For more than half a century, federal officials have classified drugs into legal categories that determine who can manufacture, prescribe, or study them, and who goes to prison for possessing or selling them. Those classifications carry enormous consequences. They also reflect decades of political pressure, moralization, myth, and stigma.

Rep. Steve Cohen (D–Tenn.) proposes to change that. His Public Health and Research Reforms in Controlled Substances Act of 2026 would substantially overhaul federal drug scheduling, shift key decisions from law enforcement to health officials, ease research restrictions, deschedule marijuana, and reduce mandatory prison penalties.

While the proposal preserves too much of the drug prohibition infrastructure, it represents a major step toward a more rational, evidence-based, and humane drug policy.

The Controlled Substances Act currently combines judgments about a drug's potential for abuse with judgments about its medical usefulness. Congress vested scheduling authority in the attorney general, who generally exercises it through the Drug Enforcement Administration (DEA). The Department of Health and Human Services (HHS) evaluates the scientific and medical evidence, but the DEA makes the ultimate legal determination of whether a drug has a "currently accepted medical use" for scheduling purposes, as the Justice Department explained in a 2024 legal opinion. Schedule I, the most restrictive category, includes substances deemed to have a high potential for abuse and no currently accepted medical use. These restrictions impede research, while officials cite insufficient evidence of medical usefulness to justify continued restrictions.

Cohen's bill would transfer authority to assess medical usefulness and drug-related risks—and to make scheduling decisions—from law enforcement to HHS, where those judgments more rationally belong. Under the new system, controlled substances would receive two classifications: a Roman numeral, I through IV, reflecting risks associated with misuse, substance use disorder, and threats to public health; and a letter, A through E, reflecting therapeutic value.

A substance could therefore be classified as high risk while still recognized for substantial medical benefits. That reflects an everyday reality of medical practice. Fentanyl, for example, can cause fatal respiratory depression and remains an indispensable anesthetic and analgesic. A drug's dangers do not erase its benefits.

The bill would also replace the vague "potential for abuse" standard for adding substances to the schedules with a standard based on the potential to develop a substance use disorder, expressly excluding isolated or occasional nontherapeutic use. Taking a substance for pleasure would no longer, by itself, satisfy that threshold.

Among the proposal's most consequential provisions is a requirement that officials consider whether scheduling a substance would itself threaten public health, including by encouraging people to substitute other drugs. They must also consider whether people use a substance to help control problematic use of another scheduled drug, as well as the harms associated with that other drug.

That would force federal officials to confront consequences that drug warriors routinely ignore. Banning a substance does not eliminate demand. Consumers may turn to underground suppliers, face uncertain potency and contamination, or switch to more dangerous products. Making a particular drug harder to obtain can leave its users worse off.

These requirements could be critical in disputes over kratom and its alkaloids, such as 7-hydroxymitragynine (7-OH), which some consumers report using for pain or to reduce their use of other opioids. Such reports should be part of an honest assessment of what consumers stand to lose when the government closes a legal supply channel.

An expert committee would evaluate each substance and publish its evidence and reasoning, making scheduling decisions more transparent and easier to challenge.

HHS would also assume from the DEA responsibility for registering researchers who study controlled substances. Qualifying researchers would gain an expedited registration pathway, with faster decisions for eligible small preclinical pilot studies. Federal officials currently demand evidence that these drugs have medical benefits while imposing restrictions that make it harder for researchers to obtain the drugs and conduct the studies needed to generate that evidence.

Cohen would require officials to reconsider existing classifications, setting a two-year deadline for 32 named substances and an eight-year deadline for most others. If officials miss those deadlines, statutory fallback classifications would apply.

The bill would also repeal the legal obligation of the director of the Office of National Drug Control Policy, the "drug czar," to oppose specified legalization efforts—a remarkable requirement for an office supposedly focused on evaluating drug policy.

Marijuana and tetrahydrocannabinols (THCs) would come off the controlled substance schedules altogether. The bill expressly makes that change retroactive, extending it to past offenses, pending cases, convictions, and juvenile adjudications.

Its sentencing reforms also merit praise. The proposal would remove the quantity-based trafficking provisions that impose five- and 10-year mandatory minimums and eliminate specified mandatory penalties when death or serious injury results. The bill would also limit certain repeat-offender sentencing enhancements to prior convictions that meet the narrower definition of a "serious drug felony." Among other requirements, the person must have served more than a year in prison and been released within 15 years of the new offense. Eligible prisoners could receive reduced sentences, and the Bureau of Prisons would be required to identify them, notify them, and file motions on their behalf.

These changes could spare people years of imprisonment. They deserve support even from those of us who would go much further.

The shortcomings remain significant.

First, the bill preserves criminal penalties for peaceful conduct involving drugs that remain controlled. It leaves the general federal simple-possession statute intact, including mandatory minimum jail terms for repeat offenses. Congress would continue to authorize imprisonment for possessing a substance without government permission.

Second, transferring power to HHS offers no guarantee against political interference. The secretary would appoint the expert committee in consultation with the drug czar. Its required membership emphasizes addiction medicine, toxicology, and substance-use services, without expressly reserving seats for pain patients, ordinary consumers, or civil liberties advocates.

The bill would allow emergency scheduling to bypass the new expert committee's review. It would also retain features of the current system: Temporary restrictions could last two years, with a possible one-year extension, and the statute would expressly exclude those orders from judicial review.

