A new rule loosening restrictions on medical marijuana will normalize it as a treatment option for senior living residents seeking relief from pain, sleep disorders and dementia-related agitation, according to industry experts, who called it the “biggest federal cannabis policy shift in more than 50 years.”
Pointing to a December executive order, the Justice Department and the Drug Enforcement Administration announced Thursday that they are moving FDA-approved and state-regulated medical marijuana from Schedule I to Schedule III under the Controlled Substances Act.
Schedule 1 drugs, such as cocaine and LSD, are not considered to have any acceptable medical uses, whereas a Schedule III drug, such as opioids and anxiety medications, are considered to carry potential medical benefits.
“These actions will enable more targeted, rigorous research into marijuana’s safety and efficacy, expanding patients’ access to treatments and empowering doctors to make better-informed healthcare decisions,” Acting Attorney General Todd Blanche said in a statement.
Separately, the Justice Department announced procedural updates to expedite the ongoing rulemaking process to fully reschedule marijuana as a less dangerous drug. The DEA is terminating the prior proceedings to move toward the completion of marijuana’s complete redesignation. A June 29 hearing is scheduled to evaluate those broader changes to marijuana’s status under federal law. The feds said those actions provide clarity to researchers, patients and providers while maintaining strict federal controls against illicit drug trafficking.
Kim Butrum, Silverado senior vice president of clinical services and a member of Argentum’s Clinical Quality Executive Roundtable, told McKnight’s Senior Living said she’s most looking forward to the June administrative hearing.
“We have seen the efficacy and benefit of medical marijuana for our resident population,” Butrum said. “We would hope the upcoming hearing would bring broader attention of the benefits of medical marijuana in the long-term care setting to the general public, and possibly create avenues for long-term care providers to discuss medical marijuana with the residents and families they serve.”
The move doesn’t legalize cannabis at the federal level, but it opens the door for more research and use by senior living residents. Josh Allen, MBK Senior Living Communities director of clinical services and a member of Argentum’s Clinical Quality Executive Roundtable, told McKnight’s Senior Living that the action taken by the agencies doesn’t close the gap between federal and state laws.
“Forty states and Washington, DC, already have medical marijuana programs, and the federal government has essentially been pretending those programs didn’t exist,” Allen said. “Moving to Schedule III narrows that gap, but it doesn’t eliminate it. Full alignment will require Congress to act.”
But the rule means that the government is “finally acknowledging what 40 states and millions of patients have known for years — that medical marijuana has legitimate therapeutic value,” he said.
Allen called the rescheduling a “genuinely positive development” for senior living residents and communities. The move, he said, will expand research, reduce stigma and give physicians and nursing teams more confidence to have open conversations about cannabis as part of a resident’s care plan.
“For years, our operators have supported medical marijuana as a treatment option where state law allows, and we’ve seen real benefits for pain management, appetite, sleep and anxiety,” Allen said, adding that rescheduling validates that work. “That’s a meaningful shift, and it’s going to accelerate the thoughtful, clinically grounded approaches many of our communities have already been building.”
Echoing Allen’s comments, LeadingAge Georgia President and CEO Ginny Helms told McKnight’s Senior Living that rescheduling will “normalize” medical marijuana as a treatment option for older adults seeking relief from pain, sleep disorders, dementia-related agitation and other conditions.
In addition, she said, lessening the stigma of medical cannabis will allow it to emerge as a “tool for well-being, allowing an alternative to opioids, antipsychotics and polypharmacy.”
Argentum Senior Vice President of Public Policy Maggie Elehwany told McKnight’s Senior Living that in states where use currently is allowed, senior living providers have reported success with medical marijuana for a variety of uses, including as an anti-inflammatory and to manage pain and anxiety while reducing the need for prescription medication, as well as appetite stimulation and behavioral intervention for dementia.
