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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.

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.”

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 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.”

A worker picks Cannabis inside a greenhouse on Nov. 10, in Kasese, Uganda. Uganda is one of several African countries looking to produce medical cannabis for export to Europe and America. On Wednesday, the U.N. Commission on Narcotic Drugs voted to reclassify cannabis. Luke Dray/Getty Images hide caption

“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.”

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.

CBD is commonly used to address anxiety, and for patients who suffer through the misery of insomnia, studies suggest that CBD may help with both falling asleep and staying asleep.

Side effects of CBD include nausea, fatigue and irritability. CBD can increase the level in your blood of the blood thinner coumadin, and it can raise levels of certain other medications in your blood by the exact same mechanism that grapefruit juice does. A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements. So, you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. In addition, the product may contain other (unknown) elements. We also don’t know the most effective therapeutic dose of CBD for any particular medical condition.

The evidence for cannabidiol health benefits

CBD may offer an option for treating different types of chronic pain. A study from the European Journal of Pain showed, using an animal model, CBD applied on the skin could help lower pain and inflammation due to arthritis. Another study demonstrated the mechanism by which CBD inhibits inflammatory and neuropathic pain, two of the most difficult types of chronic pain to treat. More study in humans is needed in this area to substantiate the claims of CBD proponents about pain control.

Some CBD manufacturers have come under government scrutiny for wild, indefensible claims, such that CBD is a cure-all for cancer, which it is not. We need more research but CBD may be prove to be an option for managing anxiety, insomnia, and chronic pain. Without sufficient high-quality evidence in human studies we can’t pinpoint effective doses, and because CBD is currently is mostly available as an unregulated supplement, it’s difficult to know exactly what you are getting. If you decide to try CBD, talk with your doctor — if for no other reason than to make sure it won’t affect other medications you are taking.

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In early 2019, the WHO recommended the CND reschedule cannabis and that cannabis “resin be deleted from Schedule 4 of the Single Convention on Narcotics Drugs (1961),” (the most restrictive category, like the CSA’s Schedule I). In addition, the report recommended that tetrahydrocannabinol (THC) be “deleted from the Convention on Psychotropic Substances (1971) and added to Schedule 1 of the Single Convention on Narcotics Drugs (1961).” Regarding CBD, the report recommended that cannabis extracts containing up to .2% THC not be scheduled within the drug control conventions. This signified a monumental change and the codifying of the medicinal value of cannabis. Further, it provided clarity around the international trade of CBD products.

In 2020, the CND again delayed a decision. Absent further delays or postponements, this December will bring the day of reckoning. Will the WHO’s recommendations finally take effect?

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Not so fast. Even if the CND enacts the recommendations, the legality of cannabis won’t change. Further, it doesn’t remove global cannabis controls from the Single Convention. The complexities of implementing the recommendations present challenges on every front.

Here’s an example: if the UN were to adopt these changes, or even if the Single Convention were abolished in its entirety (highly unlikely), its tenets continue to be ingrained in the United States’s CSA and the domestic laws of its numerous signatories. Until those laws are also repealed, amended, altered or otherwise modified, nothing will change overnight because of the political will and conflict in signatory countries.

When I examine the WHO recommendations closely, I think that most would have little impact on international drug controls and some could actually tighten requirements. Tremendous hurdles remain in signatory countries relating to technology or human resources to ensure compliance with some of the recommendations. The most obvious surround detecting specific THC content and/or the cannabinoid makeup of extracts from cannabis. The recommendations may require the creation of additional controls. In order to comply, the UN needs to set international standardized testing for THC and applicable control requirements, so that national authorities can monitor and report information to the UN.