The Pure Food and Drug Act of 1906 was the first federal law that restricted cannabis, and hundreds of laws followed that ramped up the prohibition of a plant historically viewed as medicine. The Harrison Act, the Marihuana Tax Act and the Boggs Act all represent an escalation of the war against cannabis, but the Controlled Substances Act (CSA) is the federal law primarily enforcing the current prohibition. The CSA, prepared by Attorney General John Mitchell at the request of President Richard Nixon, was passed by the 91st U.S. Congress in 1970 and signed by Nixon. The law replaced the Marihuana Tax Act (deemed unconstitutional the year before by the Supreme Court), consolidated several other laws and expanded the federal government’s role in enforcing drug laws and prohibition. A few years later, Nixon created the Drug Enforcement Administration (DEA) to serve as the lead agency enforcing drug laws and overseeing changes (along with the Food and Drug Administration) to the CSA’s five Schedules.
One of the most controversial aspects of the CSA was a Schedule I classification for cannabis and non-psychoactive hemp. This put cannabis in the same category as heroin, MDMA, mescaline and peyote—i.e., dangerous drugs of abuse with absolutely no medical value—suggesting the government deems cannabis to be worse than Schedule II drugs like crack cocaine, crystal meth and opium. Furthermore, the CSA made it a Class 1 federal felony for medical professionals and researchers to conduct legitimate studies on cannabis, which made it difficult to prove the safety and medical benefits of the plant that might justify a schedule change. Speaking of which, the Drug Enforcement Administration (DEA) denied a petition to reschedule cannabis in 2001. The denial notice said that no evidence disputes the plant’s danger, abuse potential and lack of medical value.
The Substance Schedules
Controlled substances fall into five categories determined by three criteria: abuse potential, safety and medical value. Schedule I, the most restricted category, is reserved for highly addictive drugs that lack medical value and any level of safe use, even under medical supervision. Substances in this category, which are illegal in all instances, include the following: heroin, khat, ayahuasca, GHB, lysergic acid diethylamide (LSD), mushrooms, etorphine (an opioid 3,000 times stronger than morphine used to immobilize elephants), MDMA (ecstasy), mescaline, peyote and cannabis in all its forms, including hemp and non-psychoactive cannabinoids like cannabidiol (CBD).
Schedule II is the most-restricted substance still available via a doctor’s prescription. These drugs are viewed as addictive and dangerous, but they have medical value, and safe use is possible under a doctor’s supervision. Examples include cocaine, crystal meth, amphetamines, oxycodone (OxyContin, Percocet), hydrocodone (Vicodin), morphine, opium and methylphenidate (Ritalin). The remaining three classifications are viewed as progressively less addictive and dangerous. These more readily available drugs include Schedule III substances like steroids, ketamine and buprenorphine; Schedule IV substances like benzodiazepine (Xanax, Valium, Klonopin) and so-called Z-drugs like zolpidem (Ambien) and eszopiclone (Lunesta); and Schedule V drugs like certain cough suppressants (with minor amounts of codeine) and diarrhea medications (which some people inexplicably inject like heroin). Furthermore, Congress specifically excluded alcohol and tobacco products from scheduling in 1970.
In 2016, a Vox/Morning Consult poll found that 82 percent of Americans did not realize cannabis was a Schedule I substance. In guessing its classification, respondents most commonly assumed the plant was a Schedule IV or V substance. Furthermore, the poll asked where cannabis should be classified, and the most common answer was that cannabis should be removed from the Schedules altogether.
Imagine a rock concert that filled a stadium with 50,000 people who are all smoking cannabis. What if, by the government’s and grower’s own admission, smoking the plant would cause 100 of the concertgoers to have suicidal thoughts, some of which would act on them. Furthermore, any concertgoers that continued to smoke cannabis will develop a physical dependence in as little as a month, and once this happens, individuals who abruptly stop smoking can experience seizures so violent that they can kill them. Now imagine the public and government uproar over legalization efforts if cannabis really did involve these types of risk factors.
Well, a prescribed drug does exist with these risk factors, and the National Institute of Mental Health (NIMH) estimates that five percent of U.S. adults fill at least one prescription for this drug each year. The substance is benzodiazepine, and it is the active ingredient in name brand drugs like Valium, Klonopin and Xanax. The drug, which can cause fatal grand mal seizures in users who do not gradually reduce dosage, causes suicidal thoughts and intentions in one of out of 500 users. And benzodiazepines are Schedule IV, one of the most lenient classifications allowing for widespread distribution. The Citizens Commission on Human Rights (CCHR) argued in 2011 that Klonopin in particular might be “America’s most dangerous pill,” but the federal government made cannabis the fully restricted Schedule I substance.
