NEJM Interview: Rebecca Haffajee on the rescheduling of medical marijuana products and its potential effect on research.

In April 2026, the acting U.S. Attorney General took steps to reclassify a number of medical marijuana products under the Controlled Substances Act. But questions remain about the extent to which the rescheduling will increase much needed research on marijuana. I'm Stephen Morrissey, Managing Editor of the New England Journal of Medicine, and I'm talking with Rebecca Haffajee, a professor in the Department of Health Policy and Management at the Yale School of Public Health. Dr. Haffajee has co-authored a perspective article about marijuana rescheduling and clinical trials. Dr. Haffajee, before this announcement, how was medical marijuana classified, and what did that classification mean for research and for prescribing?

Yeah. So before this final rule, or some call it an order, medical marijuana was scheduled as a Schedule 1 substance under the Controlled Substances Act, along with all marijuana. That meant, under the categories for the Controlled Substances Act and its classification system, that the drug had a high potential for abuse and no accepted medical use in the U.S. That Schedule 1 designation for medical marijuana prior to the final rule meant a number of things. Many states had authorized the medical use of the drug, and so we had, I think, by many accounts, thirty-three thousand plus prescribers that were prescribing the drug despite its Schedule 1 status. But for research, this status had a number of consequences. It meant that researchers could not obtain a diverse and robust supply of the drug. Under an international treaty, the Drug Enforcement Administration had authorized only one supplier of the drug historically that, I think, improved the diversity and array and modes of administration of the drugs that it was supplying, particularly in recent years, but that still was limited. There was a rule change in 2020, a change in DEA policy that allowed them to authorize or register six additional companies to actually supply the drug. So that modestly improved the supply. But overall, that's very few suppliers that are supplying the drug and the types of the chemical compositions, the modes of administration that they could provide did not match what was on the consumer market and being sold within the states that allow medical marijuana to be sold.

And then what change did the Trump administration make in that policy, and what explanation did it give for making the change?

So the change that the Trump administration made was to reclassify medical marijuana and also future FDA-approved marijuana products to a Schedule 3 status. So they went from Schedule 1 to Schedule 3. Under Schedule 3, this classification suggests that there is a moderate to low potential for physical dependence of the drug and that there is some medical use for the drug. In making this final rule and rendering it, the Attorney General was acting upon an executive order that President Trump had issued in December of 2025. That executive order was directing the Attorney General to make this rescheduling change, and it cited the reason as an increase in medical marijuana research to better inform doctors and patients, the millions of Americans that are actually