Rescheduling Cannabis: Potential Distant Impacts on Healthcare Providers

April 2, 2026 – On December 18, 2025, President Donald Trump signed an executive order directing the U.S. Attorney General and federal agencies to expedite the conversion of marijuana from Schedule I to Schedule III under the Controlled Substances Act (CSA). Despite the symbolic importance and initial buzz surrounding this executive order, absent significant further progress by federal agencies, states, and Congress, the executive order’s practical impact on health care providers is likely to be limited for some time to come.

When schedule changes occur, providers must consider the various effects that the interplay of federal and state laws have on their practice.

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Will healthcare providers be able to administer and prescribe cannabis?

Currently, cannabis is classified as Schedule I under the CSA, which is defined as having no currently accepted medical uses, a high potential for abuse, and not being considered safe for use under medical supervision. Reclassifying cannabis to Schedule III means that the federal government has recognized that cannabis has a lower potential for abuse than Schedule I or II substances and has accepted medical uses that are potentially similar to many other medications that health care providers can prescribe or administer.

However, by placing cannabis within the scope of medicines that doctors can prescribe, Schedule III reclassification still leaves open an additional regulatory hurdle for it to be considered a drug under the Federal Food, Drug, and Cosmetic Act (FDCA). In order for a drug to be marketed or distributed in the United States under the FDCA, the drug must be approved by the FDA. Cannabis is a complex plant containing hundreds of compounds and over 100 unique cannabinoids, but it is not currently an FDA-approved drug.

Without this FDA approval, plant forms (flowers) and cannabis products (vapes, edibles, beverages, topicals), despite reclassification, are still not compliant with federal law.Despite the reclassification, cannabis products (vapes, edibles, beverages, topicals) currently available in medical and recreational dispensaries across the country are still not compliant with federal law, nor can health care providers administer or prescribe cannabis in the regular course without FDA approval.

The FDA has approved one cannabis-derived drug and several synthetic cannabis-related drugs, rescheduling each one separately in turn, but only after going through an extensive and expensive approval process. These more traditional FDA-approved drugs are still a far cry from the drugs and products that medical marijuana patients are familiar with in state medical marijuana programs, and given the time and cost of these drug approvals, it will likely be a long time before flower or other cannabis products are approved as FDA-approved drugs, if ever.

Recognizing the new nature and history of cannabis, Congress could amend the CSA or FDCA to regulate cannabis in a clear manner and remove cannabis from regulation by either of these laws altogether.

Additional considerations for healthcare providers

If cannabis rescheduling is successful and potentially approved for prescribing or administration by health care providers, health care providers will be faced with many questions and issues to address. Existing state laws regarding cannabis create a variety of regulatory and licensing regimes that vary widely from jurisdiction to jurisdiction. Healthcare providers navigating this patchwork of laws must consider how their own state laws and practices interact with the new federal reality.

Rather than an actual prescription, most state medical marijuana programs require a doctor to certify that a patient has a qualifying condition and then make a referral or recommendation to the patient regarding medical marijuana. Patients then enroll in a medical program that grants them access to a medical cannabis dispensary. Direct dispensing or administration by health care providers would upend these long-standing programs, and health care providers should closely monitor how this impacts their own personal state licenses and state medical cannabis programs and determine whether they can participate in one or both models.

Some state legislatures may seek to conform their state medical marijuana programs to a more restrictive federal model, and health care providers should closely monitor the proposed changes and advocate for sensible regulations that protect licensure and the quality and continuity of patient care.

Differences in orientation towards the criminalization of cannabis are another way in which regulations vary from state to state, and health care providers operating in states with stricter or prohibitionist cannabis laws should consider the extent to which those states may seek to continue their policies despite changes at the federal level.

The issue of FDA preemption of state drug laws, such as in the case of medication abortion pills, has recently become a controversial and unresolved area of ​​law. The history of cannabis in the United States has always included major conflicts between federal and state regulations, and we foresee that this may continue in new dimensions despite changes at the federal level.

It is foreseeable that rescheduling and further FDA approval of cannabis or cannabis products will lead to patients contacting their healthcare providers about their use, and healthcare providers must be prepared to appropriately address patient inquiries, concerns, and treatments. Stigma and uncertainty remain when it comes to medical marijuana, and some medical providers may now be avoiding the drug altogether in the wake of federal prohibition.

New approvals at the federal level may raise liability issues for health care providers who are not up to date with the latest clinical guidelines regarding the medical use of cannabis and who do not provide relevant appropriate standards of care.

Timing considerations

Without action from Congress, the reality is that schedule changes will only impact health care providers in the distant future. The actual rescheduling process has long been stalled – President Trump’s executive order was originally intended to speed up a process that began in 2022 when President Biden asked the Department of Justice and Health and Human Services to reschedule cannabis.

There has been no substantive update on the rescheduling process since President Trump’s order in December 2025, and as discussed, traditional FDA approval of cannabis or cannabis products can take years.