By Dr. Sesi Akoto, Medical Coordinator, Sanctuary Clinics
Author, How to Help Your Loved One Get Off Cannabis

Recently, news broke that the Trump administration is actively reviewing a proposal to move cannabis from Schedule I to Schedule III under the Controlled Substances Act, with a decision expected in the coming weeks. 

• This shift would officially recognize that cannabis has accepted medical use and a lower potential for abuse than drugs like heroin.
• It could open the door to broader medical research, reduce tax burdens like IRS 280E penalties, and allow cannabis businesses easier access to banking and capital.

As a physician, I welcome expanded research. We’ve needed rigorous clinical trials for years, especially for the developing mind and those with pre-existing vulnerabilities. Rescheduling could:

• Enable well-funded, scientifically grounded studies into the risks and therapeutic potential of cannabis.
• Move the conversation beyond anecdotes and toward evidence-based medicine.

But let’s be crystal clear: research must precede—not follow—commercial availability.

For years, I’ve warned that normalization creates a dangerous illusion of safety—one we can no longer afford to ignore.

• Adolescents and young adults undergo critical neurological development in areas governing memory, reasoning, and impulse control.
• Regular cannabis use during this period is linked to:
  • Impaired learning and memory
  • Increased risk of anxiety, depression, and psychosis

Lower academic motivation and future attainment
(These are realities we witness daily at Sanctuary Clinics.)

• Individuals with pre-existing mental health conditions or histories of trauma are at significantly greater risk of:
  • Cannabis-Induced Psychosis (CIP)
  • Cannabis Use Disorder (CUD)
• We see more teens and young adults entering treatment with dual diagnoses—fueled by high-potency cannabis, legalized environments, and societal messaging that downplays harm.

• As the Fox article I cited earlier emphasized: the more normalization spreads, the more children are at risk.

Legalization has led not to safer use, but to easier access, greater social acceptance, and a spike in mental health crises tied to cannabis abuse.

In How to Help Your Loved One Get Off Cannabis, I wrote:

“There’s a storm brewing. The clouds look astonishingly similar to those which gathered… before the opioid epidemic… I am very concerned that we are on the verge of a drug contagion that is going to dwarf the opioid epidemic.”

That metaphor feels more urgent than ever. We’ve been down this road before.

Rescheduling must not be a step toward unchecked commercialization. It must be controlled, cautious, and above all, child-first.

1. Research Comes First
   Any policy shift must mandate longitudinal studies—particularly on adolescence, co-occurring disorders, and long-term brain health.
2. Potency Limits and Clear Labeling
   Just like alcohol and tobacco, cannabis products need standardized potency measures and health warnings, especially under an environment of rescheduling.
3. Support Systems for Families
   Sanctuary Clinics and similar providers must be equipped and funded to handle increased referrals for CIP and CUD—especially in states with legal adult use.
4. Policy Guardrails for Youth Protection
   • Restrict marketing and prevent youth-targeted advertising
   • Enforce age verification, tax surcharges aimed at prevention
   • Fund school and community education programs, focusing on science, not stigma

Rescheduling cannabis to Schedule III could open valuable avenues for research, reduce unnecessary taxation burdens, and potentially destigmatize medical investigations. That is the silver lining I reluctantly welcome.

However, unless we meaningfully guard against commercialization and insist that research guide policy, we risk leaving youth—and those with underlying mental health vulnerabilities—exposed to an expensive and avoidable public health crisis.

Let us not repeat history by waiting decades to admit what we should have known all along: just because something is easier to access doesn’t mean it’s safe—especially for the vulnerable mind.

In vigilance and hope,
Dr. Sesi Akoto
Medical Coordinator, Sanctuary Clinics
Author, How to Help Your Loved One Get Off Cannabis