The bill would also transfer production quotas to HHS rather than abolish them. As I have argued before, presuming to know how much of each opioid more than 320 million Americans will need in the coming year exemplifies what economist Friedrich Hayek called the "fatal conceit." These quotas have contributed to shortages of injectable opioids in hospitals, jeopardizing care for surgical patients and those on ventilators. Transferring that power to a health agency does not solve the underlying knowledge problem. Congress should abolish the quotas.

The proposal substantially increases many maximum fines even as it reduces mandatory prison penalties. For an individual convicted of Schedule I or II trafficking without a qualifying prior conviction, the fine ceiling would rise from $1 million to $10 million. Congress should question this punitive expansion.

Finally, marijuana descheduling would leave Food and Drug Administration (FDA) authority intact. The bill expressly preserves the agency's powers under federal food and drug law, allowing it to regulate cannabis products that qualify as drugs, foods, or other products within its jurisdiction. It provides no explicit protection for a recreational cannabis market from FDA restrictions.

Those weaknesses warrant amendments. Scientific evidence can help people understand risks, but it cannot, by itself, justify depriving competent adults of the freedom to decide which risks they will accept. Autonomous adults should remain free to make informed choices about what they put into their bodies.

Cohen, who is retiring from Congress at the end of his term, is unlikely to see this sweeping reform pass during the brief post-election lame duck session. But his proposal can serve as a benchmark for reforming the Controlled Substances Act in the next Congress. Providing his successors with a framework that places greater weight on scientific evidence, recognizes the harms of prohibition, and reduces unjust punishment would leave Cohen with a substantial drug policy reform legacy.

The post Rep. Steve Cohen Thinks the DEA Shouldn't Be Practicing Medicine appeared first on Reason Magazine.

Nearly half of confirmed infections have been fatal, while undetected transmission, attacks on health workers and limited treatment options hamper containment.

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The Eola outbreak in the Democratic Republic of the Congo has surpassed 10,000 confirmed cases, with nearly half of those infected dying, as health authorities struggle to contain the fastest-growing outbreak on record and prevent further spread across Africa.

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The outbreak, declared in May and caused by the rare Bundibugyo virus, has become the deadliest Ebola epidemic in Congo’s history, according to data released Tuesday by the country’s Health Ministry. No approved vaccine or treatment is available for this strain.

The epidemic has spread to 66 health zones across eight provinces, up from three when the outbreak was first declared. At least 2,600 patients have recovered, but response teams continue to face armed conflict, poor road conditions, community resistance and distrust fueled by misinformation.

Footage shows healthcare workers singing and dancing at an Ebola treatment centre in DR Congo after the last patient made a full recovery and left.

The Doctors Without Borders-run centre in Mongbwalu was where the latest outbreak began. pic.twitter.com/syUqGFQYlP

— Al Jazeera English (@AJEnglish) October 29, 2026

The outbreak has also spread farther across Africa than any previous Ebola epidemic, reaching three regions of the continent. Cases have been reported in five countries, including Kenya, Nigeria, Uganda and France. Uganda and France currently have no active cases.

Weak disease surveillance has compounded the crisis, with many initial infections confirmed only after patients developed symptoms or traveled elsewhere. The spread of the virus beyond known contacts remains a major obstacle to containment.

About 80% of reported infections in Congo involve people who were not among the contacts being monitored by health authorities, indicating that transmission chains remain undetected. According to the Africa Centres for Disease Control and Prevention, at least 95% of cases would need to be identified among known contacts for the outbreak to be considered largely under control.

At least half of recorded deaths have involved people who were never admitted to treatment centers, highlighting the difficulty of persuading communities to report symptoms and seek medical care.

The response has also been undermined by overcrowded treatment facilities, inadequate transport and repeated strikes by health workers protesting delayed or unpaid wages. In the Nia Nia health zone in Ituri province, some Ebola response personnel, including surveillance and community engagement staff, went on strike last week over unpaid bonuses owed since late August.

Violence against health workers remains another serious concern. On Saturday, a nurse was killed and another health worker seriously injured while responding to an Ebola alert in Bafwasende, in Tshopo province. More than five months after the outbreak was declared, response teams continue to face attacks by angry residents.

In Ituri, the outbreak’s epicenter, burial teams must also persuade families to hand over the bodies of relatives who have died from Ebola so they can be buried safely. Some residents remain skeptical of the disease’s severity despite being directly exposed to the risk.

Sephora Bgosi, a member of an Ebola burial team in Ituri, said some people continued to underestimate the disease even when they faced a direct risk of infection. She stressed that Ebola is highly dangerous and can be fatal.

Ebola Disrupts Essential Health Services

The epidemic is placing additional pressure on Congo’s already underfunded and overstretched health system, disrupting essential services and diverting attention from other outbreaks, including cholera.

Maternal deaths have doubled in some provinces since the outbreak began, as more pregnant women avoid hospitals for fear of infection and isolation. Routine services, including childhood vaccinations, have also been disrupted. Schooling has been interrupted in affected areas, where millions of children are already out of school, while families face trauma, stigma and further economic hardship.

Despite the mounting toll, the outbreak has produced rare moments of relief. A video that went viral this week showed health workers in full protective equipment dancing as the last two patients were discharged from a treatment center in Mongbwalu, in Ituri province.

At least 2,600 people have recovered in Congo, offering some respite to communities affected by the epidemic. World Health Organization Director-General Tedros Adhanom Ghebreyesus responded to the video by acknowledging that the outbreak remained far from over while emphasizing the importance of every recovery.

African health ministers were scheduled to hold a virtual summit on Wednesday to strengthen the continent’s collective response. Jean Kaseya, head of the Africa Centres for Disease Control and Prevention, stressed the need for faster cross-border action, closer coordination, greater solidarity and decisive political leadership as the virus continues to spread.