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DEA could reclassify marijuana to a less restrictive category – a drug policy expert weighs the pros and cons

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theconversation.com – Chris Meyers, Adjunct Professor of Philosophy, George Washington University – 2024-10-09 07:20:00

The move would not make marijuana legal at the federal level for recreational use and would require dispensaries to comply with medical marijuana requirements.

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Chris Meyers, George Washington University

The Drug Enforcement Administration announced in early 2024 that it would act on President Joe Biden’s call to reclassify marijuana, moving it from the tightly controlled Schedule I category that it has been in since 1970 to the less restrictive Schedule III status of the Controlled Substances Act. That triggered a long process of hearings and reviews that will not be completed until after the presidential election in November.

The news drew strong reactions from critics: 25 Republican lawmakers sent a letter to Attorney General Merrick Garland protesting any changes to federal marijuana laws. They argued that the decision “was not properly researched … and is merely responding to the popularity of marijuana and not the actual science.”

As a philosopher and drug policy expert, I focus on assessing arguments and evidence rather than politics or rhetoric. So, what are the arguments for and against rescheduling cannabis?

Scheduling under the Controlled Substances Act

The Controlled Substances Act places each prohibited drug into one of five schedules based on known medical use, addictive potential and safety. Schedule I drugs – which, along with marijuana, also includes heroin, LSD, psilocybin, ecstasy (MDMA) and quaaludes – is the most restrictive category.

Schedule I substances cannot be legally used for any purpose, including medical use or research, though an exception for research can be made with special permission from the DEA. The criteria for inclusion in the Schedule I category is that the substance has a high potential for abuse, is extremely addictive and has “no currently accepted medical use.”

Schedule II, which is slightly less restrictive than Schedule I, includes drugs that are addictive and potentially unsafe but also have some accepted medical use. These include strong opioids such as fentanyl, as well as cocaine, PCP and methamphetamine. Though they are still tightly regulated, Schedule II drugs can be used medically with a prescription or administered by a licensed physician.

Schedule III is much less restrictive and is intended for substances with legitimate medical use and only moderate risk of abuse or dependency. This category includes low-dose morphine, anabolic steroids and ketamine.

Schedule IV – which includes the sedative valium, the weak opioid tramadol and sleep medicines such as Ambien – is even less restrictive.

The least restrictive category is Schedule V, which includes cough syrups with codeine and calcium channel blockers such as gabapentin and pregabalin. All scheduled drugs require a doctor’s prescription and can be distributed only by licensed pharmacies.

What rescheduling would mean for marijuana

The push to reschedule is largely to make federal laws consistent with state medical marijuana programs that – as of October 2024 – are legal in 38 states plus the District of Columbia.

Moving marijuana to Schedule III would not change its legal status in states where it is banned. It would make marijuana legal at the federal level but only for medical use. Recreational use would still be federally prohibited, even though it is currently legal in 24 states plus Washington.

Rescheduling, however, might not make medical marijuana any easier for patients to access and could even make it much harder for some. Currently, getting a medical marijuana card is quite easy in most states. In Washington D.C., where I live, patients can self-certify.

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Reclassifying marijuana as a Schedule III drug would legitimize its medical use.

If marijuana is reclassified as Schedule III, medical marijuana programs will have to start requiring a doctor’s prescription, just like with all other scheduled substances. And it could be distributed only by licensed pharmacies, which would put medical dispensaries that are now selling it without a license from the Food and Drug Administration out of business.

Rescheduling, however, would give medical marijuana legitimacy as a bona fide medicine. And the intent of the move is to increase access, even if it is unclear how rescheduling would achieve that.

So, assuming that rescheduling would have the intended effect of expanding access to medical marijuana, should it be rescheduled?

Medical uses of marijuana

Though there are three criteria for Schedule I in the Controlled Substances Act, the DEA in fact relies on only the medical use criterion. This was the basis of the DEA’s proposal to reschedule marijuana. The fact that almost 75% of Americans live in a state with a medical marijuana program suggests that marijuana has an accepted medical use.

