- A White House directive is ordering federal authorities to speed up the reclassification of a form of cannabis as a less dangerous drug.
- The action may also establish a pilot program that allows Medicare recipients to be reimbursed for some cannabis-related products.
- Experts say the reclassification should also improve scientific research on the cannabis plant.
Older adults who are covered under Medicare may be among the first people to see benefits from a White House directive to speed up the reclassification of a form of cannabis under federal law.
Last week, President Donald Trump issued an executive order directing Justice Department officials to quicken the approval process to change marijuana, a form of cannabis, from a Schedule I drug to a Schedule III drug.
As a Schedule I drug, cannabis is officially considered a substance with “no currently accepted medical use and a high potential for abuse.” Other Schedule I substances include heroin, LSD, and MDMA.
Experts say that even if this schedule change takes place in the near future, it will likely be subject to legal challenges, judicial review, and a lengthy implementation period that could span years.
“The process is not designed to be expeditious,” said Paul Armentano, the deputy director for the National Organization for the Reform of Marijuana Laws (NORML).
However, there is one aspect of the proposed changes that could provide some financial relief for adults 65 years and older who use cannabis-based products.
The executive order that could benefit adults 65 years and older as early as April.
This would allow older adults on Medicare to be given medical marijuana if deemed necessary and recommended by a medical doctor. It would also allow qualifying Medicare recipients to be reimbursed by Medicare for up to $500 per year for qualifying cannabinoid (CBD)-based products. This program could start as early as April 1.
The reimbursements may not be available under Medicare Advantage (Part C) plans. You should check with your specific insurance provider for more information.
The financial relief could be a boon as cannabis-based products are becoming more popular among older adults. A 2024 study stated that 14% of people 65 years and older reported using a CBD product in the prior year.
Sherry Yafai, MD, an emergency medicine physician and founder and medical director of The RELEAF Institute in Los Angeles, said the reimbursements would be highly beneficial for this older portion of the U.S. population.
“Seniors who are most often impacted by pain, sleep disturbances, and chronic illness will now have a cost-effective option to treat these issues. Up until now, these options have been expensive and out of pocket,” she told Healthline.
Armentano noted that there are many details that still need to be worked out regarding this reimbursement program.
“The federal government is going to have to offer a few more specifics on what products are eligible,” he told Healthline.
Yafai added that older adults will need to be careful about using CBD products while they are taking other medications.
“Seniors are often on multiple prescription medications that can interact with cannabis medications,” she said. “They often require physician counseling on dose, mode of administration, and potentially lowering of other medications.”
The Stanford scientists pointed out that marijuana in the 1970s contained between 1% and 4% tetrahydrocannabinol, or THC, the psychoactive component of the plant. That figure today is now around 20% with some cannabis flowers containing up to 35% THC.
Other formulations, such as concentrates, oils, or edibles, can have concentrations up to 90%, the scientists reported.
They said these higher THC concentrations can increase the risk of accidental over-consumption by older adults.
In addition, the scientists stated that past research has indicated that there may be a link between cannabis use and some forms of heart disease, a high risk factor for older adults.
Nonetheless, the Stanford medical professionals said there is some anecdotal evidence that cannabis can be effective in helping ease chronic pain.
“THC has gotten a bad rap over the years, but in very small doses it can be therapeutic,” wrote Eloise Theisen, MSN, a nurse practitioner at Stanford Medicine. “There’s also a lot of stigma around its effects of euphoria. In our patients who may have months to a few years to live, still being able to experience joy is really important.”
Armentano said switching cannabis from a Schedule I to a Schedule III drug won’t produce significant changes for most people who use the drug.
Medical marijuana is now legal in 40 states, 24 of which have also approved cannabis for recreational use. It is also legal medically in the District of Columbia and 3 territories. You can check the current law in your area on the NCSL website.
However, it is still illegal under federal law. Armentano said that means that technically, federal agents can arrest a person for possessing or using cannabis, even in states where it’s legal.
He notes the conflict between federal and state laws will remain even if cannabis is reclassified as a Schedule III drug.
Even under a reclassification, doctors cannot prescribe medical marijuana, although they can recommend it in states where it’s legal.
Armentano said the scheduling reclassification could have minor impacts. For example, people in federal housing would no longer be subject to eviction for possession of cannabis. It would no longer be illegal for a person who possesses cannabis to own a firearm. It would also give medical personnel at the Veterans Administration more flexibility in recommending cannabis.
“Over time, we could see a lot of changes on the margins,” he said.
Armentano noted that with a classification change, companies that produce cannabis products and services would be able to take advantage of tax breaks. They’d also be able to receive funding from investment firms as well as do business with banks, which are currently prohibited under federal law from dealing with cannabis-related firms.
“It will level the playing field a bit,” he said.
These changes, he added, could lower the price as well as the availability of cannabis products.
Yafai said there are still a number of other issues that need to be ironed out. Among them:
- How will the reclassification actually be implemented?
- Will pharmacies be required to dispense cannabis, or will distribution remain in the hands of dispensaries?
- Will age limits be better enforced?
- Will there be limitations placed on how much THC will be in products?
- Will there be any uniformity among states with the reclassification?
Yafai added that there will be opposition, including potential objections from pharmaceutical companies as well as the alcohol and tobacco industries.
Indeed, criticism has already been leveled at the president’s executive order.
The non-profit organization Smart Approaches to Marijuana issued a statement, calling the reclassification a “public health disaster.”
Keith Humphreys, PhD, a professor of health policy at Stanford University in California, issued a number of objections to the reclassification.
“The declassification shows the impact of the campaign donations and lobbying by industry, which succeeded in giving them a rescheduling that produces an enormous tax break for them,” Humphreys told Healthline.
“The public should expect increased marketing of marijuana, which the public will now subsidize through the tax system,” he added.
Armentano said the public’s opinion may indeed shift now that a Republican-led White House has proclaimed that marijuana should no longer be classified as a highly dangerous drug.
“I do think it changes the conversation. I do think that is significant,” he said. “It’s a significant reversal of the federal government’s position.”
Yafai said she is looking forward to a new era for cannabis use.
“I look forward to the medical ‘perks,’ including easier access to research, potential medical coverage from insurance companies, increased usage from physicians, and potential increase [in] education across the U.S.,” she said.
There’s no shortage of research on cannabis.
The conclusions have been varied.
Armentano points out that all this research has been hampered by cannabis’s classification as a Schedule I drug.
The classification means researchers are limited in providing cannabis to study participants in a controlled environment. So, most research has been observational, with scientists only able to analyze data from people who use cannabis on their own.
Under the reclassification, researchers should be able to conduct double-blind clinical trials.
In addition, the reclassification will allow scientists to use cannabis dispensed by state-approved facilities as opposed to a federal supply that may not be similar to what most people use.
Yafai said these changes should result in better research.
“Researchers will be able to more rapidly access cannabis for studies,” she said. “There will be more funding for research as well. Lastly, this would allow researchers to potentially use cannabis that is available locally as opposed to research-only grade cannabis, giving research more real-world outcomes. Ultimately, this will give us faster and more access to high quality medical research on cannabis.”
