First published December 4, 2020.
On 2 December 2020 the UN Commission on Narcotic Drugs (CND) voted 27 to 25, with one abstention, to remove cannabis and cannabis resin from Schedule IV of the 1961 Single Convention on Narcotic Drugs, the strictest category, where it had sat alongside heroin for 59 years. The decision recognised that cannabis has medical value. It did not legalise cannabis anywhere: the plant stays under international control in Schedule I.
Here is what the vote changed, what it left untouched, and why it still mattered.
How the UN drug schedules work
The Single Convention, the backbone of the global drug control system, sorts substances into four schedules. Confusingly, they are not ranked in numerical order. From strictest to least strict they run IV, I, II, III.
- Schedule I is the standard regime: production, trade, possession and use are limited to medical and scientific purposes, with licences, estimates and reporting. Cocaine, morphine and opium are here.
- Schedule IV is a subset of Schedule I. Every Schedule IV drug is also in Schedule I, but it is flagged as particularly dangerous with little therapeutic value, and countries are invited to consider banning even medical use. Heroin is the best-known example.
- Schedules II and III cover substances and preparations under lighter controls, such as codeine and low-strength preparations.
So until 2020 cannabis was classed not only as a controlled drug, but as one that the treaty treated as having especially dangerous properties and very limited medical use.
What the World Health Organization recommended
The change came from the WHO's Expert Committee on Drug Dependence, which carried out the first full scientific review of cannabis since the treaty was drafted. In recommendations sent to the UN in early 2019, the WHO concluded that the inclusion of cannabis and cannabis resin in Schedule IV "is not consistent with the criteria for a drug to be placed in Schedule IV".
In other words, the evidence did not show that cannabis was as harmful as heroin, and there was evidence of therapeutic uses. Cannabis-based medicines are approved in several countries for conditions such as nausea and vomiting caused by chemotherapy and some severe forms of childhood epilepsy.
The WHO made several other recommendations, including changes to how extracts, tinctures and THC are listed. The commission did not adopt those and approved only the Schedule IV removal. The WHO also clarified that pure cannabidiol (CBD), which is not intoxicating, is not under international control.
A narrow, divided vote
The CND has 53 member states, and the result was very close. Among the supporters was the United States, which said it backed removal from Schedule IV but wanted cannabis kept in Schedule I because it still poses "significant risks to public health". Ecuador supported all of the WHO's proposals.
Opponents included Chile, which cited links between cannabis use and depression, anxiety and cognitive problems, and Japan, which warned about harms to young people. The decision, formally CND Decision 63/17, entered into force in April 2021.
What changed and what did not
It is easy to read headlines about the UN "downgrading" cannabis and assume something bigger happened. The practical picture is more modest:
- Still controlled: cannabis, resin, extracts and tinctures remain in Schedule I, so international rules on cultivation, trade and non-medical use still apply. THC and related cannabinoids are covered separately by the 1971 Convention on Psychotropic Substances.
- No change to national laws: penalties for possessing, growing or selling cannabis are set by each country. The vote did not alter any of them.
- Symbolic and scientific shift: for the first time the UN system formally accepted that cannabis has medical value, removing an argument often used against research and medical programmes.
Conor O'Brien of the cannabis industry analysts Prohibition Partners said at the time that one of the original reasons for the WHO recommendations was "to open up the path to research". Researchers broadly agreed that the decision made it easier for universities and regulators to justify clinical studies.
Common misunderstandings
"The UN legalised marijuana." It did not. The treaty still requires parties to limit cannabis to medical and scientific use, even though some countries, such as Canada and Uruguay, have chosen to legalise recreational use regardless.
"Cocaine was in Schedule IV with cannabis." Cocaine is controlled in Schedule I, not Schedule IV. The comparison that made headlines was with heroin.
"Medical cannabis is now proven for everything." The evidence varies widely by condition and product. Anyone considering a cannabis-based treatment should talk to a doctor.
The wider shift in drug policy
The UN vote came weeks after US voters weighed in on drug laws. In November 2020 Oregon approved Measure 110 with about 58% of the vote, turning possession of small amounts of drugs such as heroin, methamphetamine and cocaine into a civil violation and funding addiction services. Dealing stayed a crime.
The experiment proved controversial. Amid a surge in fentanyl deaths and public drug use, Oregon's legislature passed House Bill 4002 in 2024, making possession a misdemeanour again from 1 September 2024 while keeping the expanded treatment funding.
The model Oregon looked to was Portugal, which decriminalised personal possession in July 2001. There, people caught with up to a ten-day supply are referred to a Commission for the Dissuasion of Drug Addiction, made up of a social worker, a psychiatrist and a lawyer instead of a criminal court. Drug-related deaths and HIV infections among people who use drugs fell sharply in the following years, although deaths have since risen again and researchers caution that it is hard to prove what caused each change. Trafficking remains a serious crime in Portugal.
The common thread is a move toward treating drug use as a health issue. The 2020 vote did not settle that debate, but it took one long-standing argument off the table: by the UN's own expert reckoning, cannabis does not belong in the same category as heroin.
Sources: UN News: UN commission reclassifies cannabis, 2 December 2020; Wikipedia: Single Convention on Narcotic Drugs; Complex: UN removes cannabis from most dangerous substances list; Wikipedia: 2020 Oregon Ballot Measure 110; Wikipedia: Drug policy of Portugal.
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