this is not the end of the road. The order does not automatically change federal law; the DEA must follow a strict process and issue a final rule. Until then, cannabis remains in Schedule I, and research and clinical practice continue under burdensome constraints.
Rescheduling cannabis to Schedule III does not solve every regulatory or clinical challenge, but it does represent a powerful alignment of federal policy with medical evidence, one that would expand research, empower clinicians and, most important, better serve patients who rely on cannabinoid therapies.
Health care professionals are ready to implement this policy shift to improve care. Now we must ensure that the administrative process moves forward swiftly and thoughtfully, with patient welfare and scientific evidence at the forefront.
• Dr. Susanna Kmiecik is an assistant professor and anesthesiologist at Georgetown University Medical Center.
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