(Potential) Rescheduling of Cannabis in the US: Policy, Process, and Patients

December 29, 2025 / drcareyclark / 3 Comments

Cannabis has been a DEA Schedule I drug since the initiation of the Controlled Substances Act (CSA) in 1970. Schedule I drugs are those classified as having a high potential for abuse and no known medical benefit. Cannabis has remained a schedule I drug despite the National Academies of Science, Engineering, and Medicines (2017) publication entitled The Health Effects of Cannabis and Cannabinoids, where NASEM concluded that there is substantial evidence for cannabis effectiveness in treating chronic pain, chemotherapy induced nausea and vomiting, and multiple sclerosis spasticity; moderate evidence around cannabis improving sleep with short term outcomes related to sleep apnea, fibromyalgia, chronic pain, and multiple sclerosis; and limited evidence around cannabis’s effectiveness with anxiety, PTSD, Tourette’s, IBS, TBI outcomes, dementia, glaucoma, and other neurodegenerative diseases.

Because cannabis has remained a Schedule I drug, research has been greatly hampered, and the NASEM (2017) report called for the development of a national cannabis research agenda focusing on clinical and observational research, health policy and health economics research, and public health and public safety research.

The NASEM report can be accessed here: https://www.ncbi.nlm.nih.gov/books/NBK423845/

Additionally, in 2003, the federal government issued a patent on cannabinoids related to the drug’s ability to help with healing from brain trauma and age-related brain changes.

There is a lot of excitement in the medical cannabis world around the potential rescheduling of cannabis related to the US president’s December 18, 2025, executive order 14370 to reschedule cannabis. However, in 2024, the U.S. Department of Justice initiated a rulemaking process to begin the rescheduling process, and President Biden issued an executive order in 2022 directing the Department of Health and Human Services and the Department of Justice to review the rescheduling of cannabis. The DHHS in 2023 recommended that cannabis be moved to Schedule III, and in May 2024, the Attorney General signed off on a proposed rule to reschedule cannabis, which was also published in the Federal Register. This can be accessed here: https://www.federalregister.gov/documents/2024/05/21/2024-11137/schedules-of-controlled-substances-rescheduling-of-marijuana

However, an administrative law hearing is needed to formalize the process, and it has been stalled over the past year due to lawsuits alleging bias and procedural misconduct in the rescheduling process. Lawsuits include those from Doctors for Drug Policy Reform that allege they were excluded from the list of 25 designated hearing participants due to supporting rescheduling, Panacea Plant Sciences has sued the federal government because small cannabis businesses have been excluded from the hearings, Attorney Matt Zorn has claimed in a law suit that collusive communications occurred between the DEA and the anti-cannabis group Smart Approaches to Marijuana (focuses on the Freedom of Information Act), and a group of pro-rescheduling entities has been granted an interlocutory appeal based on the DEA being a proponent of the proposed rule. The interlocutory appeal has indefinitely stayed the rescheduling hearing process. Essentially, all of these lawsuits are focused on the concern that the DEA has stacked the witness selection process to ensure that cannabis remains a Schedule I drug in direct opposition to the DHHS recommendation that cannabis be rescheduled to Schedule III. The DEA and the DHHS have historically had differing views of DEA/ CSA scheduling. The current 2025 executive order does not address this issue; it does not provide a defined means to bypass the existing legal process, and the CSA of 1970 does not permit a President to unilaterally reschedule a drug.

The only other approaches toward timely rescheduling of cannabis include an act of congress, which may be required to address the issues of banking concerns, research processes, and address the current conflicts between federal and state laws regarding cannabis. Additionally, Attorney General Bondi could expedite the process by bypassing the notice-and-comment process.

