The cannabis industry’s fragmented foundation is creating a host of problems tied to the lack of federal legalization. Many experts believe that without a national medical cannabis framework, the future of cannabis as a medicine in America could leave patients unprotected, research underfunded, and the industry consumed by unchecked commercial interests.

Few voices have been more vocal about this than Dr. Jordan Tishler, a Harvard-trained physician who spent 15 years working in a VA hospital before dedicating his career to cannabinoid medicine. Today, as the founder of InhaleMD and the president of the non-profit Association of Cannabinoid Specialists, Tishler is a leading advocate for creating a structured, federally recognized medical cannabis system.

“Over 180 million Americans over the age of 50 will develop one or more illnesses that can be treated with cannabis,” Tishler explains. “We cannot leave their care to marketing claims, dispensary staff, or patchwork state laws. Patients deserve proper medical treatment.”

Why Federal Legalization Falls Short

The current push for legalization often centers on ending prohibition, addressing social justice issues, and creating economic opportunities. While those goals matter, Tishler argues that legalization without a medical framework could actually undermine the perception of cannabis as medicine.

“Without a national medical system, we will see an industry driven by sales rather than science,” he warns. “Companies will have no incentive to invest in costly clinical research if they can simply go to market and make unverified claims. That would be the death knell of cannabis as a legitimate medicine.”

The problem is already visible in the hemp market, where unsubstantiated health claims and mislabeled products have flooded store shelves. Without federal oversight, Tishler says, cannabis risks becoming more snake oil than science-backed treatment.

Patients Caught in the Middle

Right now, medical cannabis patients face enormous disparities depending on where they live. In states like California, only a small fraction of cannabis is sold through medical channels, leaving patients to rely on retail budtenders for guidance.

 Florida remains the only state that requires a prescription-style “Order” that dispensaries must follow, but most states treat cannabis more like a consumer good than a medication. That lack of structure leaves vulnerable patients, many of them elderly or living with chronic illness, without consistent, professional guidance.

What a National System Could Look Like

According to Tishler and the Association of Cannabinoid Specialists, a true medical cannabis system would need to accomplish several key goals:

1. Federal legalization of medical cannabis so patients can access treatment under the care of qualified clinicians.
2. A standardized prescribing system that ensures patients receive consistent dosages, product types, and usage instructions.
3. Insurance coverage so treatment is accessible to all patients, not just those who can afford to pay out of pocket.
4. Ban on unsubstantiated claims to protect patients from predatory marketing.
5. Interstate operability so patients can travel with their medicine without fear of losing access or facing discrimination.
6. Ongoing scientific research is driven by a regulatory framework that incentivizes companies to conduct clinical trials.

These policies would not only protect patients but also advance cannabis science, strengthen the healthcare system, and put the U.S. on par with other countries, like Germany and Israel, that have integrated medical cannabis into national health programs.

The Social Justice Connection

For Tishler, the conversation about medical cannabis is inseparable from social justice. Healthcare outcomes in the U.S. are already poor compared to other developed nations, and they are significantly worse for communities of color. Without a national program, cannabis care will continue to follow the same inequitable patterns.

“Medical cannabis treatment must be part of the social justice discussion,” Tishler says.”Ending the war on drugs is not enough. Patients need safe, effective medicine and knowledgeable guidance to achieve the best outcomes.”

A Call to Action

The cannabis industry has an opportunity to rally around this cause, but time is running out. As recreational legalization spreads state by state, the risk grows that medical care will be sidelined, leaving patients to fend for themselves in a marketplace driven by revenue, not medicine.

“Congress is willfully overlooking the importance of proper medical cannabis treatment,” Tishler says. “We need a national system now, before the window closes.”

The Association of Cannabinoid Specialists has published a white paper outlining the essential elements of reform to ensure that patient care remains at the center of cannabis policy. Their message is clear: cannabis medicine is not simply a consumer product; it is a healthcare issue.

If the U.S. hopes to move beyond prohibition while protecting patients and fostering scientific innovation, a national medical cannabis system may be the industry’s most important cause yet.

https://www.cannaspecialists.org/a_federal_framework_of_regulation_for_medical_cannabis_use

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