Policy Watch: 17 Regulatory Updates — March 17, 2026

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

The DEA placed 2-Methyl AP-237, a synthetic opioid, into Schedule I, establishing it as a controlled substance with no accepted medical use—a scheduling action unrelated to cannabis medical practice.

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

Regulatory Summary This action schedules synthetic amphetamines (DOI and DOC) as Schedule I controlled substances, with no direct relevance to cannabis medicine, clinicians, or patients.

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 scheduled six synthetic cannabinoids as Schedule I controlled substances, restricting their availability and relevant to clinicians managing patients who may use these unregulated alternatives to cannabis.

Schedules of Controlled Substances: Placement of Ethylphenidate in Schedule I

Regulatory Summary This DEA action schedules ethylphenidate as a controlled substance, which is relevant to cannabis clinicians as it establishes precedent for scheduling synthetic compounds and may inform discussions about drug interactions or co-prescribing considerations.

Schedules of Controlled Substances: Placement of Metonitazene in Schedule I

The DEA placed metonitazene, a synthetic opioid, in Schedule I, establishing stricter controls on this non-cannabis substance with minimal direct clinical impact on cannabis medicine practitioners or patients.

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

Regulatory Summary The DEA temporarily scheduled five benzodiazepine analogs as Schedule I controlled substances, relevant to cannabis clinicians managing anxiety or seizure patients who may have been using these unregulated alternatives.

Importer of Controlled Substances Application Biopharmaceutical Research Company – DEA1224

Regulatory Summary A biopharmaceutical company’s DEA application to import controlled substances enables domestic cannabis medicine research and development, directly affecting clinician access to investigational cannabinoid therapies.

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

Regulatory Summary DEA registration 2024-20083 authorizes a controlled substance importer, potentially affecting cannabis clinicians’ and patients’ access to federally regulated cannabis products and research materials.

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

Regulatory Summary DEA approval for Cambridge Isotope to import controlled substances enables research isotope availability, supporting cannabis pharmacokinetics and cannabinoid metabolism studies relevant to clinical evidence development.

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 updates 2025 Medicare payment policies and Part B coverage, potentially affecting reimbursement for cannabis-related services and clinical consultations that eligible providers may bill to Medicare beneficiaries.

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 proposes 2025 Medicare Part B payment and coverage policies; cannabis remains federally non-covered, limiting Medicare reimbursement for cannabis-based treatments regardless of state legalization.

Bulk Manufacturer-Royal Emerald (2024-11786) DEA1368

Regulatory Summary DEA approved Royal Emerald as a bulk manufacturer for controlled substances, enabling increased production capacity for cannabis-derived pharmaceutical products used in clinical settings.

Importer Controlled-VA Cooperative (2024-11795) DEA1374

Regulatory Summary DEA Form 1374 establishes importer controlled substance cooperative procedures, enabling licensed cannabis clinicians to legally procure federally-regulated cannabis products for patient treatment under DEA oversight.

Importer Controlled- Quagen Pharma (2024-11892) DEA1381

Regulatory Summary DEA Form 1381 import control action for Quagen Pharma restricts controlled substance importation, potentially affecting cannabis-derived pharmaceutical product availability and supply chains for clinical practitioners.

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

Regulatory Summary The DEA’s May 2024 exemption list for chemical preparations clarifies which cannabis-derived or cannabis-related formulations may be exempt from Schedule I restrictions, directly affecting prescribing options and product availability for clinicians and patients.

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 Summary This final rule establishes 2024 Medicare/Medicaid payment policies and coverage requirements that may affect cannabis medicine access and reimbursement for eligible patients under these federal 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 establishes 2024 Medicare/Medicaid payment policies and coverage requirements; cannabis clinicians should note potential implications for reimbursement eligibility and documentation standards for cannabis-based treatments under federal insurance programs.

These regulatory actions reflect ongoing federal efforts to manage emerging synthetic drugs and novel psychoactive substances that continue to circumvent existing controlled substance laws, requiring periodic scheduling updates to address public health threats. The numerous importer and manufacturer applications alongside Medicare payment policy updates indicate the routine administrative work necessary to maintain pharmaceutical supply chains while ensuring appropriate oversight of controlled substances in clinical practice. Overall, the digest captures the balance regulators must maintain between preventing drug abuse and supporting legitimate pharmaceutical distribution and medical care delivery.