Cannabis and the CSA
The Controlled Substances Act (CSA) originally made cannabis a Schedule I drug, but Congress (which set the original classifications) meant it as a temporary placement while the newly formed National Commission on Marijuana and Drug Abuse investigated cannabis. More commonly referred to as the Shafer Commission after its chairman, the group included former Republican Governor Raymond Shafer, Republican Congressman Tim Lee Carter of Kentucky, Republican Senator Jacob Javits, Democratic Senator Harold Hughes of Iowa and others including medical doctors, college presidents, attorneys and psychiatrists.
In early 1972, Chairman Shafer delivered its findings to Congress in a report titled "Marihuana, A Signal of Misunderstanding" calling for an end to cannabis prohibition. “[The CSA] implies an overwhelming indictment of the behavior which we believe is not appropriate,” said the report about cannabis. “The actual and potential harm of use of the drug is not great enough to justify intrusion by the criminal law into private behavior, a step which our society takes only with the greatest reluctance.... Looking only at the effects on the individual, there is little proven danger of physical or psychological harm from the experimental or intermittent use of the natural preparations of cannabis."
The Commission attacked the “lurid accounts” of unsubstantiated cannabis-related atrocities and the constitutionality of prohibition in general for private consumption. "The use of drugs for pleasure or other non-medical purposes is not inherently irresponsible,” noted the Commission in support of recreational use. “Alcohol is widely used as an acceptable part of social activities."
This was not the report President Nixon wanted or expected. Publically released Oval Office transcripts show that Governor Shafer visited Nixon before the release of the report to warn him. In addition to saying people who fight cannabis prohibition are “not good people,” Nixon delivered a warning to the Chairman, saying, “You're enough of a pro to know that for you to come out with something that would run counter to what the Congress feels and what the country feels, and what we're planning to do, would make your commission just look bad as hell.”
The Commission, to its credit, delivered the report and called for an end to prohibition. Despite the report, cannabis remained a Schedule I drug, and a congressional subcommittee in 1974 formed to counter the original. Mississippi Senator James Eastland led the subcommittee. The rich plantation owner, who viciously supported racial segregation, said the Supreme Court decision desegregating schools destroyed the Constitution, even stating, “You are not obliged to obey the decisions of any court which are plainly fraudulent sociological considerations." Eastland, who denied the Klu Klux Klan presence in his state, even claimed the famous 1964 disappearance of three civil rights workers in his state was merely a hoax. Public perception largely saw cannabis a drug used by hippies, Latinos and African-Americans, which some might say played a role in Senator Eastland’s claims that cannabis was actually more dangerous than the Shafer Commission suggested.
Buds vs. Benzos
As part of the Controlled Substances Act (CSA) of 1970, illicit and prescription drugs fall into various Schedules based on safety, abuse potential, accepted medical use and other key criteria. The most-restricted classification, Schedule I, reflects dangerous substances with high abuse potential and no medical value. On the other end of the spectrum, Schedules IV and V are the least-restricted categories, and individuals can typically procure such prescriptions with ease. Unfortunately, political posturing appears to play some role in classification when schedule makers show such egregious bias against cannabis and leniency toward benzodiazepines.
Cannabis has a Schedule I classification joining hardcore drugs like LSD, PCP, mescaline, heroin, peyote, psilocybin mushrooms, Peruvian torch cactus and Etorphine, an opioid 3,000 times more potent than morphine. The placement epitomizes the government’s stance that cannabis requires more restrictions and regulation than Schedule II drugs like cocaine, opium and crystal meth. The scheduling, which makes the plant illegal without exception, also puts onerous restrictions on clinical studies and medical research, and the government targeted cannabis with additional layers of oversight. From 1999 to 2015, the U.S. Public Health Service (PHS) had to approve cannabis-related research, a review process only applied to cannabis and that rarely allows research into therapeutic uses. President Obama lifted this restriction in June 2015, to which the Marijuana Majority responded, “The next step should be moving marijuana out of Schedule I to a more appropriate category, which the administration can do without any further Congressional action.”
Benzodiazepine, meanwhile, is Schedule IV, which suggests the drug must entail significantly less danger and abuse. But does it?
Benzodiazepines are a class of central nervous system (CNS) depressants that includes brand names like Xanax (alprazolam), Valium (diazepam), Klonopin (clonazepam) and Ativan (lorazepam) and street names like Benzos, K-Pin and Xannies. The drug is a chemical fusion of benzene and diazepine rings that bind to gamma-aminobutyric acid (GABA) receptor sites in the CNS. The binding opens a chlorine (Cl-) channel and increases the concentration of Cl- ions in the postsynaptic neuron, which hyperpolarizes the neuron and makes it less excitable. Benzodiazepines are, in effect, a way to enhance the efficacy of GABA neurotransmitters, which can potentially reduce anxiety, panic attacks, muscle spasms, epilepsy, seizures and insomnia. In most cases, benzodiazepines are meant to act as a short-term bandage, not a cure or maintenance plan, since extended use prompts the brain to compensate for the enhanced efficacy by reducing natural GABA production. This process, known as downregulation, can occur in as little as four weeks.
