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Reclassification of Marijuana from Schedule I to Schedule III: A Treatment Provider Perspective

In a significant move, the Biden administration has reclassified marijuana from a Schedule I to a Schedule III substance, representing a major shift in both medical and legal frameworks. According to data from the National Survey on Drug Use and Health, over 48.2 million Americans used marijuana in 2019, indicating its widespread use and the potential impact of this reclassification. This change brings new opportunities and challenges, especially for mental health professionals.

Dr. Michael Olla, Medical Director at Valley Spring Recovery Center, emphasizes that removing cannabis from Schedule I was appropriate and long overdue. Cannabis is not in the same category as heroin and has very low lethality if taken in overdose. He notes that there are legal substances that are arguably much more dangerous, and there are virtually no reports of fatal cannabis overdose in humans. However, Dr. Olla highlights the difference between recreational and medicinal use of cannabis, with the latter offering promising new horizons for the treatment of various diseases and has demonstrated its medical usefulness in a variety of illnesses safely and effectively since at least 2008. The American College of Physicians called for a review of cannabis’s Schedule I classification in its position paper titled “Supporting Research into the Therapeutic Role of Marijuana.”

Clinical Director Kristie Ashe, LCSW, and Dr. Michael Olla offer their expert insights on the implications of this reclassification at Valley Spring Recovery Center. They discuss the potential benefits for reducing drug-related crime and improving mental health treatments, while also cautioning about the increased risks due to higher THC levels in modern marijuana and the need for careful regulation.

What Are the Cultural and Legal Impacts of the Marijuana Law Changes?

Kristie Ashe: The reclassification will have profound cultural and legal impacts. We can expect a decrease in drug-related crime as marijuana-related convictions decline. This shift will not only reduce the burden on the legal system but also help individuals who previously faced harsh penalties for marijuana possession to reintegrate into society. This change has the potential to increase employment opportunities and enhance overall life sustainability for those affected.

Dr. Michael Olla: It’s a double-edged sword. Over one-third of Americans insist on using marijuana regularly. The reclassification makes sense because marijuana’s lethality is limited compared to more harmful substances. This change can help reduce incarceration rates and treat marijuana use less criminally. However, it is important to note that marijuana today has much higher concentrations of THC than in the past, which can lead to increased cases of psychosis in certain individuals.

What Are the Unforeseen Mental Health Consequences of Reclassifying Marijuana?

Kristie Ashe: With the high THC levels in modern marijuana, we are seeing more cases of long-term effects such as psychosis and delusional behaviors. Pre-existing conditions like bipolar disorder and schizophrenia can be exacerbated. In children, marijuana use can significantly impact the development of neuropathways and brain development, leading to potential cognitive deficits.

Dr. Michael Olla: People with psychotic disorders should avoid marijuana as it can induce paranoia. Although there are many different risks associated with taking any medication, including aspirin, marijuana can bring on withdrawal symptoms and hypertension. It’s a double-edged sword like any intervention; there is a time and place for it, but it is not suitable for everyone.

What Is the Impact on Patient Outcomes for Those with Existing Substance Use Issues?

Kristie Ashe: From a harm reduction standpoint, marijuana can be beneficial when used under continued treatment and monitoring, especially for clients with a history of heroin and fentanyl use. It offers a less harmful alternative and can aid in reducing cravings and withdrawal symptoms. However, it is crucial to monitor usage to ensure it is not being overused or negatively impacting the patient’s life. Medical marijuana can also be helpful in managing anxiety if properly monitored.

Dr. Michael Olla: Like any other substance, marijuana should be regulated to ensure safety. It is not yet FDA approved for PTSD use, but it has shown promise as one of the world’s oldest medications. The concept of “Cali sober,” where medical marijuana is used therapeutically while abstaining from other drugs, has been effective for some. However, marijuana can be particularly detrimental to developing brains, increasing the risk of long-term effects such as psychosis and delusional behaviors.

How Can the Benefits and Risks Be Balanced?

Dr. Michael Olla: The key is regulation and safety. Certain individuals, especially those with psychotic disorders, should not use marijuana. Early intervention can be particularly helpful, especially for conditions like PTSD. As with any medical intervention, the benefits must be weighed against the risks, and the use of marijuana should be tailored to the individual needs of each patient.

Kristie Ashe: The criteria for determining marijuana’s appropriateness in treatment remain the same. It is essential to evaluate whether patients can work and maintain a sustainable life while using marijuana. Regular monitoring and comprehensive assessment are crucial to ensuring that patients receive the maximum benefit with minimal harm.


The reclassification of the legal landscape surrounding marijuana from Schedule I to Schedule III is a pivotal moment in the treatment of substance use and mental health. While it offers new opportunities for research and therapeutic use, it also requires careful consideration of the potential risks and challenges. At Valley Spring Recovery Center, we are committed to providing informed and balanced care, ensuring that our patients receive the best possible outcomes.

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