Medical Marijuana

In line with the positions of the American Medical Association, American Psychiatric Association, and American Society of Addiction Medicine, Partnership to End Addiction encourages researching the medicinal value of cannabinoids (the chemical compounds found in the marijuana/cannabis plant, such as THC and CBD), while restricting the medical use of marijuana/cannabis to the conditions and medications that have been approved by the U.S. Food and Drug Administration (FDA).

The FDA’s process for approving new drugs is the current standard for verifying that a medication is safe and effective for a particular indication. The FDA evaluates data on the safety, efficacy, dosage, and side effects of new medicines and oversees the manufacturing process to ensure quality control and proper labeling. Without FDA review, there is no centralized evaluation of the evidence to determine whether a drug works to treat a specific condition and what dose is safe and effective.

While the FDA has not approved marijuana for the treatment of any disease or condition, it has approved several related products. The FDA has approved three THC-based drugs for nausea stemming from chemotherapy – Cesamet (which contains a compound similar to THC), Marinol (which contains THC), and Syndros (which contains THC) – along with Epidiolex (which contains CBD) for the treatment of epilepsy.

State medical marijuana laws bypass FDA review and allow patients to use marijuana if they have specific medical conditions approved by the state. Some states currently list medical conditions (e.g., some psychiatric and neurological disorders) based primarily on anecdotal reports, expert opinions, and non-randomized studies. There is not sufficient high-quality evidence from randomized, controlled clinical trials to determine whether marijuana is actually safe and effective for treating most of these conditions (e.g., acute pain, insomnia) and, for some conditions, the risks of marijuana use may outweigh the benefits.

State medical marijuana laws also create a distribution channel that lacks sufficient oversight of standardization and purity of each “dose.” Furthermore, some state marijuana laws approve smoked marijuana as medicine. Smoking is not a medically-accepted route of administration for any medication because smoking can damage the lungs and result in second-hand exposure. Similarly, high-potency products are not recommended, as they are associated with increased risk of psychotic symptoms and generalized anxiety disorder.

Partnership to End Addiction strongly encourages more high-quality research on the medicinal value of cannabinoids to treat health conditions. While administrative and legal barriers (including, historically, marijuana’s Drug Enforcement Administration (DEA) classification as a Schedule I drug) make it difficult to conduct such research, forgoing FDA review and allowing state legislators or voters to make health care decisions without this centralized review of the evidence poses an unacceptable risk to the public’s health.

Following an executive order signed in December 2025 that instructed federal agencies to more quickly ease restrictions on marijuana, the Department of Justice (DOJ) announced the rescheduling of medical marijuana in April 2026. This downgraded medical marijuana (defined as FDA-approved products and state-licensed medical marijuana) from Schedule I to Schedule III, which will create more opportunities for research and treatment. The order sets up an expedited system for state-licensed medical marijuana producers and distributors to register with the DEA and makes clear that marijuana researchers will not be penalized for obtaining state-licensed marijuana products for use in their work. However, the order partially circumvented the usual rescheduling process for controlled substances, which typically requires reviews by the U.S. Department of Health and Human Services (HHS) and the DEA.

To protect public health and encourage research on the potentially therapeutic components of marijuana, Partnership to End Addiction recommends the following:

• All marijuana products recommended for medical use should be subject to FDA review and approval for safety and efficacy.
• The National Institutes of Health (NIH) should develop streamlined procedures to increase research on the utility of cannabinoids for medical use and encourage the development of safe and effective THC-based, FDA-approved medications if the research bears out its utility as a medication.
• State policymakers, physicians, and patient advocates should work to encourage or fund research to test the safety and efficacy of marijuana-based and cannabinoid medications.
• States that have approved medical marijuana should:
  • Establish surveillance programs to monitor safety, adverse events, and outcomes;
  • Ensure that marijuana product packaging and labeling present accurate ingredients and potency (THC and CBD percentages), medically approved dosing recommendations, and warnings about risks of use;
  • Task health agencies (rather than legislatures, the public, or others) with regulating marijuana and determining the eligible conditions for its use;
  • Provide education to prescribers and consumers about the risks associated with marijuana, including accidents, cognitive deficits, addiction, and psychosis, as well as on how to mitigate the risks of marijuana use and prevent and manage marijuana use disorder;
  • Ensure that the medicinal market is restricted to those with legitimate certifications from medical providers; and
  • Consistently and meaningfully enforce rules that prohibit dispensaries from marketing or selling the drug to those without a certification or to minors.