Legislation to legalize cannabis at the federal level recently proposed by Sen. Chuck Schumer (D-N.Y.) and a group of Senate Democrats is long overdue. While it aims to fix injustices done to communities of color that have been most harmed by the war on drugs, it excludes one very important demographic: patients.
The bill is presented as “comprehensive” cannabis reform. It makes cannabis legal in the United States for recreational use and has many provisions for expanding the cannabis industry. It also adds taxes that provide revenue to the federal government and stipulates that some of the money collected be used to enhance the lives of communities that have been most hurt by the failed war on drugs.
Leaving out patient care overlooks the largest group of people who will or may be affected by this new law.
An estimated 115 million Americans over age 50 will develop one or more illnesses such as osteoarthritis, anxiety, insomnia, or cancer that are treatable with cannabinoid medicines. Not providing for them in the discussion draft underscores that lawmakers are not paying attention to the needs of patients, the ways in which patients differ from recreational users, and the ways in which a recreational paradigm does not support needed clinical care.
First, legislation should decouple medical and recreational cannabis. While legalization of recreational cannabis may address the needs of healthy people, it does not address people’s medical needs. People need competent care based on sound science that is aligned with the same fundamental values that apply in all areas of medicine, including respect for patient choices through informed consent, beneficence through sound medical advice that ensures patients benefit while minimizing harm, issuing exact prescriptions to ensure that patients get the right medicine, and justice by ensuring that everyone is treated fairly and all have the same treatment opportunities.