“The diagnosis and management of benzodiazepine dependence,” a study published in Current Opinion in Psychiatry in 2005, wrote, “Despite repeated recommendations to limit benzodiazepines to short-term use (2–4 weeks), doctors worldwide are still prescribing them for months or years. This over-prescribing has resulted in large populations of long-term users who have become dependent on benzodiazepines and has also led to leakage of benzodiazepines into the illicit drug market.”
Once a person becomes physically dependent on benzodiazepine, quitting the drug abruptly can result in multi-year withdrawal symptoms and potentially fatal grand mal seizures. The “sharp sting in the tail” is how the Journal of the Royal College of General Practitioners characterized the withdrawals in 1989, while “Withdrawal from Long-Term Benzodiazepine Use” in The British Journal of General Practice in 2006 emphasized the necessity for medically supervised detoxification and gradual reductions in dosage.
Recovery from benzodiazepine dependence and addiction also involves high rates of relapse. In 2011, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a special Treatment Episode Data Set (TEDS) report on the drug. The findings noted that benzodiazepines lead all drugs in rehabilitation admissions involving previous rehab stints (70.5 percent), and 38.6 percent reported three or more previous admissions. The study added that 95 percent of benzodiazepine-addiction admissions—which increased threefold between 1998 and 2008—also involved other substance addictions. And taking benzodiazepines with other drugs is yet another area of concern.
Once a person becomes physically dependent on benzodiazepine, quitting the drug abruptly can result in multi-year withdrawal symptoms and potentially fatal grand mal seizures.
“Acute respiratory failure from abused substances,” a study published in the Journal of Intensive Care Medicine in 2004, said alcohol, cocaine, amphetamines, opiates and benzodiazepines increase the risk of a CNS depression (i.e., overdose) when two or more are taken in tandem. These substances interact with the medulla—a part of the brain stem that helps regulate the respiratory and cardiovascular systems—symbiotically enhancing each other’s effects. Cannabis-related neural receptors are not prominent in the medulla so the plant does not physiologically contribute to such overdoses. The study also noted that CNS stimulants (e.g., amphetamines, Ritalin, Adderall) can exhaust the respiratory system, which lowers the threshold for respiratory failure when combined with benzodiazepine-class depressants. This finding is particularly concerning since many stimulant users turn to depressants to take the edge off later.
The Citizens Commission on Human Rights International in 2011 characterized Klonopin (a benzodiazepine with a long half-life) as “America’s Most Dangerous Pill,” while the Addiction journal that same year published “Benzodiazepines Revisited—Will We Ever Learn?” documenting 50 years of problems. When addictions do take hold, the American Family Physician in 2000 said symptoms can include memory impairment, psychomotor retardation, emotional blunting and paradoxical disinhibition inciting aggression, impulsivity and rage. Furthermore, the U.S. Food and Drug Administration (FDA) warning guide for the medication suggests that one in 500 users experiences suicidal thoughts. So, if everyone at a 50,000-seat Rolling Stones concert regularly takes “Mother’s Little Helper,” approximately 100 of them feel suicidal impulses because of it.
Whether taken medically or recreationally, benzodiazepines are associated with high rates of misuse and abuse. PBS News reported in 2013 that depressants are the second-most abused class of prescription drugs (trailing painkillers), yet their Schedule IV status makes for relatively easy access through prescriptions or illicit sales. The U.S. Centers for Disease Control and Prevention (CDC) highlighted the drug’s availability in a recent report that said U.S. prescribers wrote 37.6 benzodiazepine prescriptions for every 100 people in 2012. For the sake of clarity, that is 37.6 sets of pills, not individual pills.
If everyone at a 50,000-seat Rolling Stones concert regularly takes “Mother’s Little Helper,” approximately 100 of them feel suicidal impulses.
In 2013, the U.S. Court of Appeals for the D.C. Circuit ruled on Americans for Safe Access v. Drug Enforcement Administration, a federal case involving cannabis as a controlled substance. The patient-advocacy group Americans for Safe Access sought a reclassification of cannabis to at least Schedule III—at the time the same classification as opium poppy-produced Vicodin—and still more restricted than benzodiazepines. The National Institutes of Health (NIH) has a patent on cannabinoids as neuroprotectants, and the National Institute on Drug Abuse (NIDA) recently cited studies suggesting “whole-plant marijuana can slow the growth of cancer cells” and possibly kill certain cancer cells. Nevertheless, the DEA argued that cannabis has no “accepted medical use,” and the three-judge panel sided with the DEA.
When looking at the clinical findings, many might agree that benzodiazepine involves significantly more risk than cannabis, yet the scheduling denies any access to cannabis and relatively easy access to benzodiazepine. What motivates the disparity? Several factors might play a role, but the pharmaceutical industry as a whole is the national leader in lobbyist spending. The Center for Responsive Politics reported that it spent $231 million on lobbying in 2014, which dwarfs the $141 million spent by the oil and gas industry. The reclassification fight continues, but government intent is certainly suspect as long as cannabis remains Schedule I and benzodiazepines Schedule IV.