The U.N. Commission on Narcotic Drugs voted to reclassify cannabis Wednesday, taking it off the strict Schedule IV list that includes dangerous and highly addictive drugs such as heroin. The U.N. still deems cannabis a controlled substance. But the move, which the U.S. supported, could ease restrictions on research into marijuana's therapeutic use.

The 53-member commission approved the change in a close vote, by 27-25, with 1 abstention. Russia was a vocal opponent of the move, calling cannabis "the most abused drug globally."

The U.N. vote follows guidance from the World Health Organization and its expert committee on drug dependence, which had recommended deleting "cannabis and cannabis resin" from Schedule IV of the 1961 Convention on Narcotic Drugs. The drug will now remain in Schedule I rather than appearing on both lists.

The vote had been closely followed by marijuana activists and the burgeoning cannabis industry, as it could bolster arguments for easing legal restrictions on marijuana and establishing consistent regulations.

Clearing the way for research

In its recommendation to the U.N. Commission on Narcotic Drugs, the WHO committee noted that cannabis can have adverse effects and cause dependence. But it also cited the drug's benefits in reducing pain and nausea, as well as easing symptoms of medical conditions such as anorexia, epilepsy and multiple sclerosis. And it noted that unlike opioids such as fentanyl, cannabis is not associated with a significant risk of death.

The committee said, "the inclusion of cannabis and cannabis resin in Schedule IV is not consistent with the criteria for a drug to be placed in Schedule IV."

The WHO committee also said that despite "limited robust scientific evidence on the therapeutic use of cannabis," the drug has been shown to be different from Schedule IV substances that have little or no therapeutic use.

"This is a major win for cannabis advocates around the world with considerable symbolic and some practical implications for cannabis regulation," according to Conor O'Brien of Prohibition Partners, a global industry analyst group.

Taking cannabis off of the list of most restricted substances, he added, means that the U.N. agrees with the WHO "that cannabis is not 'liable to produce ill-effects' on the scale of other drugs in Schedule IV, and that cannabis has significant potential therapeutic value."

"One of the original reasons for the WHO making these recommendations were to open up the path to research and medical product development," O'Brien told NPR via email. "Today's results will hopefully encourage much activity in this field which will in the future enable further liberalization of cannabis and patient access."

He called the vote "an important step in cannabis becoming more accessible and certainly from today's verdict, more acceptable."

It's up to each country to form their own drug policies and punishments. But international drug control treaties allow their parties to ban or limit the manufacture or import of the most dangerous substances. Under the 1961 convention, Schedule IV is reserved for drugs that are particularly liable to abuse and harm.

"Such liability is not offset by substantial therapeutic advantages," the U.S. Justice Department says in its guide to complying with the treaties. With cannabis now classified differently, the calculus for studying its potential benefits is now likely to change.

Citing the FDA, the U.S. votes yes

The U.S. was represented at the session by Ethan Glick, counselor for U.N. Affairs at the U.S. Mission to International Organizations in Vienna, who said, "the legitimate medical use of a cannabis preparation has been established through scientific research, and cannabis no longer meets the criterion for placement in Schedule IV of the Single Convention."

Glick cited the U.S. Food and Drug Administration's approval in 2018 of a purified cannabidiol extract for use in treating rare seizure disorders in children. And he cautioned that cannabis poses public health risks, particularly to young people and pregnant women.

But reclassifying cannabis in a less strict control category, Glick added, could spark new research into its medical benefits.

"This action has the potential to stimulate global research into the therapeutic potential and public health effects of cannabis and to attract additional investigators to the field including those who may have been deterred by the Schedule IV status," Glick said.

The vote to change how cannabis is classified was the top item on the agenda for the morning session of the commission's virtual meetings that began Wednesday. The sessions are a key international forum for drug policy discussions.

The proposal has gone through an extensive review. The WHO made its recommendation nearly two years ago, setting off months of consideration and debate. This summer alone, the Commission on Narcotic Drugs says, its virtual meetings on the proposals were attended by more than 600 experts from more than 100 countries.

Ahead of Wednesday's vote, a Buenos Aires-based advocacy group sent a letter to the commission, specifically asking it to ease access to medical marijuana. The Grupo de Mujeres de la Argentina Foro de HIV, Mujeres y Familia said that under the current legal framework, people have been "unjustly deprived of their liberty because they fight every day to calm their pains naturally from this plant - as alternative and traditional medicine."

The move to pull cannabis out of Schedule IV was the only cannabis-related initiative to win approval Wednesday, as commission members rejected a handful of other recommendations from the WHO regarding THC and cannabis extracts.

Most of the other cannabis votes were also close – except for a broad rejection of a proposal that would have used a footnote in Schedule IV to declare that preparations containing cannabidiol, or CBD, "are not under international control" as long as they contain less than 0.2% of THC, the main psychoactive component of cannabis.

That rejection came despite a plea from the European Medicinal Cannabis Association, which submitted a position paper to the commission titled, "CBD is not a narcotic."

A U.S. State Department spokesperson told NPR that the vote in favor of reclassification "is not an endorsement of the use of the cannabis plant or cannabis resin for medical purposes," adding that it won't change marijuana's status under the Controlled Substances Act or international conventions.

Countries gave a range of reasons for voting down the CBD proposal, with some saying it was overly broad or vague. Glick said the U.S. disagreed on legal grounds: Because cannabidiol isn't currently listed on the schedule of controlled substances, he said, a special vote isn't required to keep it off the schedule.

Instead, he said, the expert committee's recommendation should itself be enough to establish that CBD is not subject to international control.

"Cannabidiol has not demonstrated abuse potential, and it is not our position that cannabidiol should be or is under the control of the international drug conventions," Glick said.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

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