The U.S. Department of Veterans Affairs (VA) has released an updated directive that reaffirms its doctors are prohibited from issuing medical cannabis recommendations to their military veterans patients. The new document also notes the revised federal definition of marijuana that went into effect with the legalization of hemp.
The revised Veterans Health Administration (VHA) guidance is largely consistent with a previous version it released in 2017, which itself was updated to explicitly encourage VA doctors to discuss veterans’ marijuana use. That policy technically expired at the end of 2022, but without an update the 2017 guidance stayed in place until last Friday, when the new version was issued.
Advocates and lawmakers have continually pushed VA to make changes allowing its doctors to fill out forms recommending medical cannabis to veterans who live in legal states, but the department has long resisted that change—and the revised VHA directive makes clear that “VA health care providers are prohibited from recommending, making referrals to, completing forms or registering Veterans for participation in a State-approved marijuana program.”
The House recently approved a bipartisan amendment to a spending bill that would allow VA doctors to recommend medical cannabis to military veterans. The Senate Appropriations Committee also passed the reform as part of its version of the appropriations legislation.
Rep. Brian Mast (R-FL), the lead sponsor the House amendment, told Marijuana Moment on Thursday that VA’s updated directive “is exactly why this provision is needed.”
“The bureaucracy at the VA is not just creating confusion, it’s keeping veterans from being able to access a proven treatment option,” he said. “My bipartisan amendment passed the House with the strong support and the Senate version of the package has a provision that mirrors it, so we’re confident we’ll succeed in finally addressing this outdated rule.”
Mast sponsored the amendment alongside Reps. Earl Blumenauer (D-OR), Dave Joyce (R-OH) and Barbara Lee (D-CA)—all four co-chairs of the Congressional Cannabis Caucus.
“Last week, I led a divided Congress to make progress on medical cannabis for our veterans,” Blumenauer told Marijuana Moment on Thursday. “The Biden administration should be able to do the same. Our veterans deserve better.”
The updated directive says VA providers can continue to “discuss relevant clinical information regarding marijuana use with Veterans who request information about marijuana or report marijuana use and document this information in the Veteran’s electronic health record.”
The guidance also says that it’s VA policy that veterans “must not be denied VHA services solely because they are participating in a State-approved marijuana program or because they acknowledge use of marijuana.”
It also highlights that the federal definition of marijuana was revised to distinguish it from hemp, which was legalized under the 2018 Farm Bill. Cannabis containing up to 0.3 percent THC is now exempt from the marijuana definition under the directive.
Other changes to the guidance include updates to the “roles, titles and responsibilities” of top VA officials who are charged with educating patients and providers about the department’s cannabis rules.
While some had hoped VA would modernize its marijuana policy for veterans under the Biden administration, the agency has continued to push back against congressional efforts to allow its doctors to issue medical cannabis recommendations or mandate clinical trials into the efficacy of marijuana for various health conditions that commonly afflict veterans.
The department has also faced criticism over recently updated guidance for clinicians that strongly recommends against the use of marijuana in the treatment of post-traumatic stress disorder (PTSD).
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Meanwhile, a report attached to the House spending legislation by the Appropriations Committee also includes a section noting that “VA has clarified that nothing in VA statutes or regulations specifically prohibits a veteran whose income is derived from state-legalized cannabis activities from obtaining a certificate of eligibility for VA home loan benefits.”
Meanwhile, Democratic senators sought to pass a series of marijuana reform amendments through the chamber’s version of the National Defense Authorization Act (NDAA).
One successfully adopted provision would bar intelligence agencies like the CIA and NSA from denying security clearances to applicants solely due to their past marijuana use.
Another proposal, led by Sen. Brian Schatz (D-HI), would have allowed veterans to use medical cannabis in states and territories where its legal, mirroring a standalone bill that the senator introduced in April, but it was not brought up for consideration.
A recent survey of veterans who use cannabis found that they report improved quality of life and reduced use of certain prescription drugs, including opioids.
Photo courtesy of Chris Wallis // Side Pocket Images.