A federal commission tasked with developing recommendations to improve mental health treatment for military veterans has reached a surprising conclusion: Congress and the executive branch need to promote research into the therapeutic potential of marijuana and psychedelics such as psilocybin mushrooms and MDMA.
Following months of meetings, the Creating Options for Veterans Expedited Recovery (COVER) Commission released its report in January. But despite the novelty of its drug policy findings, the document has gone largely unnoticed by reform advocates and the media. Chaired by presidential appointee Jake Leinenkugel, the panel determined that cannabis and psychedelics represent promising mental health treatment options for veterans that should be fully explored.
“Medical cannabis and psychedelic drugs may have uses in treating mental health issues among veterans; however, these substances are currently classified as Schedule 1 under the Controlled Substances Act, which precludes VA from conducting research on their efficacy,” the panel said.
The scheduling status of these substances has meant that the process of obtaining approval to research them is needlessly burdensome and that the supply of marijuana and other controlled drugs that’s available for studies is inadequate, the commission, members of which were appointed by congressional leaders and the president, found.
“The U.S. federal government’s policies have blocked externally valid, randomized clinical trials on the effects of cannabis,” the report says. “Scientists seeking to conduct research on cannabis must submit to an arduous application process that may last years. The research requires approval from multiple government agencies, including some with stated opposition to any therapeutic uses of cannabis.”
The panel further asserted that the Schedule I status of the drugs has effectively blocked VA from researching them at all, though that point has been disputed by advocates.
“Because VA is unable to conduct research into issues that are actively affecting veterans’ health care (medical cannabis) or issues that could dramatically affect veterans’ health care (medical psychedelics), VA is unable to explore possibilities such as whether medical psilocybin is effective in decreasing anxiety and depression in patients with life-threatening cancer. The opioid epidemic highlighted the need for third-party research into negative effects of treatment interventions and underscored that FDA approval alone does not reveal all of the potential negative consequences that can come about when a prescription treatment is made available to the public.”
Veterans across the U.S. are already using cannabis in compliance with state laws to treat a host of mental health conditions, the report states, and that “necessitates that VA better understand medical marijuana, and how it can benefit and harm patients who use it, so VA providers can better care for these veterans.”
Reform advocates and a growing group of bipartisan lawmakers have long argued that expanding research into the medical value of cannabis for veterans is an imperative—but what’s particularly striking about this commission’s report is that it explicitly acknowledges the potential of specific psychedelics as well. It notes that the “psychedelic research movement is gathering momentum” with investigations into how psilocybin and MDMA can impact conditions such as post-traumatic stress disorder being carried out privately by universities and research institutes.
“Although the findings have limited generalizability due to sample size and homogeneity issues, studies have shown some promise for treating disorders for which available treatments are insufficient—mood, substance, anxiety disorders, post-traumatic stress disorder—using psychedelics, including MDMA,” the COVER Commission report says.
To that end, the commission issued a recommendation: VA should “engage with other federal agencies, as appropriate, to research the potential short- and long-term risks, as well as benefits, of medical cannabis and psychedelic drugs.”
It also recommends that the executive and legislative branches require the National Institute On Drug Abuse to develop “strains of cannabis with THC levels equivalent to those being used by medical cannabis users in the states where medical cannabis is legal to ensure that research on medical cannabis use generates meaningful information on the related risks and benefits.”
That would address the fact that studies have shown that the marijuana that’s produced at the only federally authorized manufacturing facility is chemically more similar to hemp than cannabis sold in state-legal markets.
Further, VA physicians should be given “up-to-date information on research related to use of medical cannabis and psychedelics, including MDMA” and be better educated about “their ability to discuss the benefits and possible negative effects of medical cannabis with veterans in their care,” the report continues.
The panel said that there “are significant questions about the benefits and costs of using cannabis and psychedelics in treating mental health issues. The efficacy and safety of these types of treatments are unclear, but it is essential that VA engage in research to better understand them.”
“VA should engage with other federal agencies to conduct research into the positive and negative effects on veterans’ mental health of medical cannabis and psychedelics, including methylenedioxymethamphetamine (MDMA),” a summary of the report states.
Rep. Lou Correa (D-CA), a longtime advocate for marijuana research for veterans who is sponsoring the VA Medicinal Cannabis Research Act, told Marijuana Moment that the commission’s report “shows exactly why my bill is so important.”
“The Department of Veterans Affairs acknowledges cannabis can be a valuable medical tool for our veterans,” he said. “We must pass the Medicinal Cannabis Research Act so the VA can finally conduct this critical research and get veterans the medicine they need.”
Correa’s medical marijuana research bill was approved by a House committee in March but has not yet been scheduled for floor action by Democratic leaders.
Based on testimony in past hearings, it’s unclear whether VA will be inclined to embrace the COVER Commission’s recommendations, as department officials have stood opposed to several modest marijuana reform bills that were discussed in committee last year. That included legislation to protect VA 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 any case, the commission’s report seems to reflect an evolved understanding of the policy changes that would be necessary to effectively investigate whether marijuana or certain psychedelics would be able to provide relief to veterans suffering from a wide range of mental health conditions. It was released three years after the panel was established as part of the 2016 Comprehensive Addiction and Recovery Act.
Transcripts of commission meetings leading up to the report’s publication showed that members routinely participated in conversations about the limitations of mental health research opportunities for controlled substances under prohibition.
For example, Leinenkugel, the chairman, who has previously expressed interest in advancing VA studies into the medical benefits of marijuana for veterans, said during a hearing in July 2018 that he was “blown away” by the amount of research that’s been conducted on the subject in other countries such as the Canada and Israel.
“They, for some reason, found much more reason to take cannabis and cannabinoid oils to a further legal way for their veterans, not for recreation but for usage of the veterans,” he said. “It was a wake-up call for me personally.”
Col. Matthew Amidon, a member of the commission, told the chair that the panel “should remember also that there’s H.R. 5520, which is the 2017 Cannabis Research Act, which is a bill right now which we might want to refer to as we articulate a vision with cannabis bills.”
At another meeting, Leinenkugel said that “I think that our largest [veterans service organizations] have stated through their membership that over 90 percent of American Legion, which is two million strong, veterans are advocating that we at least take a look at research within the VA, which I don’t think we’re doing.”
“To me, that makes no sense. It’s a plant, it’s an herb. I’m not advocating for recreational use at all, but from this commission, we need to look at every variation of complementary type of care under what we had yesterday, whole health,” he said. “I know I’m editorializing a little bit, but I want to at least get it on the public record that these are things that I think we need to start taking a look at.”
All told, the conversations reflect a growing recognition that—despite ongoing federal prohibitions—there’s a need to promote research into controlled substances that hold therapeutic potential. And that’s not just coming from advocates, it’s coming from Trump appointees and military brass alike.
Now it’s up to Congress and the White House to follow through with the recommendations of the panel that the two branches created and appointed.