Photograph by Jim Wilson, New York Times
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Ian Almerico carries a tray of cannabis clones at Harborside, a medical marijuana dispensary in Oakland, California. On election day, voters in Florida, North Dakota, and Arkansas supported initiatives to legalize medical marijuana.

Photograph by Jim Wilson, New York Times

Will the Trump Administration Weed Out Medical Marijuana?

The president-elect previously has said that regulating cannabis is a state issue—but some of his closest advisers think otherwise.

Medical marijuana had a yuge win on election day.

In each state where the issue was on the ballot—Florida, Arkansas, Montana, and North Dakota—voters supported initiatives that would provide or expand patients’ access to cannabis products for ailments that include post-traumatic stress disorder, epilepsy, Parkinson’s disease, cancer, and glaucoma.

All told, 29 states and the District of Columbia now have legislation permitting medical marijuana.

But come January, will the Trump administration allow this to continue?

That’s a question, because while the states may be the laboratories of democracy, the United States government is the ultimate arbiter in this case. Under federal law, marijuana, regardless of its intended use, remains illegal.

The Drug Enforcement Administration (DEA) has signaled that it prefers to keep it that way. In August, the government agency announced that it would continue to classify marijuana as a Schedule I substance—placing it in the same category as heroin, LSD, and other drugs that have a high potential for abuse and no medical value.

As such, federal prosecutors across the country go after marijuana growers at their own discretion. The Obama administration has issued guidelines on this, suggesting, for instance, that law enforcement officials should not harass patients but should instead look with suspicion at “large-scale, privately-operated industrial marijuana cultivation centers” that are poised to earn millions of dollars by growing tens of thousands of plants.

Previous statements by president-elect Donald Trump suggest he favors a similar approach. This past February, when Fox News host Bill O’Reilly denounced medical marijuana as a “ruse,” Trump countered. “I know people that have serious problems ... it really does help them,” he said.

And last year at a political rally, Trump said, “In terms of marijuana and legalization, I think that should be a state issue, state-by-state,” adding, “I think medical should happen—right? Don’t we agree? I think so.”

Still, it’s not an issue that appears to be at the top—or even the lower-middle—of Mr. Trump’s to-do list when he comes into office, meaning that others might convince him to adopt a different position.

“I think members of his new administration will have significant impact on how he thinks,” says John Hudak, an expert on the legalization debate with the Brookings Institution in Washington, D.C. “If you look at some of the drug warriors that he surrounds himself with, like Rudy Giuliani and Chris Christie, you could imagine a President Trump persuaded that marijuana laws raise crime rates and destabilize society.”

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Scientists have identified dozens of active chemical compounds in marijuana, called cannabinoids—some of which show promise for treating ailments where conventional drugs have been ineffective.

Nor does Hudak expect that grassroots support will sway either the White House or the GOP-controlled Congress, despite the growing acceptance of medical marijuana at the state level. “I think it's important to remember that marijuana is still used by a small number of Americans regularly and, because of that, most people don't consider this a real priority issue,” he says. “For most Americans, there are five other things they'd rather fight over.”

In the long term, a decision made by the DEA earlier this year might have the biggest impact on the issue.

Scientists have identified dozens of active chemical compounds in marijuana called cannabinoids, some of which show promise for treating ailments where conventional drugs have been ineffective. (Read about the new science of marijuana.)

Those researchers, however, confront a catch-22. Federal regulations make it extremely difficult for them obtain research-grade marijuana because the plant is classified as a Schedule I substance with no medical applications. But, how can they prove that cannabinoids might have medical uses if they can’t study them?

For years, the only cannabis farm sanctioned by the U.S. government was maintained at the University of Mississippi and overseen by the National Institute on Drug Abuse (NIDA), which places orders for specific strains that it wants grown for research. But the DEA now says that other facilities can apply to legally grow marijuana.

“I don't think ending the NIDA monopoly expands research,” says Hudak. “But I think it improves research because it provides access to higher-quality, research-grade marijuana, a more diverse supply.”

And, if cannabis extracts ever prove their worth in treating conditions such as Alzheimer’s disease and schizophrenia, support for medical marijuana could become a demand.