WHO recommends rescheduling cannabis and descheduling pure CBD – reaction

Politics

The World Health Organization’s Expert Committee on Drug Dependence (ECDD) has told the United Nations Commission on Narcotic Drugs (CND) that cannabis and cannabis resin should be removed from Schedule IV of the 1961 Convention, the category reserved for the most dangerous substances. 

In 1954 the WHO started an initiative to eradicate cannabis from the global medicine cabinet but things have finally taken a turn for the better.

The recommendations also said that THC in all forms should be removed from the 1971 Convention and placed with cannabis in Schedule I of the 1961 Convention, significantly simplifying cannabis classification.

Furthermore, it said pure CBD and CBD preparations containing no more than 0.2% THC should not be included in any way in the international drug control conventions.

It added that pharmaceutical preparations containing D9-THC, if they follow certain criteria, should be added to Schedule III of the 1961 Convention, recognising the unlikelihood of abuse.

The recommendations are nonbinding and must be voted on by the 53 member countries of the CND. The recommendations were originally supposed to be heard in December, which would have meant a vote in March. However, the delay may push that decision into 2020 to provide additional time for member states to review the recommendations.

UKCSC chairman Greg de Hoedt commented: “Although the suggestions by WHO represent relative progress and recognise that cannabis has medicinal value by moving it out of schedule IV, placing it in schedule I would still not allow recreational use, and would therefore continue to prohibit people the right to grow, including for patients who cannot afford to pay to the high costs pharmaceutical corporations charge for cannabis medicine. This would also restrict business opportunities for non-pharmaceuticals. Even if these suggestions are taken up, the legalisation movement will have to put pressure on politicians to act where scientists feel unable to.”

On its recommendation to reschedule cannabis and cannabis resin, the ECDD said: “The evidence presented to the Committee did not indicate that cannabis plant and cannabis resin were particularly liable to produce ill-effects similar to the effects of the other substances in Schedule IV.

“In addition, preparations of cannabis have shown therapeutic potential for treatment of pain and other medical conditions such as epilepsy and spasticity associated with 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.”

The report also recommends that extracts and tinctures of cannabis be deleted from schedule I  because they encompass “diverse preparations with a variable concentration of delta-9 THC”, some being non-psychoactive and with “promising therapeutic applications”.

On THC, the ECDD said the dangers associated with it are similar to those of cannabis and cannabis resin, so it would be consistent to have them all together in the same category. The report compares the reclassification to cocaine being in the same category as the coca leaf and morphine in the same category as opium.

“Due to the chemical similarity of each of the six isomers to delta-9-THC, it is very difficult to differentiate any of these six isomers from delta-9-THC using standard methods of chemical analysis,” the report said.

It was noted that there are currently two main types of medications containing delta-9-THC:

  • preparations that contains both delta-9-THC and CBD, such as Sativex.
  • preparations that contain only delta-9-THC as the active compound, such as Marinol or Syndros/Nabilone.

Because “the evidence concerning the use of these delta-9-THC-containing medicines is that they are not associated with problems of abuse and dependence and they are not diverted for the purpose of non-medical use”, and “in order not to impede access to these medicines” the committee recommended not to include these medicines in the restrictive categories schedule I or II.

Instead, the less restrictive schedule III was recommended: “The Committee recommended that preparations containing delta-9-tetrahydrocannabinol (dronabinol), produced either by chemical synthesis or as a preparation of cannabis, that are compounded as pharmaceutical preparations with one or more other ingredients and in such a way that delta-9-tetrahydrocannabinol (dronabinol) cannot be recovered by readily available means or in a yield which would constitute a risk to public health, be added to schedule III.”

Martin Jelsma of the Transnational Institute told mjbizdaily.com that he worries about possible implications for medicinal preparations.

“On the one hand, the WHO notes that ‘preparations’ (defined as mixtures containing a scheduled substance) on the basis of treaty article 2.3, are subject to the same measures of control as the drugs which they contain, except for specific exemptions made for preparations under schedule III,” he said.

But the WHO also recommends an exemption for THC as a component of a pharmaceutical preparation that “cannot be recovered by readily available means”.

“It appears that the WHO attempts to introduce a somewhat arbitrary and ill-defined distinction between products like Sativex and Marinol (which are specifically mentioned as examples) and other types of medicinal cannabis preparations,” Jelsma said.

Such an exemption could “favour specific products of the pharmaceutical industry over more natural oils/extracts without a clear rationale”.

Dr Melissa Bone, lecturer at Leicester University, told UKCSC: “I imagine flowers will fall under ‘cannabis and cannabis resin’ but having them taken out of schedule IV is still a major step forward.

“Article 2(5) single convention means that any drug in schedule IV could only be legal for scientific or medical research so it was a mission to produce, manufacture, possess etc cannabis and toe the line with the conventions – the International Narcotics Control Board (INCB) which basically oversees how the treaties are implemented had loads of political influence and for a long time had a punitive stance and prevented the WHO from rescheduling, but now that the WHO finally has, the INCB has to tow the line and has to administer an estimates system to estimate the amount of a drug a country needs; and cannabis will fall in line with that now I think.

“This is much more on a medical level in terms of falling in line with the international treaties. If we were to adhere to the international treaties then the most they allow for regarding non-medical use of cannabis is possession-only, certainly not production, trade etc – Canada is basically breaking international law right now!

“But the treaties do allow medical use and because of this scheduling it has potentially just become a whole lot easier for medical regulations regarding cannabis.”

Melissa also said that neurologists’ fears over prescribing THC could also be tempered. “In terms of what this could do for the medical profession’s view of cannabis, it should really help to start making a difference on a global scale.”

Transform’s Steve Rolles said on Twitter that he suspected political interference with the report had taken place, which would explain the initial delay.

“The really weird thing about the recommendation to keep cannabis in schedule 1 is that they actually acknowledge it is bullshit in the actual recommendation,” he said. “Crucially ECDD state they “did not consider that cannabis is associated with the same level of risk to health of most of the other drugs that have been placed in schedule I” – in other words, on the objective risk assessment they are tasked to do, it shouldn’t be in schedule I.

“The reason they give for leaving it there was because they ‘noted the high rates of public health problems arising from cannabis use and the global extent of such problems’. This reasoning doesn’t make sense. The risks of ‘health problems’ are part of the risk assessment which they note – in the previous sentence – do not put cannabis at the ‘same level of risk to health’.

“The ‘global extent of the problem’ – ie lots of people use cannabis – is not a reason to ignore their risk assessment and mis-schedule it It is anti science. It almost feels like there has been political interference.

“It wouldn’t be the first time bigger political agendas impinged on nominally independent UN agency decision making. Cast your mind back to the WHO report on cocaine that the US insisted (under threat of withdrawing WHO funding) be suppressed. Or the retraction of the UNODC position statement advocating decriminalisation.

“Why was the announcement of the ECDD findings on cannabis rescheduling unceremoniously delayed at the last minute? The reasons given for the delay were never very convincing – that they needed more time. Or as the UN rumour mill (and I concede it is just that) suggested – WHO top brass were taking heat from some member states unhappy with a call for rescheduling down from I.

“Obviously this is just speculation – but it seem plausible; there’s a track record there’s motive (drug warrior Member states) there’s the delay and there’s the weirdness of the recommendation & reasoning – something the committee members must be frankly embarrassed by.”

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