There is a clear need for more medical cannabis research, and moving the drug to a schedule III would bypass researchers’ requirement to have a Schedule I license and the requirement to only access cannabis from a handful of government cannabis sources that may not provide access to quality cannabis products. Rules will need to be changed, and funding for cannabis research as a national public health agenda item will be initiated, with the goal of USFDA treatments being developed. By rescheduling, the reduced stigma associated with the prohibition of the cannabis plant may help to encourage academics, pharmaceutical companies, and cannabis businesses to engage in more cannabis research. Still, again, Congress will likely need to clarify or revise previous laws. For instance, Biden’s 2022 Medical Marijuana and Cannabidiol Research Act has not led to greater cannabis research because of the lack of access to the product, high costs associated with the security of cannabis products, lack of funding sources for research, and issues with federal law prohibiting the transfer of cannabis across state lines.

Additionally, implications around what rescheduling means for cannabis producers, medical cannabis patients, and healthcare providers remain unclear. Cannabis being rescheduled does not change the federal legality of cannabis. It would still be a federally controlled substance, and currently, whether or not patients will be able to have cannabinoid therapeutics covered by insurance remains in question. While dronabinol, a synthetic THC medicine, is a Schedule III drug, it is only approved for CINV when other methods have failed, and loss of appetite and weight loss with anorexia and cachexia. It is not a first-line treatment for any health condition, although prescribing in pediatric settings appears to have increased over the years. Additionally, dronabinol may not be as therapeutically effective as whole-plant cannabis due to its lack of various cannabinoids, terpenes, and flavonoids that are found in whole-plant cannabis and may support optimal functioning of the body’s master regulator, the endocannabinoid system.

While this process of rescheduling cannabis to Schedule III comes with a great deal of uncertainty and legal concerns, it is part of the process of ending the prohibition era of cannabis and entering into an era of cannabis regulation. Ideally, the patients who could benefit from access to cannabis and cannabinoid therapeutics are always at the forefront of benefits in the political process. Patients’ access to safe, tested, effective cannabinoid therapeutics remains a social justice issue, a research priority, and an advocacy concern for nurses. Nurses are ethically obligated to support patients’ autonomous right to access cannabinoids and to ensure that beneficence and nonmaleficence are upheld.

Resources

National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on the Health Effects of Marijuana. (2017). An evidence review and research agenda. The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research.National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK423845/

https://alaskapublic.org/news/economy/2025-12-26/marijuana-rescheduling-would-bring-some-immediate-changes-but-others-will-take-time

https://mjbizdaily.com/news/great-leaps-in-cannabis-research-expected-after-marijuana-rescheduling/613762/

https://www.nbcnews.com/health/health-news/medical-marijuana-research-open-floodgates-cannabis-reclassification-rcna249811

Nanette Massey calls out racism in cancer care

October 9, 2023 / Peggy L Chinn / Leave a comment

Nanette D Massey, who was an inspiration for, and has worked with “Overdue Reckoning on Racism in Nursing” for over 3 years, has written an article in NABJ Black News and Views that describes the appointment of two Black women to the top administration of Roswell Park cancer center in Buffalo, New York, as a result of a report that detailed widespread racism toward Black nurses, doctors and other staff.

In the article, Nanette describes the situation that the report revealed at Roswell Park, and the changes that the institution is taking to begin making the needed changes. Nanette’s own work has focused on raising the awareness of white people to the widespread realities of racism, and supporting any and all action to bring about change. In the Black News and Views article, she acknowledges the work we are doing in our “Overdue Reckoning” project, including our current October series focused on actions needed by white nurses. Nanette cites Lucinda Canty’s remarks about the systemic ways in which hospitals are designed to sustain racism:

The experiences of Lucinda Canty Ph.D., one of the authors of “An Overdue Reckoning On Racism In Nursing” and an associate professor of nursing at UMass Amherst, add more logs to this fire.