“Rescheduling could have several benefits, most importantly supporting critically needed research into the potential benefits and side effects of the drug, managing dosage, along with ensuring more consistency of the product and better labeling,” Elehwany said.
National Center for Assisted Living Executive Director LaShuan Bethea told McKnight’s Senior Living that NCAL supports the ability of residents and their doctors to determine the most appropriate and beneficial treatments for each resident’s unique needs.
“Access to care should include access to a wide variety of treatments that follow regulatory, legal and quality standards and align with the resident’s clinical care plan,” Bethea said.
With expanded access to approved therapies and support for state-regulated medical marijuana programs, Helms said, the senior living and care industry needs to take effective steps to help with the safe and effective introduction of medical cannabis as a treatment option.
Helms said senior living communities, along with medical directors and clinical teams, must learn about the safe and effective use of medical cannabis from experts who understand the health of older adults and proper use of medical cannabis.
“Now that the federal government is working to make medical cannabis more available, we’ll need to ramp up education and policy initiatives to support older adults who choose this emerging treatment option,” Helms said.
Independent living residents will have fewer barriers for accessing medical cannabis, but barriers for other long-term care residents and patients will need to be addressed, she said. Potential impediments include barriers with the Food and Drug Administration and the DEA that prevent physicians and pharmacists from supporting residents who want medical cannabis.
Allen said that communities that accept Medicaid, Department of Housing and Urban Development financing or Medicare still will need to navigate federal funding conditions, adding that the Centers for Medicare & Medicaid Services will need to issue updated guidance to provide clarity to senior living operators. Marijuana also still is based on state-level physician recommendations, rather than traditional federal prescriptions, so storage, administration and staff protocols will continue to require careful policy work, he said.
“The good news is that our industry has been doing that work for years, and now we have real federal momentum behind us,” Allen said. “Rescheduling opens the door to better research, better clinical guidance and, ultimately, better care for seniors who benefit from this medication.”
Helms added that senior living communities will need to bring in experts to educate residents and their families about medical cannabis as an emerging treatment. LeadingAge Georgia and its members are focusing on medical cannabis treatment of dementia-related agitation.
“We see this as a well-being / quality-of-life issue for older adults living with Alzheimer’s and other forms of dementia, as well as their families who watch the suffering,” Helms said, adding that LeadingAge Georgia is launching a pilot of hemp-based medical cannabis in six communities.
The new DEA rescheduling order only applies to FDA-approved products containing marijuana and to products subject to a state medical marijuana license.
The order creates an expedited registration pathway for state-licensed medical marijuana entities seeking federal DEA registration as manufacturers, distributors and/or dispensers, LeadingAge Vice President of Legal Affairs Clarett Yen told McKnight’s Senior Living. The rule also removes the potential for criminal or civil liability from researchers using approved and state-licensed products in their research.
“As a result, this order appears to loosen research restrictions, which may in turn promote further research on marijuana, which is a LeadingAge goal,” Yen said.
Marijuana has been classified as a schedule I drug since Congress enacted the Controlled Substances Act in 1970. The move to reschedule it by the Justice Department and the DEA in 2024 followed a Department of Health and Human Services recommendation in August 2023 to reschedule marijuana, with a finding that it has medical and scientific value. The HHS recommendation considered the potential for abuse, scientific evidence of marijuana’s pharmacologic effects and potential risks to public health.
A growing number of states have legalized cannabis for medical or recreational purposes, or both. As of June 26, 40 states, three territories and Washington, DC, allowed the medical use of cannabis products. In addition, 24 states, three territories and Washington, DC, had enacted measures to regulate cannabis for recreational use, according to the National Conference of State Legislatures.
Earlier this month, CMS launched a new Medicare pilot program to expand access to hemp-derived products to some older adults. CMS invited organizations participating in certain CMS Innovation Center models to begin offering a new Substance Access Beneficiary Engaging Incentive. Through the optional incentive, eligible hemp-derived products can be incorporated into care plans under clinician guidance.
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