Historic directive fast-tracks cannabis rescheduling and expands CBD research as millions of Americans turn to cannabis for chronic pain relief

President Donald Trump has signed a sweeping executive order aimed at accelerating medical cannabis research and improving access to cannabidiol products, marking a significant policy shift in federal cannabis regulation. The order, signed on 18 December 2025, directs the Attorney General to expedite the reclassification of cannabis from Schedule I to Schedule III of the Controlled Substances Act.

A Long-Overdue Recognition

The executive order acknowledges what Australian cannabis advocates have long argued: decades of restrictive drug policies have stifled legitimate medical research. The directive specifically recognises that the FDA found scientific support in 2023 for cannabis's use in treating anorexia related to medical conditions, nausea and vomiting, and pain.

The numbers are staggering. Chronic pain affects nearly 1 in 4 United States adults and more than 1 in 3 United States seniors, and 6 in 10 people who use medical cannabis report doing so to manage pain. With 40 states plus the District of Columbia operating regulated medical cannabis programs, the federal government's Schedule I classification has created a stark disconnect between state-level medical acceptance and federal prohibition.

The Rescheduling Push

The path to rescheduling has been in motion since 2023, when the Department of Health and Human Services recommended moving cannabis to Schedule III. This recommendation was based on findings that more than 30,000 licensed healthcare practitioners across 43 US jurisdictions are authorised to recommend medical cannabis for over 6 million registered patients treating at least 15 medical conditions.

Schedule III classification would recognise cannabis as having accepted medical use and lower abuse potential than Schedule I or II substances. The Department of Justice issued a proposed rule in May 2024, which received nearly 43,000 public comments and is currently awaiting an administrative law hearing. Trump's executive order now directs the Attorney General to complete this rulemaking process "in the most expeditious manner."

CBD and the Hemp-Derived Cannabinoid Maze

The order also tackles the increasingly complex regulatory landscape surrounding CBD and hemp-derived cannabinoid products. One in 5 United States adults and nearly 15 percent of seniors reported using CBD in the past year, yet current regulations leave patients and healthcare providers navigating a confusing patchwork of rules.

A particular concern highlighted in the order is the quality and labelling of CBD products. Recent studies found that some commercially available CBD products were inaccurately labelled regarding their composition, creating safety risks for consumers. The directive calls for developing regulatory frameworks including guidance on THC limits per serving, per-container limits, and CBD-to-THC ratio requirements.

The order also addresses an upcoming complication: section 781 of Public Law 119-37 will reclassify some full-spectrum CBD products as controlled marijuana under the CSA due to THC content, adding another layer of complexity to an already tangled regulatory environment.

Bridging the Research Gap

For Australian observers, the executive order's emphasis on research infrastructure will sound familiar. The directive specifically calls for research methods utilising real-world evidence to assess health outcomes of medical marijuana and legal CBD products, with particular focus on long-term effects in vulnerable populations such as adolescents and young adults.

The order notes that inadequate research has left American patients and doctors without proper prescribing guidance. One patient survey showed that just 56 percent of older Americans using marijuana have discussed the usage with their healthcare provider, placing patients on multiple medications at increased risk of drug interactions or adverse events.

Implications for Pain Management

The executive order places particular emphasis on chronic pain management and alternatives to opioids. Research cited in the directive found that 20 percent of participating US veterans reported using fewer opioids as a result of their medical marijuana use. Evidence also suggests improvements in seniors' health-related quality of life and pain outcomes with medical marijuana use.

This focus on pain management alternatives resonates strongly with Australian cannabis policy discussions, where chronic pain represents a significant portion of medical cannabis prescriptions under the Special Access Scheme and Authorised Prescriber pathways.

Implications for State Programs and Home Cultivation

While the executive order represents a major policy shift, it's important to understand what it does and doesn't change for patients currently accessing cannabis through state programs. Rescheduling marijuana to Schedule III would not federally legalise medical cannabis, but it would significantly reduce legal risks and barriers.

Under Schedule III, marijuana would remain a controlled substance requiring prescriptions from licensed healthcare providers. This creates complications for existing state medical programs, which typically operate through "recommendations" rather than prescriptions due to federal restrictions. The transition period could create regulatory uncertainty for patients, dispensaries, and healthcare providers navigating between state and federal frameworks.

For home cultivation, the implications are mixed. Schedule III substances can only be possessed with a valid prescription, which would technically conflict with state-based home grow programs that operate outside the prescription model. However, federal enforcement priorities and prosecutorial discretion will likely play a larger role than the technical scheduling in determining how home cultivation is treated in practice.

The order's emphasis on working with Congress to update hemp-derived cannabinoid definitions could also affect home growers cultivating low-THC plants. Depending on how new THC limits and CBD-to-THC ratios are defined, some home cultivation practices currently considered legal hemp production might face reclassification.

State-based programs would also benefit from expanded research infrastructure. Better clinical data on dosing, efficacy, and safety could help healthcare providers within state programs offer more informed guidance to patients, potentially improving outcomes and reducing the current trial-and-error approach many patients experience.

What This Means

The executive order represents the most significant federal policy movement on medical cannabis in recent US history. By directing expedited rescheduling and calling for comprehensive CBD regulatory frameworks, the Trump administration is attempting to align federal policy with the medical reality experienced by millions of Americans.

For Australia's cannabis sector, the US policy shift could accelerate international research collaboration and provide valuable real-world evidence on medical cannabis outcomes. As the world's largest pharmaceutical market begins closing the gap between cannabis prohibition and medical acceptance, the ripple effects will likely be felt across global cannabis policy and research landscapes.

The order does not legalise recreational marijuana nor does it create immediate changes to current law. However, by prioritising research infrastructure and recognising the medical utility of cannabis, it marks a pragmatic shift toward evidence-based drug policy—something cannabis advocates on both sides of the Pacific have long called for.