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Federal Commission Pushes Expansion Of Marijuana And Psychedelics Research For Military Veterans

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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.

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Kyle Jaeger is Marijuana Moment's Sacramento-based senior editor. His work has also appeared in High Times, VICE and attn.

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Federal Agency Loosens Marijuana-Related Grant Funding Restrictions For Mental Health Treatment

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The federal Substance Abuse and Mental Health Services Administration (SAMHSA) loosened restrictions this week on grant funding for state health providers and other entities that allow patients to use medical marijuana for mental heath treatment.

The Pennsylvania Department of Drug and Alcohol Programs flagged the new policy change in a notice to SAMHSA grant recipients on Monday. It said that the federal agency has removed language from its terms and conditions that until now has prevented grant funds from going to any institution that “provides or permits marijuana use for the purposes of treating substance use or mental disorders.”

This restriction led the state department to issue a memo in June warning recipients and applicants about the possible withholding of funding.

Despite the recent change, SAMHSA is still continuing a narrower ban that says federal funds themselves “may not be used to purchase, prescribe, or provide marijuana or treatment using marijuana.”

The broader prohibition, which has now been rescinded, prompted a notice last year from Maine’s Education Department, which said is was no longer eligible for certain federal funds to support mental health programs in schools because the state allows students to access medical marijuana.

It seems the federal agency is now being somewhat more permissive.

Here’s how SAMHSA’s updated marijuana restriction reads:

“SAMHSA grant funds may not be used to purchase, prescribe, or provide marijuana or treatment using marijuana. See, e.g., 45 C.F.R. 75.300(a) (requiring HHS to ensure that Federal funding is expended in full accordance with U.S. statutory and public policy requirements); 21 U.S.C. 812(c)(10) and 841 (prohibiting the possession, manufacture, sale, purchase or distribution of marijuana).”

The older, more broad prohibition read:

“Grant funds may not be used, directly or indirectly, to purchase, prescribe, or provide marijuana or treatment using marijuana. Treatment in this context includes the treatment of opioid use disorder. Grant funds also cannot be provided to any individual who or organization that provides or permits marijuana use for the purposes of treating substance use or mental disorders. See, e.g., 45 C.F.R. § 75.300(a) (requiring HHS to “ensure that Federal funding is expended in full accordance with U.S. statutory requirements.”); 21 U.S.C. §§ 812(c)(10) and 841 (prohibiting the possession, manufacture, sale, purchase or distribution of marijuana). This prohibition does not apply to those providing such treatment in the context of clinical research permitted by the DEA and under an FDA-approved investigational new drug application where the article being evaluated is marijuana or a constituent thereof that is otherwise a banned controlled substance under federal law.”

The marijuana restrictions were first added to grant award terms for Fiscal Year 2020. The language was initially carried over to Fiscal Year 2021 but was more recently switched out for the narrower language by the federal agency.

In a January 2020 FAQ that the Pennsylvania department shared from SAMHSA this June, the federal agency responded to a prompt inquiring whether grant recipients can serve patients who are “very clear about their wish to remain on their medical marijuana for their mental or substance use disorder.”

“No. The organization cannot serve a patient who is on medical marijuana for a mental or substance use disorder and wishes to remain on such treatment,” it said. “SAMHSA promotes the use of evidence-based practices and there is no evidence for such a treatment; in fact, there is increasing evidence that marijuana can further exacerbate mental health symptoms.”

While the agency seemed adamant in enforcing that policy at the time, it appears to have had a change of heart and has since loosened the restriction.

A SAMHSA spokesperson told Marijuana Moment that the new rules took effect on Sunday, but played down their significance.

“This Aug. 1 clarification simply made clearer what was already in place: SAMHSA funds should not be used to procure a federally prohibited substance,” he said in an email.

While it is true that the revised provision, as was the case in the prior language, states that federal funds cannot be used to pay for marijuana, the spokesperson avoided commenting on the new deletion of the broader prohibition on grants going to entities that otherwise allow patients to use medical cannabis to treat substance use or mental disorders.

After SAMHSA announced in 2019 that its marijuana policy would impact organizations applying for its two main opioid treatment programs and another that provides funding to combat alcoholism and substance misuse, the Illinois Department of Human Services and Oregon Health Authority issued notices on the impact of the rule.

