A House committee on Thursday approved a bill that would require the U.S. Department of Veterans Affairs (VA) to conduct clinical trials into the therapeutic potential of marijuana for military veterans.
The House Veterans Affairs Committee passed the legislation, sponsored by Rep. Lou Correa (D-CA), in a largely party line vote of 18-11, with all Democrats in support and all but one Republican opposed.
The VA Medicinal Cannabis Research Act would mandate that the department launch a series of studies on using medical marijuana to treat PTSD and chronic pain. Earlier versions of the measure cleared the panel in 2020 and 2018 but were not enacted into law.
“Our veterans are no strangers to confronting challenges, and that’s why Congress needs to explore alternative treatment options,” Correa told Marijuana Moment. “The VA Medicinal Cannabis Research Act of 2021 meets veterans where they already are and opens a new door for federal policy that supports treatment options preferred by veterans.”
“How can we not try to gather the vast resources of Congress and the federal government to explore alternative treatment options like cannabis when veterans themselves are telling us that’s what they need,” the congressman said. “To not support this legislation would be to defer once again of our obligation to care for those who have sacrificed so much to help protect our nation.”
A subcommittee held a hearing on the proposal last month, and the Biden administration expressed opposition to the reform.
Separately on Friday, the full House is set to take up an infrastructure bill that includes provisions aimed at allowing researchers to study the actual marijuana that consumers are purchasing from state-legal dispensaries instead of having to use only government-grown cannabis.
At Thursday’s committee markup on the veterans-focused bill, members rejected an amendment that was filed by Rep. Mariannette Miller-Meeks (R-IA). Its text, which was identical to standalone legislation the congresswoman filed in April, essentially represented a more dialed back, less prescriptive proposal to encourage VA medical cannabis studies as compared to Correa’s measure.
Miller-Meeks’s legislation says that the department would have to “conduct and support research relating to the efficacy and safety of forms of cannabis” for chronic pain, PTSD and “other conditions the Secretary determines appropriate,” without the specific requirement for full clinical trials as in Correa’s bill. It would also require fewer unique strains of cannabis be analyzed, among other differences.
“Congressman Correa and I agree” on the fundamentals of the issue, Miller-Meeks said. “However, his bill takes an overly prescriptive approach to requiring the VA conduct research on medical marijuana.”
“I am sure that it is well-intentioned,” she continued. “However, what that would do is unfairly tie the hands of the VA researchers who are responsible for designing and conducting these studies and undermine their work to such an extent as to render it meaningless.”
Chairman Mark Takano (D-CA) responded that he could not support the amendment because it would give VA “far more leeway in determining…the possible use of cannabis and treating pain and PTSD and veterans.”
“With all due respect, VA could be doing that level of research now and simply has chosen not to,” he said. “VA’s Office of Research and Development can absolutely handle a clinical trial. It already conducts many of them. And it’s time to bring the scientific weight of that gold standard approach to the issue of cannabis use.”
Despite opposition from VA officials, the committee went ahead with passing Correa’s original bill.
A representative of the department said at last month’s subcommittee hearing that any clinical trials involving human subjects that carries potential risks must use the “smallest number of participants needed to avoid unnecessarily putting subjects at risk.”
With respect to marijuana, some effects “are not known,” VA’s David Carroll said, “thus a circumscribed approach to determine dose, administration modality and best outcome measure must be shown in a proof-of-concept approach to ensure the validity of the research.”
Additionally, Carroll argued that certain requirements stipulated in the bill such as studying seven different cannabis varieties are “not consistent with the current state of scientific evidence, which suggests that smaller, early phase, controlled clinical trials with a focused set of specific aims are optimal to determine proof of concept for using cannabis to treat specific conditions.”
The department’s response to the bill is consistent with its past testimony—but it still comes as a disappointment to advocates who had hoped VA under Biden would ultimately embrace the modest reform.
Hopes were raised even higher after the bill sponsor, Correa, recently informed a separate House panel that he’d had a conversation with VA Secretary Denis McDonough about the issue of marijuana and veterans.
Groups that represent military veterans, meanwhile, have backed the legislation.
“We simply must equip VA and its healthcare providers with scientific guidance about the potential impacts, benefits and/or dangers of cannabis used to treat chronic pain and PTSD,” Takano said ahead of the vote. “The VA tells us that it is monitoring smaller research projects on cannabis outside VA. This really is not sufficient.”
