Drug law sits at the intersection between punishment and public health. Since at least the enactment of the Controlled Substances Act (CSA) of 1970, U.S. law has weighted that balance in favor of punitive control policies, giving the U.S. Department of Justice (DOJ)—through the Drug Enforcement Administration (DEA)—primary authority in deciding which drug-related activities are legitimate and which can land you in prison. Federal health agencies supply scientific input, but the ultimate scheduling decision has rested with law enforcement.
A new bill from Rep. Steve Cohen (D-Tenn.), the Public Health and Research Reforms in Controlled Substances Act of 2026, would rebalance that equation. It moves core scheduling and research authority from the DOJ to the Department of Health and Human Services (HHS), overhauls how drugs are scheduled and studied, and removes marijuana from the list of controlled substances.
But the bill’s most consequential changes aren’t merely about which agency makes scheduling decisions, but how those decisions are made. Cohen’s bill would, for the first time, require the government to weigh the costs of prohibiting a drug, not just the risks the drug itself might pose.
Since the CSA’s adoption, federal law has sorted drugs into five categories based on their perceived danger to individuals and society. Schedule I substances are prohibited outright, deemed to have a high abuse potential and no accepted medical uses (this schedule includes marijuana, heroin, LSD, psilocybin, MDMA); schedules II through V gradually loosen restrictions for drugs deemed to have a lower abuse potential and accepted medical uses.
The attorney general, through the DEA, applies an eight-factor analysis that largely puts the burden of proof on the substance, focusing almost entirely on its potential to harm individuals and society. Therapeutic uses are technically part of this evaluation, but the agency has historically treated FDA approval as the measure of “accepted medical use.” That’s something of a catch-22, as FDA approval is a high bar to clear and, for a substance that is already scheduled, stigmatized, and difficult to study due to the restrictions imposed by the CSA, makes generating the evidence to support its approval even more difficult.
More fundamentally, current law does not ask the government to weigh a drug’s potential harm against the harms of prohibiting it, such as eliminating useful therapies and pushing users toward more dangerous drugs or sources.
Cohen’s bill makes that comparison mandatory. Officials must consider as a factor “what threat to public health, if any, from scheduling the drug or other substance, including replacement by alternative drugs or substances.” They must also consider whether that drug is currently being used to reduce people’s dependence on other harmful substances to which users might return should their drug of choice be restricted.
Cannabis offers an example of how Cohen’s bill might work in practice. For more than half a century, marijuana has sat in Schedule I alongside heroin and LSD based on the DEA’s determination that it has no accepted medical use. That classification has never matched the evidence, with thousands of years of medicinal use, scientific validation of its efficacy for conditions like chronic pain and chemotherapy-induced nausea, and state-authorized medical cannabis programs since 1996. Under the framework Cohen proposes, that evidence would have to be weighed along with the harms users might face from prohibition.
To make these considerations systematic, the bill replaces the current five schedules with a dual approach. A drug would receive a Roman numeral (I through IV) to reflect its risk of misuse, potential for dependence, and threat to public health, plus a letter (A through E) reflecting its therapeutic value. A drug could therefore be classified as high-risk while still being recognized as substantially beneficial in a medical context. This is a reality medical practitioners face daily, with drugs like fentanyl that carry significant risks but remain indispensable in surgery.
Scheduling authority would move to the secretary of HHS. The attorney general would supply a law enforcement evaluation on the single factor of illicit manufacturing and trafficking, with the attorney general and Office of National Drug Control Policy (ONDCP) authorized to request and initiate scheduling action, but HHS would make the ultimate determination. A new 15-to-25-member expert committee appointed by HHS would conduct a transparent “multicriteria decision analysis,” scoring substances against 15 factors and weighting the evidence, with its analysis published and available to the public.
The bill also modernizes emergency scheduling. The standard of an “imminent hazard to the public safety,” which currently allows the attorney general to bypass the eight-factor analysis to temporarily list substances as schedule I, is undefined in federal statute. Cohen’s bill would substitute this with a defined “imminent significant threat to public health” standard, and shift initiation of emergency scheduling from the attorney general to the ONDCP director (colloquially known as the “drug czar”).
The bill also eliminates quantity-based mandatory minimum sentences for trafficking while keeping maximum limits, including up to life in prison where death or serious bodily injury occurs, and preserves enhanced penalties for repeat offenders and serious drug felonies. But it also creates a resentencing pathway for previous convictions and requires the Bureau of Prisons to identify eligible prisoners and file motions on their behalf. Marijuana and THC come off the schedules entirely, though the FDA retains authority over cannabis products. The bill also allows continued marijuana testing of federal employees.
The bill is not so radical that it ends the federal government’s punitive approach to drug policy. It still permits federal imprisonment for those possessing illicit drugs. Transferring scheduling authority to HHS is also no guarantee against political interference, since the HHS secretary is appointed by the president and appoints the expert committee members. But the transparency provisions in Cohen’s bill would at least make such political interference more visible to the public by, for example, disclosing how the expert committee weighted the evidence behind its analysis.
The bill also retains an emergency-scheduling pathway that would allow HHS to bypass the new expert committee and its transparent scoring process. But it would still require consideration of the statutory factors—including the harms of prohibition—when the ONDCP director initiates emergency scheduling. The bill also raises maximum fines for certain drug offenses, though Cohen argues this is largely to account for inflation since the penalties were set in 1986.
Cohen is retiring this year, and his bill is unlikely to pass in the lame-duck session, so it is best seen as a benchmark for future CSA reform efforts. At a minimum, those efforts should adopt Cohen’s provision requiring the government to weigh the costs of prohibition, including the damage done to individuals and society when legal supply channels close. Adopting that requirement would shift federal drug policy away from its current default of control first, evidence later, and toward an approach more grounded in science and public health.