More importantly, Schedule III of the Controlled Substances Act already includes dronabinol, which is delta-9 THC, the active ingredient in marijuana. Although dronabinol is synthesized in the lab rather than extracted from the cannabis plant, it is the exact same molecule. The FDA approved THC in the form of dronabinol in 1985 for treating anorexia caused by HIV/AIDS as well as nausea and vomiting due to chemotherapy. Placing marijuana in the same schedule as its primary active ingredient makes a lot of sense.

Another argument in favor of rescheduling is that it would open up new opportunities for medical research into marijuana’s effects, research that is currently hampered by its Schedule I status. This work is critical because the system of cannabinoid receptors through which marijuana causes its therapeutic and psychoactive effects is crucial for almost every aspect of human functioning.

Research has shown that cannabis is effective not only in treating nausea and AIDS but also chronic pain and some symptoms of multiple sclerosis.

There is also good evidence that marijuana can help treat other conditions, including Lou Gehrig’s disease (amyotrophic lateral sclerosis, or ALS), glaucoma, irritable bowel syndrome, insomnia, migraine, post-traumatic stress disorder and Tourette syndrome. Keeping marijuana in the Schedule I category severely hampers research that might establish more effective treatments for these conditions.

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Researchers have been extremely limited in their abilities to study marijuana because of its Schedule I classification.

Balancing risks and benefits

Those opposed to rescheduling cite possible health risks associated with marijuana consumption. Heavy use is linked to an increased risk of developing schizophrenia. However, the increased risk of schizophrenia from cannabis use is comparable to that caused by watching excessive television, eating junk food or smoking cigarettes.

Long-term marijuana use can also lead to sleep problems and diminished visuospatial memory. It can also cause gastrointestinal trouble, such as cannabis hyperemesis syndrome, which is characterized by nausea, vomiting and abdominal pain. The symptoms, while extremely unpleasant, are temporary and occur only after consuming marijuana. The condition disappears in people who stop using.

Marijuana use can also be addictive. According to the Centers for Disease Control and Prevention, about three out of every 10 regular marijuana users meet the diagnostic criteria for cannabis use disorder.

All of the concerns above are legitimate, though it is worth noting that virtually no effective medicine is free from undesirable side effects. And although marijuana can be habit-forming, it is not as addictive as alcohol, tobacco, oxycodone, cocaine, methamphetamine or benzodiazepines. None of those other drugs are categorized as Schedule I, and alcohol and tobacco are not scheduled at all.

Unlike most other prescription medications, marijuana use is associated with many benefits. For example, in states where marijuana has been legalized, worker’s compensation payments have fallen by an average of 21% among people over 40. Researchers think that this is because marijuana helps workers better manage chronic pain. The use of marijuana for pain management also helps to reduce dependency on opioids. One study found that U.S. counties with one or two marijuana dispensaries had an average of 17% fewer opioid-related fatalities compared with counties with no dispensaries.

Research also shows that marijuana use can help to prevent Alzheimer’s by blocking the enzymes that produce amyloid plaques. It also shows promise for reducing a person’s risk of developing Type 2 diabetes by helping the body regulate insulin and glucose levels.

All of these benefits add up to marijuana users having an overall lower rate of premature death than nonusers.The Conversation

Chris Meyers, Adjunct Professor of Philosophy, George Washington University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Measles can ravage the immune system and brain, causing long-term damage – a virologist explains

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theconversation.com – Peter Kasson, Professor of Chemistry and Biomedical Engineering, Georgia Institute of Technology – 2025-03-31 07:16:00

Measles infections send 1 in 5 people to the hospital.
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Peter Kasson, Georgia Institute of Technology

The measles outbreak that began in west Texas in late January 2025 continues to grow, with 400 confirmed cases in Texas and more than 50 in New Mexico and Oklahoma as of March 28.

Public health experts believe the numbers are much higher, however, and some worry about a bigger resurgence of the disease in the U.S. In the past two weeks, health officials have identified potential measles exposures in association with planes, trains and automobiles, including at Washington Dulles International Airport and on an Amtrak train from New York City to Washington, D.C. – as well as at health care facilities where the infected people sought medical attention.