Veterans can purchase medical cannabis in 36 states & recreational cannabis in 19 states.@RepLouCorrea's bill would equip VA & its healthcare providers with scientific guidance about the potential impacts, benefits, & dangers of cannabis use to treat chronic pain & PTSD.
— House Veterans' Affairs (@VetAffairsDems) November 4, 2021
“The bill directs VA to bring the important methodological rigor and clinical trial framework to bear on these important questions,” the chairman said. “We owe our veterans no less.”
Rep. Nancy Mace (R-SC) was the only GOP lawmaker to support the bill’s advancement through committee.
Takano said the cannabis legislation and other bills approved during the markup “will become part of our annual Veterans Day legislative package” and that he looks forward “their passage on the House floor.”
Because Veterans Day is next Thursday, the chairman’s comments signal the marijuana bill may move through the full House on an expedited basis in the coming days.
Its legislative text says the VA secretary “shall carry out a series of clinical trials on the effects of medical-grade cannabis on the health outcomes of covered veterans diagnosed with chronic pain and covered veterans diagnosed with post-traumatic stress disorder.”
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It lists both “required elements” of the trials and “optional elements.” When it comes to the chronic pain trials, the agency would have to look at the impact of marijuana consumption on osteopathic pain, opioid use and dosage, benzodiazepine use and dosage, alcohol use, inflammation, sleep quality, agitation and quality of life.
For the PTSD-specific studies, VA would examine the extent to which cannabis affects basic symptoms of the condition, the use and dosage of benzodiazepines, alcohol use, mood, anxiety, social functioning, agitation, suicidal ideation and sleep quality.
Optionally, the clinical trials “may include an evaluation of the effects of the use of cannabis to treat chronic pain and post-traumatic stress disorder on” pulmonary function, cardiovascular events, various forms of cancer, intestinal inflammation, motor vehicle accidents, mania, psychosis, cannabinoid hypermesis syndrome, neuropathy or spasticity.
The bill further details specific methodological standards of the clinical trials that would be required. It would, for example, mandate that researchers use “not fewer than seven unique plant cultivars” with specific ratios of THC and CBD, and says the trials will involve “whole plant raw material and extracts.”
In addition to his standalone bill, Correa separately proposed requiring VA cannabis studies as an amendment to a defense spending bill that passed the House in September. But he withdrew it prior to a House Rules Committee hearing.
A Senate committee in June held a hearing on a bill to similarly require the department to conduct clinical trials into the therapeutic potential of marijuana for military veterans with PTSD and chronic pain—but a VA representative said that the Biden administration is opposed to the reform. The Senate panel has not yet voted on its version of the legislation.
During the last Congress, in 2019, the VA under President Donald Trump came out against a series of bills that were designed to protect benefits for veterans who use marijuana, allow the department’s doctors to recommend medical cannabis and expand research into the plant’s therapeutic potential.
In 2018, the House Veterans’ Affairs Committee was the first congressional panel to approve a marijuana reform bill by passing an earlier version of legislation to encourage VA to conduct research on the medical benefits of cannabis.
Despite VA’s stated opposition to a variety of marijuana reform proposals in the past, an official with the department did say recently that it is “very closely” following research into the potential therapeutic benefits of psychedelics like MDMA for military veterans.
Earlier this year, a bipartisan coalition of congressional lawmakers reintroduced bills that would federally legalize medical cannabis for military veterans.
Rep. Greg Steube (R-FL) in January introduced a proposal aimed at ensuring that military veterans aren’t penalized for using medical cannabis in compliance with state law. It would also codify that VA doctors are allowed to discuss the risks and benefits of marijuana with their patients.
VA doctors are currently permitted to discuss cannabis with patients and document their usage in medical records, and those veteran patients are already shielded by agency policy from losing their benefits for marijuana use—but the bill would enshrine those policies into federal statute so they could not be administratively changed in the future.
A U.S. military veteran who was deported to Jamaica over a marijuana conviction was recently allowed to return to the country following a concerted push for relief by members of Congress.
Sens. Alex Padilla (D-CA), Tim Kaine (D-VA) and Mark Warner (D-VA) sent a letter to the head of the U.S. Department of Homeland Security (DHS) in July requesting that he reopen the case.
Thirty members of the Congressional Black Caucus separately urged the Biden administration to reopen certain deportation cases, including those involving cannabis.