The Scientific Issues of Regulation under the Controlled Substances Act

Written by Joshua Gates

April 14, 2024

After five decades of experience with the cannabis movement I’ve come to appreciate the rhythms and cadence of change that have transformed the understanding of cannabis in our nation as well as the various movements that have brought us to where we are today, in time, in understanding, and in the face of opportunity.

It’s time for the final movement in our own symphony of change, the movement of consumers into the public policy process as the engine and arbiter of the standards and regulations that protect their rights and interests.  This still involves a paramount concern for ending all criminal laws prohibiting cannabis use, but there are new challenges that need to be addressed as patients and caregivers interact with the health care system to address their needs.

Patients Out of Time has been a leading pioneer in medical cannabis education for three decades.  Patients Out of Time has joined with the newly formed Academy of Cannabis Education to support patients and health care professionals in asserting their rights to service from both private and public organizations.  The mission of Patients Out of Time has been repurposed to focus on support and training for patients to secure their care. The Academy of Cannabis Education has assumed the mission of educating health care professionals and supporting their efforts to develop a cannabis health system within the larger public health care system of the United States.

Our strategy is to contribute to the coming third and final movement of the reform era, the closing effort by a new generation of cannabis users to conceive of cannabis in terms of science and care rather than in terms of crime and control.

The first movement can be characterized by decriminalization, and in the era from 1965 until 1995 marijuana consumers biggest concern was avoiding arrest and/or jail time.  The second movement began in 1996 with the passage of the Compassionate Use Act, Proposition 215, in California; the legalization of medical cannabis at the state level began a new phase of incremental reforms over the last thirty years.  This second movement produced the partial legalization of cannabis that characterizes U.S. cannabis policy today.

In both movements, change was hard to come by – especially since access to the public policy process by cannabis users was suppressed by the criminal laws prohibiting the plant’s cultivation and use.  The purpose of these two prior movements was to protect cannabis users and then break down the barriers that kept them out of the public policy process. 

The third movement is the obvious next step – sending cannabis consumers into the public policy process.

For now, most cannabis policy is being made by government and industry lobbyists, with little or no consultation with consumers.  That’s one final obstacle for consumers to overcome, but there’s another one just as important.  The other obstacle is that policy today, even in this age of partial legalization, remains based on a fiction, a familiar fiction, and one that is prejudicial to the interests of consumers and beneficial to the interests of politicians and profiteers.  The final movement in the process of legalization of cannabis is to put to rest the fiction that cannabis is dangerous.

Cannabis requires a regulatory system based on science and experience rather than one based on politically convenient fiction. 

This fiction provides the rationale for tight controls over cannabis cultivation, such as arbitrary limits on personal cultivation and small-scale transfers that inflates the price of cannabis in legal markets. It also exacerbates the hyperbole and rhetoric used to justify continued arrests in areas without legal markets.  In both instances this fiction manifests injustice for cannabis users.

The question of interest is not whether cannabis should be regulated, nor is it really what those regulations should be.  What’s most important is just who is creating, implementing, and enforcing regulation of the cannabis market.

Consumers control markets, and regulatory policy should support both consumer and industry interests.  Public policy that does not solicit and respond to consumer interests will fail.  The answer to all problems and frustrations associated with the legalization and regulation of cannabis is to involve consumers in the public policy process and to pay attention to their needs and concerns along with those of other stakeholders, such as industry and government.

The brilliance of prohibition, as a strategy, is that it criminalized the stakeholders who would otherwise use the public policy process to hold them accountable for both its failures and the injustices it produced.  Now, though, while many still face jail time for cannabis use, there are enough legal cannabis users now to assert their rights for fair and equal treatment from the government, the public health system, and society.  The brilliance of the final movement of the reform process is that it will be generated by these now un-criminalized stakeholders.

Our first two movements have been primarily based on individual and systems advocacy, in which advocates seek change on behalf of those affected by bad laws, bad policies, and discrimination.  For our next movement to emerge, we need a greater emphasis on self-advocacy, with continued support for individuals from individual and systems advocacy on their behalf.

Self-advocacy is the catalyst for the final changes required to put prohibition behind us.  Much needs to be done at the national and state level with respect to regulatory policy.  The way to get those regulations right is to heighten attention on individual experiences, needs, and rights.  We need to ground policy making, in private and well as public organizations, in the service responsibilities of these organizations and the rights of those they serve.  We need to move organizational policies regarding cannabis use and care to patient centric perspectives to move the policies of public organizations to patient centric regulatory policies.

The mission of Patients Out of Time is to empower patients to advocate for their rights to care and support from both the private and public health care systems in the United States.    In addition to publicizing widely respected rights for all patients in the health care system, another arena for self-advocacy for patients concerns the removal of cannabis from the jurisdiction of the federal Controlled Substances Act (CSA).  Patients Out of Time has long had a petition to demonstrate support for de-scheduling cannabis.  As part of its repurposed mission, Patients Out of Time will be providing commentary and resources on how cannabis can be removed from the CSA, as well as continuing and enhancing support and guidance for individuals and organizations taking leadership roles in asserting patient rights and advancing access to therapeutic cannabis.

The Academy of Cannabis Education (ACE) is taking over Patients Out of Time’s legacy mission of educating health care professionals and providing scientific background on medical cannabis to patients, caregivers, and health care providers.  ACE is currently offering a video presentation on an introduction to medical cannabis (Cannabis 101) originally presented at the 15th Annual National Clinical Conference on Cannabis Therapeutics.  In support of the patient rights initiatives of Patients Out of Time, ACE will also be devoting attention to the scientific and research issues related to the regulatory status of cannabis in the United States.

Please join with Patients Out of Time and the Academy for Cannabis Education as we all work towards finally achieving the legalization of cannabis in the United States.

Jon Gettman, a former national director of NORML, is currently an Associate Professor in Criminal Justice at Shenandoah University and a board member of Patients Out of Time and the Academy of Cannabis Education.  With the support of High Times, he led two unsuccessful public interest campaigns to have marijuana rescheduled under the Controlled Substances Act to make it available for medical use.  Dr. Gettman also conducted groundbreaking research on racial disparities in marijuana possession arrests and provided the data for the ACLU’s original 2013 report on the War on Marijuana in Black and White.

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