A vote was set to take place this week at the United Nations Commission on Narcotic Drugs (CND) 63rd Session on whether to reschedule cannabis, thus recognizing its utility as a medicine. But, as Cannabis Wire reported Sunday after reviewing a draft decision by the CND chair, that vote won’t happen until December 2020. That draft decision was formally adopted this week.
Last year, the World Health Organization (WHO) made a handful of recommendations regarding the scheduling of cannabis (and its resins, preparations, derivatives, etc) in global drug control treaties. It is those recommendations that are up for a vote.
One key recommendation, made by the WHO’s Expert Committee on Drug Dependence (ECDD), would remove cannabis and cannabis resin from Schedule IV, the most restrictive schedule and for substances with negligible medical value, which would leave them only on Schedule I, the least restrictive schedule and for substances with medical value. Another key recommendation would add a note under that Schedule I entry for cannabis and cannabis resin that reads “Preparations containing predominantly cannabidiol and not more than 0,2% of delta-9-tetrahydrocannabinol are not under international control,” effectively descheduling high-CBD, low-THC products.
If adopted, this would be the first rescheduling of cannabis since the drafting of the 1961 Single Convention on Narcotics Drugs, a global drug control treaty, so it’s unsurprising that some governments are asking for more time before casting a vote that could catalyze the global cannabis industry. Some countries, like China and Russia, have already expressed expected opposition to the recommendations. Other countries, like the US, Canada, and the UK, have yet to declare a position. The US made a statement Monday, via James A. Walsh, the principal deputy assistant secretary at the Bureau of International Narcotics and Law Enforcement Affairs, saying, “We do regret that the CND was unable to take action on the WHO cannabis recommendations this week.”
Still, the CND collected questions and comments from governments throughout 2019, and there is an apparent lack of clarity and consensus in the resulting 90-page document. The US, in particular, asked more questions than any other country, and the tone of the questions were at times forceful. In one question, the US asks directly whether the WHO would consider “modifying” its recommendations based upon government feedback. Conversely, Canada, where adult use cannabis sales are legal at the national level, asked relatively few questions. One simply asked the ECDD whether they compared cannabis with alcohol and tobacco, which are not subject to international control; this, they wrote, is “particularly relevant in light of ECDD’s consideration of the harms associated with use, such as rates of substance use disorders and driving under the influence of cannabis.”
Cannabis Wire read through the document and surfaced the most illuminating exchanges. These are primarily focused on the US for two reasons: one, the aforementioned volume of questions posed by the US; and two, many countries’ questions were similar and therefore bundled together (including the US) and answered at once. While the World Health Organization answered most of the questions, other entities, including the International Narcotics Control Board and the United Nations Office on Drugs and Crime, chimed in.
One question from the US asks about the “practical impact” if the WHO recommendations on cannabis are adopted.
The International Narcotics Control Board, which is in charge of drug treaty compliance, answered this question, and what they wrote regarding CBD is particularly noteworthy as it highlights a potential lab testing hurdle:
“The main question in regard to this recommendation relates to its practical implementation at the national level. In most countries, chemical analysis down to the required threshold will not be possible because of lack of access to appropriate identification techniques. In those countries where chemical analysis to the required accuracy of 0.2 percent of THC is possible, it might not be feasible, or considered not to be a good use of resources and may not be employed. In addition, this recommendation will also give rise to an important question on the control of cannabis that is being cultivated for the extraction of CBD to be used for the mentioned CBD preparations.”
Six countries, including the US, and the EU asked about the decision to remove cannabis from Schedule IV. The US, for example, wondered why “specific preparations” found to have medical value weren’t put in Schedule III, and whether the WHO recommendation is based “on new data showing that the cannabis plant has therapeutic use” or simply based upon the fact that it “does not share similar liability to produce ill-effects” as other Schedule IV substances.
