Policy Watch: 17 Regulatory Updates — March 14, 2026

Schedules of Controlled Substances: Placement of 2-Methyl AP-237 in Schedule I

Regulatory Summary The DEA placed 2-Methyl AP-237 (synthetic opioid) in Schedule I, establishing it as illegal with no medical use—relevant to cannabis clinicians managing pain patients seeking alternative therapies.

Schedules of Controlled Substances: Placement of 2,5-dimethoxy-4-iodoamphetamine and 2,5-dimethoxy-4-chloroamphetamine in Schedule I

This DEA scheduling action places synthetic amphetamines in Schedule I and has no direct relevance to cannabis clinicians or patients, as it addresses different controlled substances unrelated to cannabis regulation.

Schedules of Controlled Substances: Temporary Placement of MDMB–4en–PINACA, 4F–MDMB–BUTICA, ADB–4en–PINACA, CUMYL–PEGACLONE, 5F–EDMB–PICA, and MMB–FUBICA into Schedule I

The DEA temporarily placed six synthetic cannabinoids into Schedule I, restricting their legal availability and potentially affecting cannabis clinicians’ understanding of emerging cannabinoid compounds and patient access to unregulated alternatives.

Schedules of Controlled Substances: Placement of Ethylphenidate in Schedule I

This DEA action scheduling ethylphenidate has minimal direct relevance to cannabis clinicians or patients, as it addresses a synthetic stimulant rather than cannabis or cannabinoid therapeutics.

Schedules of Controlled Substances: Placement of Metonitazene in Schedule I

Regulatory Summary This action schedules metonitazene (a synthetic opioid) under Schedule I, establishing controlled substance regulations unrelated to cannabis medical practice or patient care.

Schedules of Controlled Substances: Temporary Placement ofEtizolam, Flualprazolam, Clonazolam, Flubromazolam, and Diclazepam in Schedule I

This regulatory action schedules benzodiazepine analogs as controlled substances, directly relevant to cannabis clinicians managing anxiety or seizure disorders who may need to adjust treatment protocols or patient referrals for these conditions.

Importer of Controlled Substances Application Biopharmaceutical Research Company – DEA1224

Regulatory Summary DEA Form 1224 permits biopharmaceutical companies to import controlled substances for research, directly enabling clinical trials and pharmaceutical development of cannabis-derived medicines for patients.

Importer of Controlled-Bright Green(2024-20083)DEA1426

Regulatory Summary This DEA importer registration (2024-20083) permits controlled substance importation; cannabis clinicians should verify supplier licensing compliance when sourcing cannabis-derived medicines or research materials.

Importer of Controlled-Cambridge Isotope(2024-20082)DEA1429

Regulatory Summary DEA permit (2024-20082) authorizes Cambridge Isotope as a controlled substance importer, potentially enabling research into cannabis metabolite tracking and cannabinoid labeling studies relevant to clinical pharmacology.

Medicare and Medicaid Programs: Calendar Year 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; etc.

CMS establishes 2025 Medicare/Medicaid reimbursement rates and coverage policies, potentially affecting cannabis clinician billing codes and patient access to cannabis-derived treatments under federal insurance programs.

Medicare and Medicaid Programs; CY 2025 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program (CMS-1807-P)

CMS proposed 2025 Medicare payment policy updates; cannabis medicine remains federally non-covered, so this rule does not directly affect cannabis clinician reimbursement or patient access through Medicare/Medicaid programs.

Bulk Manufacturer-Royal Emerald (2024-11786) DEA1368

Regulatory Summary DEA registration 2024-11786 authorizes Royal Emerald as a bulk manufacturer, enabling increased production capacity for cannabis-derived pharmaceutical compounds used in clinical and patient treatment contexts.

Importer Controlled-VA Cooperative (2024-11795) DEA1374

Regulatory Summary The DEA document establishes importer controlled substance cooperative frameworks, directly affecting cannabis clinicians’ and patients’ access to regulated cannabis products through licensed distribution channels.

Importer Controlled- Quagen Pharma (2024-11892) DEA1381

Regulatory Summary DEA Form 1381 filing indicates Quagen Pharma’s controlled substance importation status, relevant to cannabis clinicians regarding supply chain oversight and pharmaceutical-grade cannabis product availability.

Exempt Chemical Preparations May 2024 (2024-10465) – DEA372

Regulatory Summary The DEA updated exempt chemical preparations guidance in May 2024, potentially clarifying which cannabis-derived or cannabis-adjacent compounds may be exempt from controlled substance regulations, affecting clinical prescribing authority and patient access.

Medicare and Medicaid Programs; CY 2024 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Continued Implementation of Requirements for Manufacturers of Certain Single-dose Container or Single-use Package Drugs to Provide Refunds with Respect to Discarded Amounts; Medicare Advantage (CMS-1784-F)

Regulatory Relevance to Cannabis Medicine This CMS final rule establishes 2024 Medicare payment policies and coverage requirements that may affect cannabis-derived medication reimbursement and prescribing practices within Medicare and Medicaid programs.

Medicare and Medicaid Programs; CY 2024 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Continued Implementation of Requirements for Manufacturers of Certain Single-dose Container or Single-use Package Drugs to Provide Refunds with Respect to Discarded Amounts; Medicare Advantage (CMS-1784-P)

This CMS rule updates Medicare/Medicaid payment policies and coverage requirements but does not directly address cannabis; however, it may affect reimbursement considerations for cannabis-related medical services under Medicare Part B.

These regulatory notices reflect ongoing federal efforts to control emerging synthetic drugs and designer compounds that pose public health risks, while simultaneously managing the infrastructure for legitimate pharmaceutical manufacturing and distribution of controlled substances. The dominance of scheduling actions for novel synthetic cannabinoids and benzodiazepines indicates that clandestine chemists continue to circumvent existing regulations through structural modifications, requiring periodic administrative responses to keep pace with these evolving products. The parallel approvals for pharmaceutical importers and manufacturers suggest that despite these enforcement activities, the healthcare system maintains stable access to legitimately produced controlled medications through established regulatory pathways.