EXPLAINER: What will change if the US reclassifies marijuana?

U.S. President Donald Trump is expected to sign an executive order that would reclassify marijuana under federal law and ease restrictions on research, potentially paving the way for new medical marijuana products. Here is what you need to know.

What Would the Executive Order Do?

Under the U.S. Controlled Substances Act, marijuana is currently classified as a Schedule I drug, alongside substances such as heroin, indicating a high potential for abuse and no accepted medical use. The executive order would move marijuana to Schedule III, a category that includes drugs such as codeine, morphine, certain stimulants, and some forms of steroids.

Reclassification would significantly reduce regulatory barriers for researchers, making it easier to secure funding for clinical trials. It would also allow pharmaceutical companies to pursue approval from the U.S. Food and Drug Administration (FDA). Marijuana’s Schedule I status has long discouraged drug developers from conducting the large-scale trials required for regulatory approval.

Does This Mean Medical Marijuana Will Become Legal?

No. Marijuana remains illegal under U.S. federal law. While 40 states allow the sale of marijuana products for medical use and 24 states permit recreational use by adults, these products are still considered illegal at the federal level unless they receive FDA approval.

Manufacturing, distributing, or possessing marijuana without federal authorization would remain unlawful. However, penalties associated with Schedule III drugs are generally less severe than those tied to Schedule I substances.

What Are the Medicinal Components of Marijuana?

Marijuana comes from flowering plants of the Cannabis genus and contains chemical compounds known as cannabinoids, which interact with systems in the human body. The two most well-known cannabinoids are tetrahydrocannabinol (THC), which produces a psychoactive “high,” and cannabidiol (CBD), which does not cause intoxication and may offer effects such as pain or inflammation relief.

In 2018, the U.S. Congress ruled that cannabis plants containing no more than 0.3% THC—commonly referred to as hemp—would no longer be classified as marijuana. The 10 states that have not legalized cannabis generally allow access to CBD-rich products while restricting THC content.

What Evidence Supports Marijuana-Derived Pharmaceuticals?

Only three cannabinoid-based drugs have demonstrated sufficient evidence in clinical trials to receive FDA approval.

Epidiolex, produced by Jazz Pharmaceuticals, contains purified CBD derived from hemp and is approved to treat certain seizure disorders. Dronabinol, a synthetic form of THC marketed as Marinol and Syndros, is approved to treat appetite loss in patients with HIV/AIDS and to manage nausea and vomiting caused by chemotherapy.

These drugs are considered generally safe, though they can cause side effects, as with most prescription medications. Any marijuana-derived drugs approved by the FDA would be dispensed through pharmacies by prescription. Healthcare providers prescribing Schedule III drugs must hold valid registration with the U.S. Drug Enforcement Administration.

What Conditions Show Promise for Marijuana-Based Medicines?

Dronabinol has shown potential benefits in mid-stage clinical trials for treating sleep apnea.

An experimental cannabis-derived drug developed by Vertanical demonstrated greater safety and effectiveness than placebo and opioids for chronic lower back pain in two late-stage European trials. A U.S. trial is planned for 2026.

Sativex, an oral cannabis-based spray developed by CNX Therapeutics, has shown effectiveness in treating muscle spasticity associated with multiple sclerosis. It is approved in more than 30 countries outside the United States.

Cannabinoid drugs are also being studied for conditions including autism spectrum disorder, anxiety and depression associated with bipolar disorder, endometriosis, eczema, and alcohol use disorder. Federal rescheduling is expected to accelerate research and standardized drug development across these areas.

Is Marijuana Sold at Dispensaries Safe?

Even when used for medical purposes, cannabis products such as gummies, vape oils, tinctures, and high-potency concentrates can cause side effects, including dizziness, gastrointestinal issues, and impaired cognitive function. Studies have also linked marijuana use to risks involving mental health, the cardiovascular system, the lungs, and an increased likelihood of developing type 2 diabetes.

Marijuana can interact with prescription and over-the-counter medications, including blood thinners, sleep aids, antidepressants, anxiety medications, and seizure drugs. Risks are higher for individuals with heart disease, mental health disorders, or psychosis, as well as for older adults due to fall risk and medication interactions.

Use during pregnancy, breastfeeding, and adolescence carries additional risks.

Despite limited large-scale clinical evidence, many states permit medical marijuana for a wide range of conditions. Approved uses in various states include cancer-related symptoms, glaucoma, chronic pain, ulcerative colitis, Crohn’s disease, sickle cell disease, multiple sclerosis, Parkinson’s disease, and other illnesses. Some states do not specify qualifying conditions, leaving treatment decisions largely to physicians. -Reporting by Nancy Lapid; additional reporting by Sriparna Roy and Ahmed Aboulenein; editing by Caroline Humer and Bill Berkrot/Reuters