The WHO responded: “It should be recognized that only a small subset of the drugs in Schedule I are also included in Schedule IV. Apart from cannabis and cannabis resin, they comprise a subset of opioids that have been considered at various times to be particularly liable to abuse and to produce ill-effects, and to have no substantial therapeutic advantages. … The Committee considered that neither the liability to abuse nor the liability to produce ill-effects of cannabis were commensurate with the other substances, such as carfentanil, Schedule IV.”
They continued: “The Committee also acknowledged that in 1961, when the Convention was established and cannabis was included in Schedule IV, cannabis and cannabis preparations were not recognized to have any therapeutic use or therapeutic potential. … Based on both the level of liability to abuse and to produce ill effects of cannabis and preparations of cannabis, and the recognized therapeutic value of cannabis preparations, while acknowledging the characteristics of substances currently included in Schedule IV, the Committee considered that cannabis should not be included in Schedule IV.”
Canada asked: “How does the committee reconcile its recommendation to maintain cannabis under Schedule I with the fact that the committee did not consider that cannabis is associated with the same level of risk to health of most of the other drugs that have been placed in Schedule I?”
To this, the WHO wrote: “It is important to consider the full sentence which is as follows: ‘While the Committee did not consider that cannabis is associated with the same level of risk to health, as that posed by most of the other drugs placed in Schedule I, it noted the high rates of public health problems arising from cannabis use and the global extent of such problems.’ The problems referred to are detailed in the report, but included the high rate of cannabis disorders and the impact on driving.”
Regarding the CBD recommendation, the US asked, “Can this recommendation be revised to allow countries greater flexibility in interpreting what an allowable low threshold for THC content is?”
The WHO reponse, interestingly, references Epidiolex, a CBD-based cannabis plant extract produced by GW Pharmaceuticals, a British company. Epidiolex is the first cannabis plant extract approved as medicine by the US FDA.
The WHO wrote: “The Committee considered that the percentage of CBD to be used in practice could be left to individual Member States in consultation with INCB. The value of 0.2% for THC was specified as WHO had requests from Member States to indicate what maximum percentage was considered appropriate and to ensure that the currently registered CBD medication was exempted from control. That medication has a THC content not greater than 0.15% by weight as a proportion of the total weight of plant material.” (The “currently registered CBD medication” is Epidiolex.)
The US pushed back: “We are looking at the proposed percentage of THC and we would just note that in Epidiolex, it was stated that it was 0.15 %; our records indicate that it is 0.015% so substantially lower than that which was indicated in the critical review. If we had a 0.2% THC limit in a 30 ml bottle of CBD oil, that would contain 54 mg of THC.”
The WHO response doesn’t address the .15 vs .015 discrepancy and instead goes on to clarify: “The specified level of 0.2% is by dry weight as a proportion of the total weight of cannabis plant material,” adding, “Cannabis for industrial and horticultural purposes (commonly known as hemp) is specifically excluded from control by the 1961 Convention. There is therefore no relation between the level of delta -9-THC in such products and the maximum level of delta-9-THC being recommended for cannabidiol products.”
The US also anticipated the rescheduling of other cannabinoids, writing, “If, in the future, the ECDD reviews another cannabinoid derived from the cannabis plant (such as cannabigerol or cannabidavarin) and finds that relatively pure preparations of that substance are not liable to abuse, will it be necessary to further footnote the entry for cannabis and cannabis resin to exclude those preparations from international control?”
The WHO replied: “The Committee recognised that it was possible that at some time in the future it would review another cannabinoid derived from the cannabis plant (such as cannabigerol or cannabidavarin) that is not liable to abuse but has some therapeutic value. The Committee considered that if this occurred, it may, depending on any recommendation that the Committee would provide, be appropriate to amend the footnote to include that substance as well as cannabidiol.”
There were also a number of questions regarding CBD in foods, in particular from the EU.
The WHO essentially left it up to individual countries: “The Committee was aware that CBD products, such as foods, are being sold in many countries. While CBD does not satisfy the criteria for control under the 1961 or 1971 Conventions, Member States can regulate its availability using their own national legislation.”
Editor’s note: This piece was updated to reflect the formal adoption of the decision to delay the vote.