Read the Pennsylvania department’s notice on the SAMHSA marijuana policy change below: 

Pennsylvania SAMHSA marijuana by Marijuana Moment

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Mexican Lawmakers Could Finally Legalize Marijuana Sales Next Month (Op-Ed)

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The legislature missed repeated deadlines, and then the Supreme Court moved to allow homegrow. What’s next?

By Zara Snapp, Filter

Mexico has never seemed so close and yet so far from fully regulating the adult-use cannabis market.

A first Supreme Court resolution determined in 2015 that the absolute prohibition of cannabis for personal use was unconstitutional because it violates the right to the free development of personality. To reach jurisprudence in Mexico, five consecutive cases, with the same or more votes each time, must be won before the Supreme Court. This was achieved in October 2018, which detonated a legislative mandate that within 90 days, the Senate should modify the articles in the General Health Law that were deemed unconstitutional.

The first deadline came and went without the Senate modifying the articles; so the Senate requested an extension, which was granted. The second deadline to legislate expired on April 30, 2020—but another extension was provided because of the COVID-19 pandemic.

At first, it looked like the third time was the charm. The Senate overwhelmingly approved the Federal Law to Regulate and Control Cannabis in November 2020 and passed it to the Chamber of Deputies, the lower house, for review and approval. Since the deadline of December 15, 2020, was fast approaching, the Chamber asked for its own extension. The Supreme Court granted it (until April 20, 2021) and the bill underwent significant changes before being approved by the Chamber on March 10, and so sent back to the Senate.

The Senate certainly had enough time to review and either reject or accept the changes made by the lower house. That would have made this a shorter story. However, the Senate had other plans. Rather than approve the bill or request an additional extension, it simply did not do anything. June’s national midterm elections were approaching, and political calculations were made. The legislative process came to a standstill.

Since the Senate did not approve the bill by the deadline, the Supreme Court basically did what it had mandated Congress to do. It activated a mechanism to guarantee rights that had only been undertaken once before in Mexican history: the General Declaration of Unconstitutionality (GDU).

On June 28, the Supreme Court approved, with a qualified majority of eight of the 11 Ministers, that two articles in the General Health Law must be modified to permit adults to cultivate cannabis for personal use in their homes.

These changes were officially published on July 15, with specific instructions to the Health Secretary to approve authorizations for any adult who applies.

The GDU has certain restrictions attached, including that this is only for personal use and cannot be used to justify any commercialization of cannabis or cannabis-derived products. Adults cannot consume in front of minors, or other adults who have not expressly given their permission. Nor can they operate heavy machinery or drive while under the effects.

With the GDU, the judicial process concludes. However, the Supreme Court was clear in its final recommendations: Congress can and should legislate to clear up inconsistencies and generate a legal framework for cannabis users.

Whether the Senate decides to take up the matter again in September when it returns to its legislative session will depend largely on its political whim. The body no longer has a deadline to meet; however, there are growing calls from society to regulate the market beyond home-grow, as well as several legal contradictions that obviously need to be harmonized.

The General Health Law has now been modified and the health secretary must approve permits or authorizations for adults to cultivate in their homes. But the Federal Criminal Code has not changed—it still penalizes those same activities with sanctions ranging from 10 months to three years or more in prison.

The Supreme Court decision ignores the need for a comprehensive regulation that would allow the state to apply taxes to commercial activities, which are currently still criminalized with penal sanctions. It also overlooks the urgency of an amnesty program for the thousands of people currently incarcerated on low-level cannabis charges, or hampered by criminal records for such charges.

The Senate should now revisit the bill it initially passed. It should maintain the positive aspects of the bill, which would improve things well beyond the scope of the Supreme Court decision. These include provision for cannabis associations (permitting up to four plants per person for up to 20 members), for home-grow without the need to request authorization, and for a regulated market with a social justice perspective—allocating 40 percent (or more!) of cultivation licenses to communities harmed by prohibition and imposing restrictions on large companies.

The Senate could also build upon the previous version of the bill by eliminating simple possession as a crime, by allowing the associations to operate immediately and guaranteeing the participation of small and medium companies through strong government support.

During the last three years, and before, civil society has closely accompanied the process of creating this legislation, providing the technical and political inputs needed to move forward in a way that could have great social benefits for Mexico.

By becoming the third country in the world to regulate adult cannabis use, after Uruguay and Canada, Mexico could transition from being one of the largest illegal producers to being the largest legal domestic market in the world. As well as economic benefits, this could have substantial impacts on how criminal justice funds are spent, freeing up law enforcement dollars to focus on high-impact crimes and changing the way the state has shown up in communities that cultivate cannabis.

