Tuesday, August 18, 2009

Do We Really Need a Schedule I?

For those of you that don’t know, the Controlled Substances Act places all controlled substances into one of five categories, or schedules, with each schedule having its own set of criteria for inclusion. Schedule V is the least restrictive for the safest, least abused drugs, such as cough medicine. Schedule I, on the other hand, is the most restrictive and reserved for only the most dangerous drugs that have no medical use. Schedule I substances, which include heroin, LSD, and marijuana, are strictly forbidden under virtually all circumstances, including research. That’s not to say that absolutely no research is ever done with these substances. But it’s very limited and subject to the approval of the DEA. Marijuana, for example, is at this time legally available for research purposes from only one source, and then only in a very low-grade form. What that means is that even if someone were to get to the point of conducting the large-scale clinical trials necessary for FDA approval, enough of the drug would not be available.

So what I’d like to know is why we even need a Schedule I. What’s the point? From a control standpoint, substances in Schedule I are restricted only to those doing legitimate research. Others can easily acquire them from the black market. Substances in Schedules II through V are strictly controlled, but they are legally available for research or through prescription.

So it looks like the answer to my question is that the point of having a Schedule I is to restrict research, not unauthorized, recreational use. Whether or not anyone would actually admit to that being the reason, it is certainly the result. And restricting research of any kind is not the sort of thing a free society should do. The whole point of scientific research is to further human knowledge. That’s a good thing. Restricting the generation and flow of knowledge only serves to stifle a society.

Now I can certainly understand restricting, or at least strictly controlling, certain types of research. Obviously we can’t have high school kids trying to build nuclear devices in their garages. But medical research? I think you’d be hard pressed to find too many people that believe we shouldn’t do everything we can to find new medicines and new cures. Unless of course that medicine involves marijuana (or stem cells, but that’s another story). Of course those people are probably not doctors. They have no way of knowing what might be discovered if marijuana and other Schedule I substances were able to be freely studied. And of course there’s no way to convince those people otherwise because the research cannot be done.

And it’s not only research that suffers from there being a Schedule I. Substances that have been shown to be beneficial under certain circumstances cannot be prescribed by doctors if they are in Schedule I. And it’s not just marijuana. For example, heroin is one of the most effective pain killers known. Yet only its less effective relative morphine can be prescribed. LSD and other psychedelics have been shown to have some uses in psychotherapy, yet they cannot be prescribed either. While substances such as cocaine and methamphetamine are in Schedule II and can be used therapeutically. Seems like a pretty arbitrary distinction.

So the whole existence of a Schedule I seems pretty crazy to me. What’s crazy about it is the government telling the medical community what drugs they can and can’t prescribe. Any such policies should be determined by physicians based on science, not politicians based on politics. Even crazier is restricting medical research of any kind. Regardless of where a particular line of research might lead, it will at the very least generate new knowledge. And today, just as it has been throughout human history, knowledge is power.

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