Since the passage of the Controlled Substances Act (1970), the federal government has classified cannabis as a Schedule I drug with high potential for abuse and no accepted medical use. Meanwhile, state governments have taken action to approve the use of cannabis for medical and recreational purposes. These developments have made cannabis policies unique among other policies. Beyond the interesting questions about federalism, the starkly divergent approaches to cannabis regulation lead to administrative challenges for adopting states and the industry. Creating novel medical and recreational programs comes at a cost. We examine how the federal government’s rhetorical and procedural fickleness on cannabis policy has led to several downstream administrative consequences. We also discuss whether recent events like the coronavirus pandemic and more state adoptions can accelerate change at the federal level.