“Hospital systems,” said Canty, ”were never designed for Black people, as patients or employees. Segregation of hospitals ended with the civil rights movement of the 1960’s.That’s not too long ago. The structures are still in place in the form of leadership, policies, or procedures, all designed so that people of color cannot thrive. When racial issues come to light there is no accountability.”
Nanette Massey, September 27, 2023

All of us who are nurses and who want to make change can take action anywhere we live and work. We cannot do everything that is required, but each of us can do something. Join in on our Saturday discussions for the remaining Saturdays in October! Here are topics we are planning to kick off discussions for the rest of October –

Oct. 14 – Dismantling white privilege – “What is your experience of remaining silent while people of color speak?”

Oct. 21 – DEI is not enough — “What happens when you attend the dance, but are not asked to dance?”

Oct 28 – Blueprints for action – “What antiracism actions are we committed to take on an individual, group, and structural level?”

You can learn more about Nanette, and the work that she is doing on her website, including information about her in-person workshops in upstate New York, webinars, and writing. Nanette is a highly skilled and compassionate facilitator, and without her inspiration, our work would not have evolved as it did! Connect with her now!

Nurses’ Concerns with COVID19: Update May 2, 2020

May 2, 2020 / Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 3 Comments

I find that nothing is more powerful than hearing the stories of our nurses during this pandemic crisis. This website has some of these powerful stories from nurses around the globe, sharing their experiences of caring for COVID19 patients: Nursespeak.com

PPE: Nurses continue to lack Personal Protective Equipment: A recent survey showed that 75% of staff in home-care settings are lacking in PPE. Home Care Survey. 86% of healthcare systems are also concerned with having adequate PPE available: PPE shortages

Political unrest emerges even as nurses remain on the front lines of providing care for patients during the pandemic. Nurses rose to the occasion to stand their ground in the face of protestors. Nurses Urge Protestors to Stay Home

National Nurses United organized a nation-wide May-Day protest about lack of PPE: https://www.cbsnews.com/news/may-day-protest-nurses-ppe/

Nurses also took action by protesting outside of the Whitehouse on April 21 and reading aloud the names of nurses who died from contracting COVID19 in the workplace: Nurses Whitehouse Protest

And nurses are still speaking up, even if it puts their jobs at risk: Hospitals fire and suspend staff for speaking out

Nurses deaths: The virus continues to take its toll on nurses and other professionals. Issues around post-trauma recovery are now coming to light. Healthcare workers may be feeling hopeless or helpless or suffering clear PTSD symptoms. Sadly we have lost some professionals to suicide: NYPost tragic deaths.

If you need help please reach out. National Suicide Prevention Lifeline: 1-800-273-8255

A Missouri nurse, Celia Yap Banago, who raised concern about lack of PPE died of COVID19. Nurse Banago had worked as a nurse for 40 years and was literally days away from retirement.Nurse Banago

New York State Nurses Association houses a memoriam page to nurses lost to COVID 19. NYSNA memoriam page The retired executive director of the National Student Nurses Association is counted in the losses: Rest in Peace Robert V. Piemonte, EdD, RN, FAAN.

To all of the nurses taking action, thank you for stepping up.

Nurses’ Concerns with COVID19: Update April 17, 2020

April 17, 2020 / Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / Leave a comment

The COVID19 pandemic continues to be quite an issue in New York, with over 14,000 deaths reported. I found this link to the New York Times to be helpful in assessing where we are with official numbers of reported testing and deaths (NYTimes CVOID19), though in many states we know that testing remains very limited and accuracy of tests is still only at about 67-70%.

PPE: Nurses are still without proper PPE. While the federal government claims to have distributed millions of masks and gowns, frontline workers are still faced with shortages and putting themselves at risk. Now we are seeing surges in the cost of PPE, with costs going up over 1000%, according to a report published last week by the Society for Healthcare Organization Procurement Professionals. Competitive bidding for these supplies both internationally and within our own county has compounded the issue, and if we had federal government oversight and processes in place, it is likely these issues could be addressed in ways that would help to prevent price inflation ( CNN review of the inflation of PPE cost).