Measles infections can be extremely serious. So far in 2025, 14% of the people who got measles had to be hospitalized. Last year, that number was 40%. Measles can damage the lungs and immune system, and also inflict permanent brain damage. Three in 1,000 people who get the disease die. But because measles vaccination programs in the U.S. over the past 60 years have been highly successful, few Americans under 50 have experienced measles directly, making it easy to think of the infection as a mere childhood rash with fever.

As a biologist who studies how viruses infect and kill cells and tissues, I believe it is important for people to understand how dangerous a measles infection can be.

Underappreciated acute effects

Measles is one of the most contagious diseases on the planet. One person who has it will infect nine out of 10 people nearby if those people are unvaccinated. A two-dose regimen of the vaccine, however, is 97% effective at preventing measles.

When the measles virus infects a person, it binds to specific proteins on the surface of cells. It then inserts its genome and replicates, destroying the cells in the process. This first happens in the upper respiratory tract and the lungs, where the virus can damage the person’s ability to breathe well. In both places, the virus also infects immune cells that carry it to the lymph nodes, and from there, throughout the body.

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Measles can wipe out immune cells’ ability to recognize pathogens.

What generally lands people with measles in the hospital is the disease’s effects on the lungs. As the virus destroys lung cells, patients can develop viral pneumonia, which is characterized by severe coughing and difficulty breathing. Measles pneumonia afflicts about 1 in 20 children who get measles and is the most common cause of death from measles in young children.

The virus can directly invade the nervous system and also damage it by causing inflammation. Measles can cause acute brain damage in two different ways: a direct infection of the brain that occurs in roughly 1 in 1,000 people, or inflammation of the brain two to 30 days after infection that occurs with the same frequency. Children who survive these events can have permanent brain damage and impairments such as blindness and hearing loss.

Yearslong consequences of infection

An especially alarming but still poorly understood effect of measles infection is that it can reduce the immune system’s ability to recognize pathogens it has previously encountered. Researchers had long suspected that children who get the measles vaccine also tend to have better immunity to other diseases, but they were not sure why. A study published in 2019 found that having a measles infection destroyed between 11% and 75% of their antibodies, leaving them vulnerable to many of the infections to which they previously had immunity. This effect, called immune amnesia, lasts until people are reinfected or revaccinated against each disease their immune system forgot.

Occasionally, the virus can lie undetected in the brain of a person who recovered from measles and reactivate typically seven to 10 years later. This condition, called subacute sclerosing panencephalitis, is a progressive dementia that is almost always fatal. It occurs in about 1 in 25,000 people who get measles but is about five times more common in babies infected with measles before age 1.

Researchers long thought that such infections were caused by a special strain of measles, but more recent research suggests that the measles virus can acquire mutations that enable it to infect the brain during the course of the original infection.

There is still much to learn about the measles virus. For example, researchers are exploring antibody therapies to treat severe measles. However, even if such treatments work, the best way to prevent the serious effects of measles is to avoid infection by getting vaccinated.The Conversation

Peter Kasson, Professor of Chemistry and Biomedical Engineering, Georgia Institute of Technology

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Supreme Court considers whether states may prevent people covered by Medicaid from choosing Planned Parenthood as their health care provider

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theconversation.com – Naomi Cahn, Professor of Law, University of Virginia – 2025-04-02 17:04:00

Planned Parenthood clinics, like this one in Los Angeles, are located across the United States.
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Naomi Cahn, University of Virginia and Sonia Suter, George Washington University

Having the freedom to choose your own health care provider is something many Americans take for granted. But the Supreme Court is weighing whether people who rely on Medicaid for their health insurance have that right, and if they do – is it enforceable by law?

That’s the key question at the heart of a case, Medina v. Planned Parenthood South Atlantic, that began during President Donald Trump’s first term in office.

