She’s back—and she’s making no apologies. Dr Roneet Lev, a vocal critic of marijuana reform, is returning to the White House’s top drug policy office, stoking concerns among advocates and experts who’ve been tracking federal cannabis policy shifts.
Lev, an emergency medicine doctor with a long paper trail of anti-marijuana commentary, will once again serve in the Office of National Drug Control Policy (ONDCP), the same agency she worked under during the previous Trump administration. She confirmed her new role this week, calling it an opportunity to “save lives on a much bigger scale.” Critics, however, are reading between the lines.
A Familiar Voice with a Familiar Message
Lev isn’t new to the national spotlight. During her earlier tenure as ONDCP’s chief medical officer, she gained a reputation for delivering stark warnings about cannabis. And her rhetoric hasn’t softened with time.
She’s publicly tied marijuana use to mental health deterioration and even suicide. In Florida, she campaigned against a ballot initiative that would legalise recreational marijuana, suggesting it would open the floodgates for what she calls a “predatory industry.”
More recently, Lev criticised the U.S. Department of Health and Human Services (HHS) for recommending that cannabis be moved from Schedule I to Schedule III—a technical change that could pave the way for broader medical research and commercial use.
She didn’t mince words: calling medical marijuana “an insult” to science and medicine.
That comment alone drew fierce backlash from patients, physicians, and researchers alike.
Timing Couldn’t Be More Telling
Her return comes at a particularly sensitive time for federal drug policy. In August 2023, the HHS issued a recommendation to reclassify cannabis under the Controlled Substances Act—a decision that would mark the most significant shift in national marijuana policy in over 50 years.
Supporters of the move argued it would:
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Increase access to research funding
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Allow doctors to prescribe cannabis-based medication more freely
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Signal a shift away from criminalisation
But Lev’s appointment has cast a shadow over that momentum.
While the ONDCP technically doesn’t set drug schedules—that’s the job of the DEA—the office plays a powerful advisory role. With Lev back in the building, some fear that influence may be skewed against reform.
Who Is Dr Roneet Lev?
Lev’s background is complex. She’s not some fringe figure. She’s board-certified, Ivy League educated, and formerly led Scripps Mercy Hospital’s emergency department in San Diego.
But her views on cannabis have often raised eyebrows, even among medical peers.
In a 2022 congressional hearing, Lev testified that emergency departments are overwhelmed with cases linked to cannabis-induced psychosis, especially in teens. She referred to marijuana as “today’s most misunderstood drug,” accusing the industry of glossing over risks while targeting vulnerable communities.
She’s also a frequent contributor to conservative policy journals and think tanks, including the Hudson Institute and SAM (Smart Approaches to Marijuana), where she’s penned essays warning of the drug’s dangers.
And yet, to some, her return to ONDCP feels less about data and more about ideology.
A White House Strategy or Political Signalling?
There’s no mistaking the optics.
The Trump campaign has made “law and order” a pillar of its 2024 messaging. Reappointing Lev—a known critic of marijuana liberalisation—could be read as a nod to conservative voters concerned about drug use, especially among young people.
One former ONDCP staffer, who asked not to be named, said: “Bringing Roneet back is more than a personnel decision. It’s a statement.”
Here’s how ONDCP staffing has shifted in recent years:
| Year | ONDCP Chief Medical Adviser | Presidential Administration | Public Stance on Cannabis |
|---|---|---|---|
| 2019-2021 | Dr Roneet Lev | Trump | Strongly Opposed |
| 2021-2023 | Dr Rahul Gupta | Biden | Supportive of Reform |
| 2024 (current) | Dr Roneet Lev (reappointed) | Trump | Strongly Opposed |
But not everyone inside the administration agrees with Lev’s stance. Some Republican lawmakers have even hinted at supporting incremental cannabis reform—especially if it means boosting tax revenue and job growth.
What This Means for the Future of Federal Cannabis Reform
Well, that depends.
Lev’s return could slow down the pace of reform—especially behind the scenes. She’s known to be persuasive, strategic, and not afraid to challenge mainstream narratives. Internally, she may influence how data is framed, what stories get elevated, and which research gets funded.
But remember: the Drug Enforcement Administration (DEA) still holds the pen when it comes to rescheduling decisions. And even if Lev pushes back, political pressure from states—and the public—may eventually tip the scale.
Cannabis is now legal in some form in 38 states. In the last Gallup poll, 68% of Americans supported full legalisation. Those are hard numbers to ignore.
Still, with Lev now in the mix again, policy watchers say progress could get tangled in new debates over safety, science, and ideology.
One White House official, speaking off-record, summed it up: “It’s going to get loud.”
Reactions Are Already Pouring In
It didn’t take long for critics and supporters to voice their opinions.
Cannabis advocacy groups like NORML and the Drug Policy Alliance issued blistering statements, calling Lev’s appointment “out of step with modern science” and a “political regression.” Meanwhile, groups like Smart Approaches to Marijuana praised the move as a “return to fact-based policymaking.”
Doctors appear split. Some say Lev brings a necessary caution to the table—especially with more potent THC products flooding the market. Others argue she risks cherry-picking data and undermining evidence-based public health messaging.
Social media has lit up, too. X (formerly Twitter) users debated whether her views represent sound science or moral panic. And Reddit’s r/trees subreddit, a popular hangout for cannabis users, dubbed her “the new Reefer Madness czar.”
Public health debates tend to get emotional. This one’s no different.
