Review Argues Cannabis Abuse Risk Under Medical Supervision Is Comparable to Other Prescription Drugs | Research

The takeaway

A narrative review challenged five common assumptions about cannabis abuse potential, concluding that medically supervised cannabis has abuse liability comparable to other widely used pharmaceuticals.

Medical cannabis prescribers, drug policy researchers, regulatory officials evaluating cannabis scheduling.

5 key assumptions challenged

What the researchers found

The review identified and examined five broad assumptions in the abuse liability literature: (1) a standard cannabis formulation, (2) standard routes and potency, (3) a standard pattern of use, (4) a standard user, and (5) standard vulnerability to misuse. The authors concluded that unpacking these assumptions reveals the evidence does not support treating cannabis as uniquely high-risk for abuse when used under medical supervision.

Why it matters

Cannabis scheduling and regulation debates often rest on assumptions about abuse potential. This review argues that much of the existing abuse liability research fails to distinguish between recreational and medical use, different formulations, routes, and patient populations, leading to an oversimplified picture of cannabis risk.

The numbers in context

Over 350 articles reviewed. ~90% published after 2002. ~50 papers included after abstract screening. Five broad assumptions identified and examined.

How the study worked

Narrative scoping review of over 350 articles (approximately 90% published after 2002) identified from databases using terms related to cannabis abuse, misuse, and dependence. Abstract analysis narrowed the selection to approximately 50 papers based on relevance as judged by an experienced clinician and a public health toxicologist.

What this study cannot tell us

Narrative review with author-selected papers rather than systematic methodology. Only two authors assessed relevance. May underweight evidence supporting higher abuse potential. "Comparable to other pharmaceuticals" is a broad claim given that some pharmaceuticals have significant abuse liability.

How to read the evidence

Moderate: expert review drawing on substantial literature, but narrative methodology allows selection bias in papers reviewed.

When this study was published

2025 study

The bigger picture

The distinction between recreational and medical cannabis use is often blurred in policy discussions. This review suggests that the abuse liability of cannabis under proper medical supervision may be no different from that of benzodiazepines, opioids, or stimulants that are routinely prescribed with appropriate monitoring.

Questions still open

How should cannabis abuse risk assessment differ between medical and recreational contexts? What monitoring protocols would ensure medical cannabis has acceptable abuse profiles? Should different cannabis formulations have different scheduling based on abuse potential?

Common questions

Is medical cannabis addictive?

This review argues that the abuse potential of cannabis under medical supervision is comparable to other widely prescribed drugs. The risk depends heavily on formulation, route, patient factors, and monitoring, rather than being inherent to cannabis itself.

What assumptions about cannabis abuse does this review challenge?

The review questions assumptions about standardized formulations, routes, use patterns, users, and vulnerability to misuse, arguing that cannabis abuse research often fails to account for this variability.

Read the original research

Questioning assumptions about the abuse potential of medical cannabis and cannabinoids: narrative review and commentary.

BJPsych bulletin, 1-9

View on PubMed ↗Publisher’s paper ↗

Citation

Pressman, Peter; Hayes, Andrew Wallace. (2025). Questioning assumptions about the abuse potential of medical cannabis and cannabinoids: narrative review and commentary.. BJPsych bulletin, 1-9. https://doi.org/10.1192/bjb.2025.10183