“There’s a right, and the right is the right to choose your doctor,” said Justice Elena Kagan on April 2, 2025, during oral arguments on the case. John J. Bursch, the Alliance Defending Freedom lawyer who is representing South Carolina Director of Health and Human Services Eunice Medina, countered that none of the words in the underlying statute had what he called a “rights-creating pedigree.”

As law professors who teach courses about health and poverty law as well as reproductive justice, we think this case could affect access to health care for 72 million Americans, including low-income people and their children and people with disabilities.

Excluding Planned Parenthood

The case started with Julie Edwards, who is enrolled in Medicaid and lives in South Carolina. After she struggled to get contraceptive services, she was able to receive care from a Planned Parenthood South Atlantic clinic in Columbia, South Carolina.

Planned Parenthood, an array of nonprofits with roots that date back more than a century, is among the nation’s top providers of reproductive services. It operates two clinics in South Carolina, where Medicaid patients can get physical exams, cancer screenings, contraception and other services. It also provides same-day appointments and keeps long hours.

In July 2018, however, South Carolina Gov. Henry McMaster issued an executive order that barred health care providers in South Carolina that offer abortions from reimbursement through Medicaid.

That meant Planned Parenthood, a longtime target of conservatives’ ire, would no longer be reimbursed for any type of care for Medicaid patients, preventing Edwards from transferring all her gynecological care to that office as she had hoped to do.

Planned Parenthood and Edwards sued South Carolina, claiming that the state was violating the federal Medicare and Medicaid Act, which Congress passed in 1965, by not letting Edwards obtain care from the provider of her choice.

A ‘free-choice-of-provider’ requirement

Medicaid operates as a partnership between the federal government and the states. Congress passed the law that led to its creation based on its power under the Constitution’s spending clause, which allows Congress to subject federal funds to certain requirements.

Two years later, due to concerns that states were restricting which providers Medicaid recipients could choose, Congress added a “free-choice-of-provider” requirement to the program. It states that people enrolled in Medicaid “may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service or services required.”

This provision is at the core of this case. At issue is whether a civil rights statute provides a right for Medicaid beneficiaries to sue a state when their federal rights have been violated. Known as Section 1983, it was enacted in 1871.

Bursch, backed by the Trump administration, argued before the court that the absence of words like “right” in the Medicaid provision that requires states to provide a free choice of provider means that neither Edwards nor Planned Parenthood has the authority to file a lawsuit to enforce this aspect of the Medicaid statute.

Nicole A. Saharsky, Planned Parenthood’s lawyer, argued that the creation of a right shouldn’t depend on “some kind of magic words test.” Instead, she said it was clear that the Medicaid statute created “a right to choose their own doctor” because “it’s mandatory” that the state provide this option to everyone with health insurance through Medicaid.

She also emphasized that Congress wanted to protect “an intensely personal right” to be able “to choose your doctor, the person that you see when you’re at your most vulnerable, facing … some of the most significant … challenges to your life and your health.”

Restricting Medicaid funds

Through a federal law known as the Hyde Amendment, Medicaid cannot reimburse health care providers for the cost of abortions, with a few exceptions: when a patient’s life is at risk or her pregnancy is due to rape or incest. Some states do cover abortion when their laws allow it, without using any federal funds.

Therefore, Planned Parenthood only gets federal Medicaid funds for abortions in those limited circumstances.

McMaster explained that he removed “abortion clinics,” including Planned Parenthood, from the South Carolina Medicaid Program because he didn’t want state funds to indirectly subsidize abortions.

South Carolina “decided that Planned Parenthood was unqualified for many reasons, chiefly because they’re the nation’s largest abortion provider,” Bursch told the Supreme Court.

But only 3% of Planned Parenthood’s services nationwide last year were related to abortion. Its most common service is testing for sexually transmitted diseases. Across the nation, Planned Parenthood provides health care to more than 2 million patients per year, most of whom have low incomes.

Man with gray hair in a suit and red tie speaks at a podium.
South Carolina Gov. Henry McMaster speaks to a crowd during an election night party on Nov. 3, 2020, in Columbia.
Photo by Sean Rayford/Getty Images

Section 1983

Because the Medicaid statute itself does not allow an individual to sue, Edwards and Planned Parenthood are relying on Section 1983.

