Landmark JAMA Psychiatry study demolished scientific case for downgrading marijuana’s legal status

A devastating analysis published in JAMA Psychiatry tore apart the Biden administration’s case for cannabis rescheduling, revealing how political pressure trumped scientific rigour in one of America’s most consequential drug policy decisions.

The comprehensive report, authored by Harvard Medical School’s Dr Bertha Madras and Heritage Foundation legal scholar Paul Larkin, exposed how the US Department of Health and Human Services (HHS) abandoned decades of established medical standards to recommend moving marijuana from Schedule I to Schedule III under the Controlled Substances Act.

Ignoring the Evidence

The authors revealed that HHS systematically ignored mounting evidence of cannabis harms whilst creating entirely new, legally unprecedented criteria to justify rescheduling. Most strikingly, the agency downplayed the alarming reality that cannabis use disorder (CUD) affected up to 30% of users, with rates amongst young people reaching epidemic proportions.

“The prevalence of CUD amongst adolescents and young adults (16.5%) is converging with alcohol use disorder (16.4%),” the study noted, highlighting data showing that daily cannabis use had increased fifteen-fold since 1992. Even more concerning, by 2022, America recorded more daily cannabis users (17.7 million) than daily alcohol users (14.7 million) for the first time in history.

Medical Consensus? What Medical Consensus?

Perhaps most damning was the revelation that only approximately 2% of America’s patient-care physicians actually recommended cannabis to their patients. Of the 29,500 clinicians authorised to recommend medical marijuana, just over half held proper medical degrees—the rest included dentists, physician assistants, and other healthcare workers operating far outside their expertise.

The study exposed how cannabis recommendations often lacked basic medical protocols: “Cannabis recommendations often lack details on dose, frequency, composition, route of administration, THC content, tapering, or product quality, unlike FDA-approved prescriptions.”

Cherry-Picked Comparisons

HHS’s argument that cannabis had “low abuse potential” relied on comparing it to alcohol—a substance explicitly excluded from the Controlled Substances Act. This bizarre comparison ignored cannabis-specific harms including psychosis, schizophrenia, cognitive impairment, and the debilitating cannabis hyperemesis syndrome that sent thousands to hospital emergency departments.

The authors noted that assuming causality, “one-fifth of cases of schizophrenia amongst young males might be prevented or delayed by averting CUD.”

State Programmes: Politics, Not Medicine

The report dismantled claims about widespread medical acceptance by revealing the chaotic reality of state cannabis programmes. Geographic variation in authorising clinicians ranged wildly—from 0.8 per 1,000 patients in Oklahoma to 109 per 1,000 in Mississippi—suggesting the creation of “weed mills” analogous to the prescription opioid “pill mills” that fuelled America’s overdose crisis.

Many states allowed cannabis recommendations for virtually any condition without physical examinations or diagnostic tests. By 2021, states had approved cannabis for 105 different conditions, most lacking quality research support.

The Science Didn’t Stack Up

On the crucial question of medical efficacy, the study revealed that 24 meta-analyses examining cannabis for chronic pain—the most common reason for medical recommendations—had failed to endorse its use. The International Association for the Study of Pain explicitly stated there wasn’t “enough high-quality human clinical safety and efficacy evidence” to endorse cannabis for pain management.

For anxiety and PTSD—the second and third most common qualifying conditions—”no high-quality studies exist showing cannabis is effective,” the authors reported.

Youth at Risk

The analysis emphasised how rescheduling would have sent dangerous signals to young people at a critical developmental stage. With 53% of new cannabis users starting before age 21, and minors developing CUD at twice the rate of adults, the timing couldn’t have been worse for policy changes that might normalise cannabis use.

A Policy Crossroads

The study’s conclusions were clear: “The criteria and evidence HHS used to recommend reclassifying cannabis to Schedule III are flawed. If the DEA agrees, it will contradict past federal health concerns and ignore emerging data on rising use, disordered use, and negative health effects.”

Dr Kevin Sabet, a former White House drug policy advisor, emphasised the stakes: “We cannot allow policy to be driven by commercial interests and political momentum while ignoring public health. The evidence in this paper makes it clear that rescheduling marijuana would undermine decades of prevention efforts.”

As the Drug Enforcement Administration considered HHS’s recommendation for cannabis rescheduling, this landmark analysis offered a critical framework for evidence-based decision-making. The question was whether scientific integrity would guide the future of America’s drug policy or if political pressures would take precedence.

