Cannabis is today the most consumed illicit drug in the world. An estimated 244 million people use it regularly, with significant social and economic costs including health care, criminal justice, lost productivity and traffic accidents. In advanced economies such as Australia, these costs have been estimated at around 0.26% of their GDP.
In parallel, the medicinal use of cannabis has gained ground. More than 50 countries currently allow some form of medical prescription, driven by growing social demand and partial evidence of potential therapeutic benefits in specific conditions. This context explains, in part, President Donald Trump’s recent announcement to accelerate the reclassification of marijuana within the Controlled Substances Act (CSA), moving from List I to List III.
The measure was presented as an exercise in pragmatism: facilitating scientific research and aligning regulation with the real use of the substance. However, the decision also has relevant economic implications, including tax and regulatory benefits for an expanding industry, which makes careful analysis essential.
What does it mean to move from List I to List III?
The Controlled Substances Act classifies substances according to their potential for abuse, health risk, and recognized medical value. For more than five decades, marijuana remained on Schedule I, reserved for drugs considered to have no accepted medical use and a high potential for abuse such as heroin and LSD.
Schedule III recognizes medical value and assumes a moderate or low risk of dependence. This change is not equivalent to full legalization, but it is reduces regulatory barriers to researchone of the main bottlenecks in the study of cannabis.
For Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), rigorous research is essential to define best practices in public health. In the case of cannabis, researchers today face severe restrictions on permits, storage and access to standardized products, which limits the quality and comparability of studies.
Reclassification could alleviate some of these obstacles and improve the evidence base. However, research should not trivialize the risk, nor send ambiguous messages to the population.
CBD and THC: a strategic distinction
One of the main challenges of public debate is the lack of differentiation between cannabis compounds. Cannabidiol (CBD) is non-psychoactive and has shown therapeutic potential in some conditions, still under investigation. Tetrahydrocannabinol (THC), on the other hand, is the main psychoactive component and concentrates the greatest risk of dependence and harm.
The available evidence indicates that the most severe health impacts are associated with the regular consumption of products with high concentrations of THC, which are increasingly common in legal or unregulated markets. Ignoring this distinction can lead to misguided policies and a dangerous reduction in risk perception.
Kevin Sabet, a former anti-drug policy advisor in the United States, warned that these types of decrees “send a very powerful message, especially to young people, that marijuana is less harmful than previously thought,” an interpretation that is not supported by scientific evidence.
It is estimated that one in ten people who use cannabis develops a substance use disorder, and in 2021, around 22.6 million people in the world suffered from this disorder.
In addition to respiratory risks, cannabis use is associated with mental health effects—including anxiety, depression and psychosis—and, in adolescents, with negative impacts on memory, attention and learning.
Science yes, without trivializing
From a public health perspective, marijuana reclassification may be an opportunity to strengthen research and improve regulation. But its success will depend on acting ethically in favor of the comprehensive well-being of the population, separating itself from a commercial or political narrative.
Investigating does not imply declaring harmlessness. Recognizing medical uses does not eliminate risks. And regulating without a solid information strategy can generate social costs greater than the expected benefits.
The key is not to stop science, but to prevent regulatory progress from translating into setbacks in prevention and greater damage to health.
The author is an opinion leader in addictions at a national and international level. He was director of Monte Fénix and is the founder of the Monte Fénix Center for Higher Studies, Claider Clinics and AMESAD. He is co-author of the book Addictions, the growing challenge and has been recognized for his career with various awards, currently developing the Espinosa-Larrea Foundation. His vision has marked a before and after in the treatment of addictions in Latin America.
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