Rather than eradicating crops, the government could accompany communities in gaining legal licenses, provide technical assistance and improve basic services. These positive externalities of regulation could signal a shift from a militarized state of war to a focus on rights, development and social justice.

Of course, this all depends on key political actors recognizing the benefits—and that requires political will. Mexico deserves better; however, it remains to be seen whether legislators will act.

This article was originally published by Filter, an online magazine covering drug use, drug policy and human rights through a harm reduction lens. Follow Filter on Facebook or Twitter, or sign up for its newsletter.

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Oregon Governor Plans To Veto Bill To Regulate Kratom Sales That Advocates Say Would Protect Consumers

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The governor of Oregon has announced her intent to veto a bill that’s meant to create a regulatory framework for the sale and use of kratom for adults.

The Oregon Kratom Consumer Protection Act is bipartisan legislation that would make it so only people 21 and older could purchase the plant-based substance, which some use for its stimulating effects and which others found useful in treating opioid withdrawals.

Vendors would have to register with the state Department of Agriculture to sell kratom. The agency would be responsible for developing regulations on testing standards and labeling requirements. The bill would further prohibit the sale of contaminated or adulterated kratom products.

But while the House and Senate approved the legislation in June, Gov. Kate Brown (D) said on Sunday that she plans to veto it, in large part because she feels the federal Food and Drug Administration (FDA) is better suited to regulate the products.

“Given there is currently no FDA-approved use for this product and there continues to be concern about the impacts of its use, I would entertain further legislation to limit youth access without the state agency regulatory function included in this bill,” the governor said.

This comes as a disappointment to advocates and regulators who share concerns about the risks of adulterated kratom but feel a regulatory framework could help mitigate those dangers and provide adults with a safe supply of products that have helped some overcome opioid addiction.

“Kratom has been consumed safely for centuries in Southeast Asia and Americans use it in the same way that coffee is used for increased focus and energy boosts. Many use kratom for pain management without the opioid side effects,” Rep. Bill Post (R), sponsor of the bill, wrote in an op-ed published in June. “The problem in Oregon is that adulterated products are being sold.”

“Kratom in its pure form is a natural product,” he said. “Adulterated kratom is a potentially dangerous product.”

Pete Candland, executive director of the American Kratom Association, said in written testimony on the bill in February that four other states—Utah, Georgia, Arizona and Nevada—have enacted similar legislation with positive results.

He said that “the number of adulterated kratom products spiked with dangerous drugs like heroin, fentanyl, and morphine in those states has significantly decreased” in those states.

Meanwhile, six states—Vermont, Alabama, Indiana, Wisconsin, Arkansas and Rhode Island—have banned kratom sales altogether.

Candland said that number is actually a testament to the noncontroversial nature of the plant, as prohibition is only in effect in six states despite “a full-throated disinformation campaign on kratom by the FDA with outrageously untrue claims about kratom being the cause of hundreds of deaths.”

After failing to get kratom prohibited domestically, FDA recently opened a public comment period that’s meant to inform the U.S. position on how the substance should be scheduled under international statute.

“Kratom is abused for its ability to produce opioid-like effects,” FDA wrote in the notice. “Kratom is available in several different forms to include dried/crushed leaves, powder, capsules, tablets, liquids, and gum/ resin. Kratom is an increasingly popular drug of abuse and readily available on the recreational drug market in the United States.”

Responses to the notice will help inform the federal government’s stance on kratom scheduling in advance of an October meeting of the World Health Organization’s (WHO) Expert Committee on Drug Dependence, where international officials will discuss whether to recommend the substance be globally scheduled.

Last week, the U.S. House of Representatives approved a report to spending legislation that says federal health agencies have “contributed to the continued understanding of the health impacts of kratom, including its constituent compounds, mitragynine and 7-hydroxymitragynine.”

It also directed the Health and Human Services secretary to continue to refrain from recommending that kratom be controlled in Schedule I.

Late last year, the Agency for Healthcare Research and Quality (AHRQ) asked the public to help identify research that specifically looks at the risks and benefits of cannabinoids and kratom.

The Centers for Disease Control and Prevention (CDC) last year separately received more than one thousand comments concerning kratom as part of another public solicitation.

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