The authors issued a stark warning: rescheduling “could undermine FDA authority and compromise the integrity of our drug approval process and pharmaceutical supply.”

In an era of growing policy polarisation, this analysis stood out as a rare source of clear, evidence-based guidance on one of the most significant public health decisions of our time. (Source: WRD News – JAMAWRD News – JAMA)

A System Built on Sentiment, Not Science: What began as a compassionate response to desperate families seeking relief for children with epilepsy has morphed into what critics aptly describe as “a commercial monster” – a barely regulated medicinal cannabis industry where doctors write cannabis prescriptions every four minutes and patients receive “Chernobyl-strength” products after brief phone consultations with non-medical staff.

The numbers are staggering and speak to a system utterly divorced from proper medical oversight. One doctor issued 17,000 scripts in six months – mathematically impossible to provide adequate patient care. Eight practitioners each churned out over 10,000 prescriptions for the highest-strength THC products in just half a year. A single pharmacist dispensed nearly one million cannabis products annually – that’s 2,600 products every single day for an entire year without a break.

These aren’t the statistics of a carefully managed medical programme. They’re the hallmarks of a prescription mill operating under the thin veneer of healthcare legitimacy.

The “Vote for Medicine” Deception: The rot began with what the Dalgarno Institute correctly identifies as the “vote for medicine” protocol – a deliberate strategy to bypass rigorous clinical trials and scientific evidence in favour of emotional manipulation and political pressure. The Victorian Law Reform Commission’s 2014 consultation was a masterclass in manufactured consent, drawing from a mere 99 submissions and poorly attended public hearings dominated by cannabis advocates.

Policymakers staged political theatre, disguising the legitimisation of a recreational drug as compassion and medical necessity, abandoning evidence-based policymaking. The consultation process heavily favoured bias, systematically marginalising and silencing the Dalgarno Institute’s representative when they presented evidence-based research on cannabis harms. Meanwhile, cannabis advocates freely made unsubstantiated claims such as “Many, many people have been cured – from just about anything and everything” – statements now debunked by a decade of disappointing clinical outcomes.

Doctors as Drug Dealers: The transformation of medical practitioners into what one doctor described as “glorified cannabis dealers” represents a fundamental corruption of the medical profession. Dr Claire Noonan’s experience exposes the insidious pressure applied to healthcare providers: “There was a bit of pressure to be, perhaps more of a dealer… it’s more being used for my signature on a script.”

When doctors earn money based on the number of prescriptions they write, when companies pressure practitioners to override their clinical judgment, and when nurses without medical training conduct “consultations,” it stops being medicine. It’s a sophisticated drug distribution network masquerading as healthcare.

The conflict of interest is breathtaking: companies pay doctors to write prescriptions, then directly sell and ship the products to patients. This vertically integrated drug business model operates so efficiently and with such legal protection that it would make any street dealer envious. Some companies even pay commissions to shop owners who host their iPad kiosks, creating a multi-tiered financial incentive structure that has nothing to do with patient care and everything to do with maximising drug sales.

The Australian Medical Association has recognised this perversion of medical practice, with doctors coining the phrase “I’m a healer not a dealer” – yet the system continues to pressure practitioners into exactly that role. Young doctors and those without specialist training are particularly vulnerable to these pressures, potentially compromising an entire generation of medical professionals.

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A tragic accident in Bexleyheath has shed new light on drug-driving risks as a bus driver, Martin Asolo-Agogua, pleaded guilty to causing the death of nine-year-old Ada Bicakci. The Bus driver cannabis death occurred when the driver, high on cannabis, struck Ada and her brother on Watling Street on the 3rd of August 2023. The heartbreaking incident resulted in Ada’s death two days later, while her younger brother survived the hit.

Ada, a bright and energetic gymnast and swimmer, has left her family and community grieving. She attended a local school and embraced her love of sports with an active spirit. Following her passing, her family donated her organs, saving the lives of six other children—a profound act of generosity during their darkest days.

Fatal Consequences of Cannabis Use While Driving : Driving under the influence of cannabis significantly reduces reaction times, coordination, and perception, all of which are crucial to safe driving. Court revelations showed that the driver, Martin Asolo-Agogua, had not slept the night before the crash and had consumed cannabis, an act that undoubtedly impaired his ability to drive safely. At Woolwich Crown Court, he pleaded guilty to causing death by dangerous driving and driving while unfit through drugs.

