Even if your state has legalized cannabis products, it does not mean that your pharmacy can start selling them. This axiom has been tested and proven again and this time in Georgia.

Georgia took an interesting approach regarding expanding medical marijuana access. As far as I know, it is the only state that specifically allows its pharmacies to be registered as dispensers of  low-THC cannabis oil (containing under 5% THC). Its Board of Pharmacy has approved about 23 pharmacies to carry and dispense such products in attempt to expand access to medical marijuana (primary to rural patients). At some point, it became necessary to involve pharmacies because Georgia allows only a very limited amount of dispensaries (only seven as of the date of this writing) and they are concentrated in urban areas. As a result and to provide rural patients with access to medical marijuana, the state has approved special registration for pharmacies as dispensers of medical marijuana.

Shortly after this implementation, however, DEA sent the following letter to the pharmacies across the state warning that if they dispense THC products they will be in violation of the Controlled Substances Act:

Pharmacies should avoid distributing cannabis products precisely due to federal restrictions. The only exception would be distributing FDA approved CBD products (such as Epidiolex). Likewise, prescribers do not stock or prescribe cannabis. Instead, they issue recommendations regarding medical conditions that may justify consuming cannabis products.

Now Georgia is at a loss. It is facing a dilemma: the need to provide access to medical marijuana and avoid non-compliance for its pharmacies.  Frankly, it has only one way to proceed. It needs to wait until the DEA reschedules marijuana or until any other federal green light to dispense marijuana from federally licensed facilities. Of course, Georgia can file a legal action against DEA but marijuana remains a Schedule I substance and DEA is enforcing the Controlled Substances Act (I feel like it would be a very tough uphill battle).

A legal counsel for Georgia Access to Medical Cannabis Commission (“Commission”) explained in an interview that a congressionally approved budget rider prevents federal agencies from interfering with state approved medical marijuana programs. And it appears that DEA is interfering with Georgia’s state program to expand access to medical marijuana.

But as far as I remember, the rider is expiring shortly and pharmacies are registered by the DEA who exercises broad discretion on whether to renew/issue registration to dispense controlled substance. (Besides, dispensaries remain available to dispense marijuana in Georgia). So an argument could be made that DEA is not interfering with the state program but it warns its registrants against non-compliance with federal law.

So the only feasible approach is to push for rescheduling of marijuana. To remind, the Department of Health and Human Services (HHS) has recommended to reschedule marijuana into Schedule III. (See a related blog post). DEA has not responded to the HHS’s recommendation in any way yet. But many analysts predict (based on various precedents) that DEA will follow the HHS’s recommendation. Several governors also wrote letters to the Biden administration recommending rescheduling by the end of this year and highlighting the benefits of removing cannabis from Schedule I.

Question arises: if marijuana is rescheduled, will pharmacies be able to dispense products containing cannabinoids? It still seems unlikely because the FDA will need to approve pharmaceutical preparations containing cannabis and this could take a long time.

As of today, however, DEA’s warning is clear: if pharmacies dispense cannabis products, they risk having issues with their DEA registration.