DOT Grapples with Road Safety as Cannabis Reschedules; OHSU Study Validates THC for Pain Relief

On December 28, 2025, two parallel developments highlighted the complex interplay between cannabis regulation, workplace safety, and medical science. The Department of Transportation confronted potential road safety challenges as marijuana moves toward Schedule III classification, while an Oregon Health & Science University-led systematic review provided new evidence about cannabis efficacy for chronic pain management.

DOT’s Drug Testing Dilemma

According to Dailyfly News, the transportation industry faces uncertainty about its ability to maintain drug testing programs for safety-sensitive employees once cannabis is rescheduled to Schedule III. Under current regulations, the Department of Transportation only permits commercial transportation employers to test for Schedule I and II drugs under the Controlled Substances Act.

With marijuana moving to Schedule III, the Department of Health and Human Services drug testing panel may no longer include cannabis, potentially eliminating employers’ authority to test truck drivers, pilots, train engineers, and other safety-sensitive personnel. Brenna Lyles, senior director of safety policy at the American Trucking Associations, told The Center Square that “once a drug moves to that lower schedule, it becomes less clear what they can and can’t do.”

The stakes are high: Delta-9 THC currently accounts for over 60% of all positive drug tests in the DOT’s Drug and Alcohol Clearinghouse database. The ATA is encouraging legislative or regulatory action to preserve testing requirements, potentially through “safety-sensitive carve-outs” that specifically maintain testing authority regardless of marijuana’s scheduling status.

OHSU Study: THC Works, CBD Doesn’t for Pain

Simultaneously, OPB reported on an OHSU-led systematic review published in the Annals of Internal Medicine that found THC-containing cannabis products work about as well as ibuprofen for chronic pain. The federally funded analysis of 25 randomized controlled trials in the United States, Canada, and Europe showed pain reduction of approximately 1 point on a 10-point scale, comparable to conventional painkillers including opioids.

However, the review delivered disappointing news for CBD proponents: products containing only cannabidiol had “trivial effect on pain” in randomized trials. Roger Chou, a professor and pain management specialist at OHSU who led the review, noted that “the CBD products essentially had no impact on pain.”

The study found that products with equal amounts of THC and CBD, or higher THC concentrations, while somewhat effective at reducing pain, were more likely to cause side effects like nausea, sedation, and dizziness.

Business Implications

These developments create several imperatives for cannabis operators:

1. Workplace Policy Review: Companies with transportation operations or safety-sensitive positions should review drug testing policies and prepare for potential regulatory changes. Engaging with industry associations like the ATA can help shape legislative solutions.

2. Product Portfolio Assessment: Medical cannabis companies may need to reevaluate product formulations based on the OHSU findings. THC-containing products gain scientific validation for pain management, while CBD-only products may require adjusted marketing claims.

3. Research Strategy Development: Rescheduling to Schedule III will facilitate expanded cannabis research. Companies should consider partnerships with academic institutions to build evidence for specific product formulations and indications.

4. Regulatory Monitoring: Close attention to both DOT guidance and FDA regulatory developments will be crucial as rescheduling proceeds through the rulemaking process.

Action Items for Cannabis Operators

• Conduct internal audits of workplace drug testing policies, particularly for safety-sensitive positions
• Engage with transportation industry associations to advocate for clear testing protocols
• Review product portfolios and marketing materials in light of emerging efficacy data
• Explore research partnerships to build evidence for specific cannabis formulations
• Monitor both DOT and HHS regulatory developments as rescheduling progresses

The December 28 developments underscore the multifaceted impact of cannabis rescheduling. While the move to Schedule III promises tax relief and research opportunities, it also introduces regulatory complexities for workplace safety and provides new scientific insights about product efficacy. For cannabis businesses, navigating this evolving landscape requires careful attention to both regulatory developments and emerging scientific evidence, with proactive planning to address challenges and capitalize on opportunities.