The court has informed Asolo-Agogua that a prison sentence is inevitable and has imposed an interim driving ban on him while he awaits sentencing on 9th June.

Rising Tragedy of Drug-Driving in the UK: The sad reality of Ada’s death is part of a broader issue that is escalating on UK roads. Deaths and injuries attributable to cannabis-related deaths and drug-driving crashes have increased sharply over the last decade.

Drug-Driving Fatalities on the Rise

• Drug-driving fatalities have increased by 164% over the last decade, with 124 deaths in 2023 compared to 47 in 2014.
• Such accidents now constitute 8% of all road fatalities in the UK, underscoring the urgent need for proactive measures to combat drug-driving.
• Among the most common drugs linked to these incidents are cocaine, cannabis, morphine, and ketamine, all of which severely impair driving capabilities.

Impact by Age Groups

Statistics reveal that the most affected age group is 20-29 years, followed by drivers aged 30-39. Many cannabis users in these age ranges often underestimate the significant dangers of impaired driving, believing false claims that driving under the influence of cannabis is safer.

Broader Implications of Drug-Driving: Drug use not only contributes to life-altering accidents but impacts countless families, leads to legal trouble, prison sentences, and spikes in insurance costs. Misconceptions around cannabis consumption being “harmless” have contributed to these issues, especially considering the drug’s legalisation in various contexts worldwide.

Matt Pernet, Head of Direct Line Motor Insurance, has reiterated the severe risks associated with drug-impaired driving, saying, “Anyone that gets behind the wheel after taking illegal drugs is making a terrible decision, which can have life-altering consequences for themselves and others.”

Educating Communities About Cannabis-Related Death Risks: The untimely loss of Ada Bicakci serves as a grave reminder of the need for more robust community awareness and legal measures to tackle drug-driving. It is vital to dispel myths around cannabis and its effect on individuals’ ability to drive safely.

Communities, law enforcement, and policymakers must collectively work to ensure drivers understand the legal and moral consequences of drug use. By implementing steadfast prevention efforts, enforcing stricter laws, and launching sustained education campaigns, they can protect lives, especially in response to incidents like the Bus driver cannabis death in Bexleyheath. (Source: WRD News)

(Opioid Crisis 2.0 in the making?)

The cannabis use disorder (CUD) treatment market is on the brink of rapid expansion, reflecting a global trend towards recognising the health implications linked with cannabis dependency. Accelerated by increasing cannabis consumption, legislative movements, and a heightened awareness of usage-related risks, the market is forecast to grow from a valuation of USD 1.7 billion in 2025 to USD 2.7 billion by 2035, with a CAGR of 4.7% during the period.

This surge underscores the growing need for effective treatment interventions in response to rising dependency cases. Below, we’ll explore the driving forces behind this expansion and examine how different regions and innovations are shaping the market’s trajectory.

Impact of Rising Cannabis Use Cases: The increasing legalisation of cannabis across various markets, such as North America, Europe, and parts of Asia, has brought a profound shift in consumption rates. While cannabis is often lauded for its recreational and medicinal benefits, the uptick in usage has contributed to a parallel rise in dependency cases and cannabis-related health concerns, including cognitive impairment and mental health disorders like anxiety and depression.

Healthcare systems globally are ramping up investments in interventions to address these concerns. Scientific research highlights that long-term cannabis use can lead to dependency and withdrawal symptoms, which have sparked efforts to develop both behavioural and pharmacological treatments.

(For complete Article WRD News)

(We must avoid this here – Do not legalise cannabis)

The dangers of legalised marijuana are drawing increasing attention in the United States. While marijuana use has grown markedly in recent years, experts warn of its significant impact on mental health, particularly among young adults. With its rapidly rising THC potency to levels as high as 99%, marijuana poses risks that are only now being fully understood.

The association between cannabis use, mental health challenges, and suicidality in young adults reveals complex patterns, with risks varying significantly between men and women, as evidenced by nationwide survey data.

How Legalised Marijuana Affects Mental Health

Studies reveal a worrying link between marijuana and mental health conditions, including depression, anxiety, and suicidal ideation. The number of adults using cannabis more than doubled between 2008 and 2019, climbing from 22.6 million to 45.0 million. Simultaneously, the prevalence of mental health issues, such as major depressive episodes (MDE) and suicidal thoughts, also rose sharply.

These overlapping trends are more than coincidental. Research shows that cannabis use disorder (CUD), daily cannabis use, and even occasional use are linked to higher risks of suicidal ideation, planning, and attempts.

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