Dear Attorney General Garland:

Subsequent to the letter sent to you, and to Secretary Becerra, by Senators Warren and Booker dated October 6, 2021 requesting that you exercise your authority under the Controlled Substances Act of 1970 (CSA), we write to support their request and to support your pragmatic efforts to do so.

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ACS and MSNJ

The Association of Cannabinoid Specialists (ACS) is a medical society of 1200+ clinicians who are focused solely on the use of cannabis and cannabinoid medications for the benefit of patients. You can read more about our mission at cannaspecialists.org

Joining us in sending this letter is the Medical Society of New Jersey. As you, no doubt, know MSNJ is the oldest medical society in the United States, is 3,000+ physician-members strong, and holds a strategic position in the American Medical Association. The MSNJ is known for its voice in advocating for patient and physician rights.

Schedule 1 is Inappropriate

To echo the sentiments of Senators Warren and Booker, maintaining cannabis and most other cannabinoids in Schedule 1 is untenable. This category is reserved for substances that have “no accepted medical use” among other criteria. ACS represents that these substances do have accepted and proven medical use for which there are vast data as aptly summarized in the 2017 report of the National Academy of Science. Schedule 1 is simply not appropriate.

While Warren and Booker write about decriminalization and the negative effects of prohibition on our country, we believe that the United States needs a comprehensive national approach to cannabis medicine.
Bound as we are by the commonality of Human biology, we believe that Health Equity – access to medical care – must be the first priority in cannabis reform.

A National System

ACS provides a few key provisions that are necessary for such a national medical system to be effective:

• Exact prescriptions: A prescribing paradigm that provides a system to ensure patients need both prescriptions and products that support very specific and reliable regimens. Regulations that limit the amount that a dispensary can sell to patients, as per the prescription, and based on the regimen needed by that patient, rather than limiting the amount of medicine that a patient is permitted to have in its possession.

• Medical claims: Prohibition of sales representatives from upselling or making medical determinations on behalf of the patient. Regulation addressing claims made by manufacturers, as well as statements that are allowed by lay people, such as budtenders, who are selling these products.

• State-to-state interoperability: Patients must be allowed to travel with their medication, including by air, within all U.S. states, use their medication in all states, and purchase their medication in all states subject to their prescription. These conditions are crucial to proper and effective medical treatment.

• Common safety standards: A regulatory regime that provides harmonized standards for the growing, harvesting, manufacturing, testing, and packaging of cannabis medicine in such a manner consistent with other medications.

Further details can be found in the ACS position paper on the key policy elements necessary in a national medical cannabis system.

Medical Use

This administration may have reservations about the recreational use of cannabis, but the medical use is undeniable. The present lack of modern national medical cannabis policy is harming patients.

In short, Mr. Garland, we hope that you will reconsider the schedule status of cannabis and cannabinoids in a manner that prioritizes patients and provides for proper medical care for all Americans. ACS and its members will make themselves available to provide further insights on what a clinical practice entails and to answer any technical questions you may have concerning cannabis.

Sincerely,

Jordan Tishler, MD
President, Association of Cannabinoid Specialists

Kennedy Ganti, MD
President, Medical Society of New Jersey