Lower courts have repeatedly upheld that the Medicaid statute provides Edwards with the right to obtain Medicaid-funded health care at her local Planned Parenthood clinic.

And the Supreme Court has long recognized that Section 1983 protects an individual’s ability to sue when their rights under a federal statute have been violated.

In 2023, for example, the court found such a right under the Medicaid Nursing Home Reform Act. The court held that Section 1983 confers the right to sue when a statute’s provisions “unambiguously confer individual federal rights.”

Consequences beyond South Carolina

The court’s decision in the Medina case on whether Medicaid patients can choose their own health care provider could have consequences far beyond South Carolina. Arkansas, Missouri and Texas have already barred Planned Parenthood from getting reimbursed by Medicaid for any kind of health care. More states could follow suit.

In addition, given Planned Parenthood’s role in providing expansive contraceptive care, disqualifying it from Medicaid could harm access to health care and increase the already-high unintended pregnancy rate in America.

The ramifications, likewise, could extend beyond the finances of Planned Parenthood.

If the court rules in South Carolina’s favor, states could also try to exclude providers based on other characteristics, such as whether their employees belong to unions or if they provide their patients with gender-affirming care, further restricting patients’ choices.

Or, as Kagan observed, states could go the opposite direction and exclude providers that don’t provide abortions and so forth. What’s really at stake, she said, is whether a patient is “entitled to see” the provider they choose regardless of what their state happens to “think about contraception or abortion or gender transition treatment.”

If the Supreme Court rules that Edwards does have a right to get health care at a Planned Parenthood clinic, the controversy would not be over. The lower courts would then have to decide whether South Carolina appropriately removed Planned Parenthood from Medicaid as an “unqualified provider.”

And if the Supreme Court rules in favor of South Carolina, then Planned Parenthood could still sue South Carolina over its decision to find them to be unqualified.The Conversation

Naomi Cahn, Professor of Law, University of Virginia and Sonia Suter, Professor of Law, George Washington University

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Feeling FOMO for something that’s not even fun? It’s not the event you’re missing, it’s the bonding

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theconversation.com – Jacqueline Rifkin, Assistant Professor of Marketing, Cornell University – 2025-04-02 07:48:00

They had so much fun without me.
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Jacqueline Rifkin, Cornell University; Barbara Kahn, University of Pennsylvania, and Cindy Chan, University of Toronto

Imagine you’ve planned the trip of a lifetime for your animal-loving family: a cruise to Antarctica with the unique opportunity to view penguins, whales and other rare wildlife. Your adventure-loving kids can kayak through fjords, plunge into icy water and camp under the Antarctic sky.

But rather than being ecstatic, as you anticipated, your kids whine about skipping an after-school scout meeting at a neighbor’s house. Missing this ordinary weekly event triggers such intense FOMO – “fear of missing out” – for them that they don’t want to go on your amazing expedition.

If this kind of debacle sounds familiar to you – or at least if you find it perplexing – you’re not alone. The three of us are marketing professors and social psychologists who focus on how consumers make decisions and how this shapes well-being. We’ve been studying FOMO for over a decade and recently published our work in the Journal of Personality and Social Psychology. Over the years, we’ve learned what really drives intense feelings of FOMO – which explains why a run-of-the-mill meeting might feel more crucial than an over-the-top vacation.

FOMO’s real trigger

People use the term FOMO in many different ways. In our research, we focus on a very specific type of FOMO: the kind that occurs when people miss out on events that involve valued social connections.

With this kind of FOMO, we found that the pain of missing out is not related to missing the actual event or opportunity – although that could be there as well. The FOMO we study happens when people miss the chance to bond with friends, co-workers or teammates they care about.

So, the critical part of FOMO is missing out on interactions with people you value. FOMO about a group dinner at a restaurant isn’t really about the food and great lighting. Nor is FOMO about a concert just about the band’s performance. Instead, it’s about the lost opportunity to connect and make memories with people who are important to you.

