Hundreds of pages of recently released documents provided by the Department of Health and Services affirm what the overwhelming majority of the public has known for decades: Marijuana is therapeutically useful. And its harms are not on par with those of heroin—which federal regulations currently consider it akin to—or even alcohol.
Those were the explicit conclusions of the nation’s top federal health agency, along with the Food and Drug Administration and the National Institute on Drug Abuse, in a letter calling on the Drug Enforcement Administration (DEA) to remove “botanical cannabis” from its Schedule I prohibitive status in the federal Controlled Substances Act.
By definition, Schedule I substances are federally criminalized because they possess “no currently accepted medical use in the United States,” a “high potential for abuse” and “lack accepted safety under medical supervision.” Since 1970, Congress and other federal bureaucracies have insisted cannabis remain in this strict category. But now the nation’s top federal health agencies are changing their tune.
Health and Human Services, which was tasked by the Biden administration in 2022 to review the federal designation of cannabis, based its conclusions in part on the real-world experiences of over “30,000 health care practitioners authorized to recommend marijuana” under state law and the more than 6 million state-registered cannabis patients they serve.
“The vast majority of individuals who use marijuana are doing so in a manner that does not lead to dangerous outcomes to themselves or others,” the agency concluded. “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.”
Department officials added, “The risks to the public health posed by marijuana are low compared to other drugs of abuse,” such as benzodiazepines—a Schedule IV drug—or alcohol, which isn’t scheduled at all.
Of course, the public has long been aware of this reality. Thirty-eight states regulate medical cannabis access and 24 states—home to 53 percent of the U.S. population—have legalized adult-use marijuana markets. Most of these statewide policy changes were enacted by voters at the ballot box.