“Becoming a credible healthcare category does not require whole-plant cannabinoid medicine to become indistinguishable from conventional pharmaceuticals.”
By Matthew Myro Rothman, EM2P2 and CannaLnx
For decades, the medical cannabis movement fought for something that should have been relatively simple: recognition that cannabis can be medicine.
Patients fought for access. Physicians put their reputations on the line. Advocates changed state laws. Cultivators, breeders and dispensary operators built an industry while federal policy largely refused to acknowledge what millions of patients already knew.
That fight is finally producing something closer to medical legitimacy: In April, the federal government moved qualifying state-regulated medical cannabis products from Schedule I to Schedule III.
It’s an extraordinary acknowledgment from Washington that cannabis has accepted medical use. At the same time, the Drug Enforcement Administration (DEA) launched a separate hearing process over the broader rescheduling of marijuana, proceedings with enormous implications for how federal law will ultimately treat cannabis beyond state medical programs, including the future of state-regulated adult-use markets.
But legitimacy creates a new question for our industry, and we should be paying much more attention to it: Who gets to decide what cannabinoid healthcare looks like from here?
The next cannabis fight will be less about legalization than about institutional power: who writes the rules, controls the data and builds the systems through which cannabinoid medicine enters American healthcare.
Healthcare is made up of far more than medicines and doctors. It runs on standards, reimbursement systems, provider networks, clinical data, documentation, patient records, research protocols and trusted methods for exchanging information.
Those systems determine which therapies are recognized, which providers participate, how patients access care and what information is considered credible.
As cannabinoid medicine becomes more closely integrated with mainstream healthcare, those systems will have to exist here, too. The question is whether the cannabis industry helps build them—or eventually inherits systems designed by somebody else.
Cannabis already has a body of medical knowledge
This matters because medical cannabis is not arriving at healthcare’s doorstep empty-handed.
Decades of state-regulated programs have produced an enormous body of practical knowledge about cannabinoid medicine. Patients have learned which formulations work for them. Clinicians have accumulated observations about dosing and outcomes. Breeders and cultivators have developed sophisticated knowledge of genetics and chemotypes. Dispensary professionals have spent years helping patients navigate products, delivery methods and cannabinoid ratios.
All of this despite the federal government’s archaic rules restricting cannabis research for nearly a century. Much of that knowledge developed outside traditional clinical infrastructure because cannabis had no other choice.
The challenge now is organizing and documenting it in ways that insurers, researchers, regulators and healthcare institutions can reliably use.
If we fail to do that, a strange thing could happen: Cannabis could finally achieve the legitimacy the industry spent decades pursuing while much of the knowledge that built medical cannabis remains fragmented, underdocumented or pushed aside.
That would be a tremendous loss.
Healthcare integration should not require pharmaceutical assimilation
Medical cannabis should meet healthcare expectations for safety, evidence, accountability and data integrity. Those expectations are appropriate.
But becoming a credible healthcare category does not require whole-plant cannabinoid medicine to become indistinguishable from conventional pharmaceuticals.
There is room for a parallel model: one that preserves state-regulated medical cannabis, patient choice and the expertise already developed within this industry while allowing secure interoperability with insurers, providers and the wider healthcare system.
The goal should be for cannabinoid medicine to become a peer healthcare community: credible enough to stand alongside established medical institutions, capable of producing evidence those institutions can trust and equipped to participate in reimbursement and coordinated care.
That requires infrastructure.
Infrastructure determines who has a voice
This is why the next phase of medical cannabis will be shaped by decisions that may initially sound boring: Who establishes standards? Who structures the data? How are outcomes documented? How are purchases validated for reimbursement? How do physicians, dispensaries, insurers and patients securely interact?
Those decisions eventually become the architecture of an industry.
In my work with the American Council of Cannabis Medicine (ACCM) and EM2P2 to develop the Next Frontier Pipeline, I have seen how much coordination this transition requires. Connecting cannabinoid medicine with healthcare means solving difficult questions around data standards, patient privacy, reimbursement, clinical evidence and interoperability. No single company or institution should answer those questions alone.
The infrastructure connects patients, physicians, dispensaries, laboratories, insurers, employers, health networks and other stakeholders while supporting functions including reimbursement validation, standardized data exchange, real-world evidence and interoperability.
I am obviously close to that work. But the larger point extends well beyond our platform.
Cannabis needs infrastructure built with the participation of cannabis.
The industry has an opportunity to organize its knowledge, establish credible standards and demonstrate that it can interact responsibly with mainstream healthcare without surrendering everything that made medical cannabis a distinct therapeutic community in the first place.
Federal legitimacy was never supposed to be the finish line. It’s an invitation—and a warning—to build the systems that will determine how cannabinoid medicine functions for decades to come.
The people who carried medical cannabis through prohibition should not be consulted after those systems are built. They should help design them now. The next victory will not simply be recognition that cannabis can be medicine. It will be a healthcare system capable of learning from what patients and practitioners already know—and putting that knowledge to work without erasing where it came from.
Matthew Myro Rothman is the chief science officer at EM2P2 and CannaLnx, an intelligent health platform that connects patients, doctors, dispensaries and insurers to make medical cannabis care safe, data-driven, and reimbursable.
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