Why is this upsetting? Imagine the scenario where all your best friends go out to dinner without you. They bond and make lasting memories with each other – and you’re not there for any of it.

If they get closer to each other, where does that leave you? What happens to your social relationships and your sense of belonging? Do you become a less important friend? Less worthy of future invites? Or even kicked out of the group altogether? The anxiety of FOMO can begin to spiral.

People with what psychologists call an anxious attachment style chronically fear rejection and isolation from others. Because FOMO involves anxiety about future social belonging, it may not come as a surprise that people who are naturally more anxious about their friendships tend to get more intense FOMO. When we asked people in one of our studies to scroll social media until they encountered something social they missed, we found that the more anxiously attached a participant was, the more intense FOMO they experienced.

cheerful group laughing together around an outdoor dining table
They’ll always remember that summer cookout – and you weren’t there.
Maskot/DigitalVision via Getty Images

Not just missing Coachella

Getting FOMO for an amazing event you can’t attend makes sense. But if FOMO is less about the event itself and more about the social bonding, what happens when you miss something that’s not really fun at all?

We find that people anticipate FOMO even for unenjoyable missed events. As long as there is some form of missed social bonding, feelings of FOMO emerge. One of our studies found that people anticipated more FOMO from missing an un-fun event that their friends would be at, than a fun event without their friends.

For better or for worse, sad and stressful events can often be emotionally bonding: Going to a funeral to support a friend, cleaning up the mess after a party, or even white-knuckling through a harrowing initiation ceremony can all offer opportunities to forge stronger connections with one another. Stressful contexts like these can be fertile grounds for FOMO.

How to fend off FOMO

Popular discussions about the negative consequences of FOMO tend to focus on the FOMO people feel from compulsively scrolling on social media and seeing what they missed out on. Consequently, much of the suggested advice on how to mitigate FOMO centers on turning off phones or taking a vacation from social media.

Those recommendations may be tough for many people to execute. Plus, they address the symptoms of FOMO, not the cause.

Our finding that the core of FOMO is anxiety about missed social relationships yields a simpler strategy to combat it: Reminding yourself of the last time you connected with close friends may provide a sense of security that staves off feelings of FOMO.

In an experiment testing multiple interventions, we asked 788 study participants to look through their social media feeds until they encountered a post of a missed social event. We asked about 200 of these participants to immediately rate how much FOMO they were feeling. They averaged a 3.2 on a 1-to-7 scale.

Another group of about 200 participants also scrolled through their social media feeds until they encountered a post of a missed social event. But before indicating how much FOMO they were feeling, we asked them to think back to a prior experience socializing and bonding with their friends. Encouragingly, this reflection exercise seemed to curtail FOMO. Their average FOMO rating was 2.7 out of 7, a significant drop.

group of older women on a neighborhood walk with a leashed dog
Reminding yourself about other good times with your pals can help keep FOMO at bay.
AJ_Watt/E+ via Getty Images

With the remaining participants, we tested other strategies for mitigating FOMO – thinking about the next time they might see their friends or imagining what they’d say to a FOMO-suffering friend – but the simple reflection exercise was by far the most promising.

So, reminding yourself of the meaningful relationships you already have and reaffirming your social belonging in the moment may help combat the rush of anxiety that is characteristic of FOMO.

And missing out on social bonding experiences doesn’t have to be anxiety-provoking. In fact, in our activity-packed, hectic lives, missing some “must-attend” events may be a welcome relief – especially if you remind yourself that your social belonging is not in jeopardy. Cue a recent wave of counter-FOMO programming called JOMO, or “Joy of Missing Out.”

To quote Stuart Smalley, the fictional self-help guru of 1990s “Saturday Night Live,” reminding yourself that “I’m good enough, I’m smart enough, and doggone it, people like me!” might be just the trick to mitigate FOMO.The Conversation

Jacqueline Rifkin, Assistant Professor of Marketing, Cornell University; Barbara Kahn, Patty and Jay H. Baker Professor of Marketing, University of Pennsylvania, and Cindy Chan, Assistant Professor of Marketing, University of Toronto

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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