WHO Recommends Rescheduling Cannabis in International Law for First Time in History

The World Health Organization (WHO) has suggested that cannabis should be "rescheduled" within international law given the mounting evidence showing that the drug can help with the treatment of several medical issues.

This marks a significant change in the position of the WHO, which for the last 60 years has held the view that cannabis should not be used in medicine, according to an article in the BMJ.

The WHO Expert Committee on Drug Dependence has now recommended that cannabis resin and other marijuana products should be removed from the Schedule IV category of the U.N. Single Convention on Narcotic Drugs of 1961—a landmark international treaty designed to restrict the production and supply of specific compounds.

All drugs in Schedule IV of the 1961 Convention—which are also included in Schedule I by default—are considered to have "particularly dangerous properties" which override any potential therapeutic benefits. As a result, they are the most strictly controlled, even for research purposes.

"Cannabis and cannabis resin are included in Schedule I and Schedule IV of the 1961 Single Convention on Narcotic Drugs," an extract from the committee's report reads. "Substances that are included in both these Schedules are particularly liable to abuse and to produce ill-effects and have little or no therapeutic use."

"Other substances that are included in both Schedules I and IV are fentanyl analogues, heroin and other opioids that are considered especially dangerous," the authors of the report wrote. "Use of all these substances is associated with a significant risk of death, whereas cannabis use is not associated with such risk. Based on the evidence presented to it, the Committee say that cannabis plant and cannabis resin are not liable to produce the same ill-effects as other substances in the Schedule IV category."

The fact that cannabis is in Schedule IV means that scientists who want to investigate the plant in the search for potential therapies face significant barriers. Research has shown that cannabis preparations can help with the treatment of pain and other medical conditions, such as epilepsy and symptoms of multiple sclerosis.

"In line with the above, cannabis and cannabis resin should be scheduled at a level of control that will prevent harm caused by cannabis use and at the same time will not act as a barrier to access and to research and development of cannabis-related preparation for medical use."

Despite this, the Committee argued that due to the "high rates of public health problems arising from cannabis use," it should continue to be included in Schedule I of the 1961 Convention, the second most restrictive category after Schedule IV.

The Committee also recommends that two compounds in cannabis, known as dronabinol and tetrahydrocannabinol—which are forms of THC, the main pyshcoactive ingredient—should be removed from a subsequent, supplementary U.N. treaty that covers a different set of drugs, the 1971 U.N. Convention on Psychotropic Substances, and placed in Schedule I of the 1961 Convention instead. The idea behind this proposal is to simplify the classification of THC and cannabis products.

Furthermore, the Committee proposes that products made with a cannabis extract known as cannabidiol, which contain no more than 0.2 percent THC, should be removed from all international drug control conventions.

"Cannabidiol is found in cannabis and cannabis resin but does not have psychoactive properties and has no potential for abuse and no potential to produce dependence," the proposals read. "It does not have significant ill-effects. Cannabidiol has been shown to be effective in the management of certain treatment-resistant, childhood-onset epilepsy disorders. It was approved for this use in the United States in 2018 and is currently under consideration for approval by the EU."

It is important to note that the way drugs are scheduled in the 1961 Convention differs slightly to U.S. domestic drug policy as outlined by the Controlled Substances Act—which has five categories ranging from Schedule I (most restrictive) to Schedule V (least restrictive)—as well as the 1971 Convention—which has four Schedules, ranging from Schedule I (most restrictive) to Schedule IV (least restrictive.) Domestic drug law in countries which have signed the U.N. Conventions must broadly comply with the international treaties, although national interprations may vary slightly.

According to Michael Krawitz, global policy adviser at the nonprofit advocacy organization FAAAT which campaigns for the medical use of the cannabis, the placement of the drug in the 1961 Convention was a "terrible injustice."

"The WHO has gone a long way towards setting the record straight," he said in comments provided to Newsweek. "It is time for us all to support the World Health Organization's recommendations and ensure politics don't trump science. Advocates thank the WHO Experts for their work, and WHO leadership for consistently defending the medical needs of our world."

According to the FAAAT, the latest news has significant implications for the future role of cannabis in the field of medicine.

Kenzi Riboulet-Zemouli, head of research at FAAAT, told Newsweek: "If this outcome is not the end of the road in the struggle for access and availability of cannabis-based medicines—and I hope that nobody expected that, as the mandate of WHO has always been known to be limited—it gives an important positive signal to countries."

He added: "If the recommendations of the WHO are adopted, it will substantially increase the normalization and development of access, availability, and quality of cannabis-based medicines in our health systems."

The Expert Committee makes decisions on the scheduling of substances based on their potential for harm, dependence and misuse, as well as their medical benefits. The WHO says that it has not reviewed cannabis since it was scheduled in 1961 because there was not sufficient scientific research into the health effects of the drug.

However, the organization said that in recent years this situation has changed, as have attitudes toward the drug. Cannabis and cannabis-related products have now been legalized for medical use in several countries around the world, while Canada, South Africa and Uruguay—as well as several U.S. states—permit its recreational use.

Ethan Russo of the International Cannabis and Cannabinoids Institute told Newsweek that the WHO's latest proposals were very significant given the organization's historical stance on cannabis.

"These recommendations are of monumental importance as they may lead to the overcoming of barriers to research, enhance access of patients to cannabis-based medicine, and allow free commerce of cannabis products internationally," he said.

Meanwhile, international drug policy expert Martin Jelsma from the Transnational Institute said this was the "first time in history" that the WHO had undertaken a proper critical review of cannabis and related substances.

Nevertheless, he said the committee's proposals don't go far enough, noting that its rationale for keeping cannabis in Schedule I is "highly questionable."

"The problem is that after the inclusion of cannabis in 1961 (without a proper WHO review), it became itself one of the standards for further scheduling decisions for Schedule I," he told Newsweek. "The first test the WHO must do in its review process is whether a substance has 'addiction-producing properties greater than those of codeine and more or less comparable to those of morphine' or has 'a liability to abuse comparable to that of cannabis, cannabis resin or cocaine.'

"Those are the basic criteria for scheduling decisions for Schedule I," he said. "Now one of the standards itself (cannabis) for the review process is being reviewed, that basic test needs to be done first with regard to similarity with the other standards, e.g., morphine or cocaine. The committee fails to do that which makes the recommendation to keep cannabis and resin in Schedule I very questionable on procedural grounds."

The U.N. Commission on Narcotic Drugs—which consists of 53 member nations—willl decide wether to vote on the new proposals this March or delay the vote till 2020, the BMJ reported.

This article was updated to include comments and information from the FAAAT.

A jar of Insane OG, a strain of marijuana, is displayed at the opening of "Dr. Greenthumb," the flagship medical and recreational marijuana dispensary opened today by B Real of Cypress Hill fame in Sylmar, California, on August 15, 2018. FREDERIC J. BROWN/AFP/Getty Images