Intended for healthcare professionals


WHO proposes rescheduling cannabis to allow medical applications

BMJ 2019; 364 doi: (Published 05 February 2019) Cite this as: BMJ 2019;364:l574

Linked opinion

Why I recommend medicinal cannabis as a replacement analgesic for opioids

  1. Susan Mayor
  1. London

The World Health Organization has proposed rescheduling cannabis within international law to take account of the growing evidence for medical applications of the drug, reversing its position held for the past 60 years that cannabis should not be used in legitimate medical practice.

The WHO Expert Committee on Drug Dependence met late last year to critically review available evidence on cannabis and related substances and to agree the most appropriate level of international control.1

The current scheduling of cannabis is as strict as that for heroin, and the committee believes that keeping cannabis at that level of control would severely restrict access to and research on potential therapies derived from the plant.

The committee advises on the scheduling of substances on the basis of their potential for harm, dependence, and misuse from a public health perspective, as well as their therapeutic usefulness. It has not reviewed cannabis since the original scheduling in 1961 because of limited robust scientific evidence on the health effects of cannabis and related products. But it considered that enough information has now emerged to enable a full review of cannabis and related substances, as more member states have permitted the use of cannabis for medical and non-medical uses.

In its review the committee has recommended that cannabis and cannabis resin should be deleted from schedule IV, the most strictly controlled category in the Single Convention on Narcotic Drugs treaty of 1961. Other cannabis related products should also be rescheduled, it advises.

Michael Krawitz, global policy adviser at the non-profit advocacy organisation FAAAT (For Alternative Approaches to Addiction, Think & Do Tank), said, “The placement of cannabis in the 1961 treaty, in the absence of scientific evidence, was a terrible injustice. The World Health Organization has gone a long way towards setting the record straight.” FAAAT campaigns on the medical use of cannabis.

In a statement FAAAT explained the implications of the rescheduling2: “The very positive outcome clearly acknowledges medical applications of cannabis and cannabinoids, reintegrates them into pharmacopoeias, balances harms and [effectively] repeals the WHO position from 1954 according to which ‘there should be efforts towards the abolition of cannabis from all legitimate medical practice.’”

The 53 UN countries that are members of the Commission on Narcotic Drugs will decide whether to vote on the recommendations this March or defer the vote to March 2020.


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