This video that appeared on CBS’s 60 minutes made it clear that nuses like New York nurse Kelley Cabrera are beginning to speak out. Nurse Cabrera works at Jacobi medical center in the Bronx. She makes the point that when nurses are required to reuse N95masks for up to 5 days, they are literally being provided with medical waste to be used as PPE. Nurse Kelley Cabrera 60 minute’s interview

Nurses Stories: Meanwhile, I have heard the stories of nurses continuing to work without proper PPE and we reultantly have high numbers of nurses testing positive in areas like Ohio.

Nurses have started to reject the idea that they be considered to be angels or heroes. They didn’t become nurses to die, and they don’t want to be martyrs. While the 7 pm clapping and cheering ritual in New York City seems to have built a community spirit, some nurses experience this differently. One New York City nurse wrote: ” I ask that you do not pity me, that you do not call me a hero. I do not wish to be made into a martyr….Clap for me and other healthcare workers at seven o’clock if it makes this pandemic feel more bearable. I concede, your cheers help us trudge on. Just know that cheers and hollering don’t change the outcome. This is my fervent plea – that we change what we can after all this is over”.

Fallen Nurses: The loss of nurses becomes hard to track as the numbers increase. NYSNA has set up a memoriam page: Fallen Nurses Memoriam

A 28-year-old pregnant nurse in the UK passed away on 4/12, RIP nurse Mary Agyeiwaa Agyapong. Her father passed away two weeks before she died. Mary’s baby daughter was delivered via cesarean section before Mary died.

Many other nurses and hospital staff in the UK have also died (daily mail review of nurse and staff COVID19 deaths).

Two nurses in Palmetto, Florida have also died from work related exposure to COVID19. Nurse Danielle Dicensio leaves behind a 4 year old son and hubsand. Nurse Earl Bailey also worked at the same hospital, Plametto General Hospital, and he passed away from CVOID19 a few weeks ago. Both nurses complained about not having access to proper PPE, which the hospital denies (two nurses die of COVID19 ).

A colleague of Nurse Cabrera’s (mentioned above), Freda Orcan, who worked at Jacobihospital in the Bronx passed away March 28.

ANA’s response to COVID19:

The Ameican Nurses Association has issued a statement that nurses should be reporting when then experience retaliation around their raising concerns regarding their personal safety in the workplace, as these are OSHA violations (OSHA and retaliation issues). While hundreds of complaints have been filed, it’s difficult to determine specifically how OSHA is responding to reports made. There is a plethora of information on their website regarding COVID19 issues (https://www.osha.gov/SLTC/covid-19/),

The ANA has created a page of resouces for nurses (ANA COVID19 page). There have developed a corona virus response fund for nurses. There is also a section about ethical guidelines for nurses that may help some in their decision making process and calls forward the bigger ethical issues that nurses are facing, and links that show all of the steps that ANA is taking in advocating for nurses.

The latest ANA/ AHA/AMA letter witten calls for the government to address the issue of minorities and the disparities they experience with receiving adequate care for their COVID19 issues. (ANA letter to the Secretary, US Department of Health and Human Services). The letter in part reads:

“As organizations that are deeply committed to equity in health status and health care, we have long recognized differences in the incidence and prevalence of certain chronic conditions, such as diabetes, asthma, and hypertension — conditions that are now known to exacerbate symptoms of COVID-19. We also recognize that other factors, including but not limited to socioeconomic status, bias and mistrust of America’s health care system, may be resulting in higher rates of infection in communities of color. Lack of access to timely testing and treatment will inevitably lead to worse outcomes for these patients.

As America’s hospitals and health systems, physicians and nurses continue to battle COVID-19, we need the federal government to identify areas where disparities exist and help us immediately address these gaps.”

While ANA has been interacting at the national level, my perception from the nurses directly working with patients on the frontlines is that they feel under-represented and that ANA is not providing them with the voice they need. One time letters to federal authorities seem to make little measurable immediate impact. around what matters for nurses being able to practice safely. They also feel that many of the practicing nurses don’t belong to ANA exactly for this reason: that there is somehow a gap between the reality of nursing practice and the work and publications of the ANA. The crisis is far from over.

May all nurses and all beings know some peace and ease.

Nurses’ Concerns with COVID19: Update April 7, 2020

April 7, 2020April 7, 2020 / Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 2 Comments

At this point, things are so disheartening for so many people. The range of nurses’ stories is so wide and varied, from OR nurses being essentially laid off due to no elective surgeries happening, to nurses being offered a lot of money to come to New York City to work.

New York State has taken the unprecedented step of merging all of its 200 hospitals into one system (New York State hospital system consolidation ).

There’s a lot of death. One nurse told a story of how she had 10 patients in one shift and 7 of them died. In some hospitals, there is a different kind of rapid response team called, specifically for CVOID19 patients, and they are being called sometimes just minutes apart on different units throughout the hospital.

Also, nurses are working with their colleagues who end up being patients in their same units; one nurse told of their nursing supervisor being hospitalized in their own ICU, and they conjectured the supervisor most likely would pass away there.

There’s a lot of understaffing and over-working, including on the medical-surgical units. Part of this is because nurses themselves are becoming ill and unable to come to work.

Some nurses are actually more frightened to work in the medical-surgical units because they have a lack of PPE, and all patients are presumed to be COVID19 negative. Of course, when tests come back days later, the nurses discover that they worked with these COVID19 positive patients without proper PPE. There are also many issues around HIPPA and staff not being able to find out the COVID19 status of the patients they worked with previously.

Another nurse relayed this story: he works twelve-hour shifts on a medical-surgical floor, and their usual patient load now runs from 12-15 patients, the only real charting they really do is vital signs and meds. This is possible because NYC has suspended a lot of normal operations when it comes to providing care as per the governor’s laws:

“A massive section of regulations on the “minimum standards” governing hospitals — dealing with everything from patients’ rights to the maintaining of records — has been suspended ‘to the extent necessary to maintain the public health with respect to treatment or containment of individuals with or suspected to have COVID-19’.” (read about all of the laws suspended) .

This nurse cries after every shift, and he stated his tears are so different from before, in part due to his utter exhaustion. His family and friends want him to quit, they are worried about his health, but he stated he can’t quit now, they need him too much.

Nurses are asking about ramifications of quitting their jobs; some claim that they have been threatened that they will be reported to their board of nursing for disciplinary action (this is not the reportable offense of walking out and abandoning patients, rather for resigning their position). While these threats are likely idle, some nurses are still fearful of losing their licenses.

One nurse states that she works in a COVID19 only ICU unit. She says it’s mostly completely staffed by RNs: they have no NPs, PAs, Residents, Techs, or Housekeepers. Nurses and ICU Attending and Intensivists care for the patients. Med Surg nurses act as techs and assist the ICU nurses.

Recruiting: There is still a lot of recruiting going to bring nurses to NYC. One new graduate nurse (recently licensed, with no work experience) posted on social media about being offered to be “trained” to work in the ICU in NYC. All of her travel and lodging would be covered. She would be required to work 21 days, 12-hour shifts, with no days off. The majority of the experienced nurses tried to set her straight about why this was a really bad idea, but we have no idea if she proceeded or not.

It’s not just NYC: We now have a 54-year-old nurse in Michigan who died, Lisa Ewald.

Unfortunately, nurse Ewald may have had some issues with initially being tested by her workplace, Herny Ford Health System in Detroit, Michigan. She was likely exposed on March 24, received her positive test on March 30, and passed away on April 3. She died alone in her home. (Lisa Ewald’s story).

Rest in Peace Nurse Ewald.

Meanwhile, more than 700 Henry Ford employees have tested positive for COVID19; 500 of the positive tests are nurses. (Henry Ford COVID19)

The field of nursing will be forever changed by this.