Officials at the U.S. Department of Veterans Affairs (VA) have come out against a series of bills that are designed 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.
Lawmakers and advocates representing veterans discussed the proposals during a congressional hearing on Tuesday. And while the Trump administration representatives present said the department opposes the bills, support was widespread among witnesses and subcommittee members, at least for some of the legislation.
“This is the first time we’ve had a hearing like this with a substantive committee,” Rep. Earl Blumenauer (D-OR) said. “One of the great tragedies of our time is the failure to adequately address the needs of veterans returning home from Iraq and Afghanistan… An overwhelming number of veterans tell me that cannabis has reduced PTSD symptoms [and] the dependency on addictive opioids.”
Rep. Julia Brownley (D-CA), chair of the House Veterans’ Affairs Subcommittee on Health, thanked Blumenauer for introducing his Veterans Equal Access Act, which would allow VA physicians to issue medical cannabis recommendations for veterans. She said “it’s an important bill” and that she’s also heard from veterans who want the proposed policy change.
I just testified in @VetAffairsDems on veterans access to medical cannabis. @RulesDemocrats are discussing how we can achieve universal health coverage w/ #MedicareForAll. @HouseJudiciary is holding its first hearing on the #ERA in 36 yrs.
— Earl Blumenauer (@repblumenauer) April 30, 2019
The congresswoman also thanked Rep. Lou Correa (D-CA) for filing his VA Medicinal Cannabis Research Act, which would require the VA to conduct a clinical study on the benefits and risk of medical marijuana in the treatment of conditions such chronic pain and post-traumatic stress disorder.
“It’s time to make sure that veterans get to know what cannabis is good for and what cannabis is not good for. We need medical research,” Correa said. “We owe our veterans a tremendous amount. The least we can do is make sure we’re giving them the proper treatment for those invisible wounds that they brought back from the battlefield.”
“I agree we need to push the VA forward on this,” Brownley said.
The panel also talked about a bill from Rep. Greg Steube (R-FL) that would codify an existing VA policy prohibiting the department from stripping veterans of their benefits just because they use cannabis in compliance with state law.
After the lawmakers spoke to make the case for their respective legislation, veterans advocates and three VA officials offered their feedback and took questions from the committee.
Keita Franklin, national director of suicide prevention in the VA’s Office of Mental Health and Suicide Prevention, said that the department opposes all of the cannabis bills. She said the proposal to require the VA to conduct clinical research on medical cannabis is too ambitious and risky, stating that “a smaller, early-phase trial design would be used to advance our knowledge of benefits and risk regarding cannabis before moving to a type of more expansive approach as described in this proposed legislation.”
“Any trial with human subjects must include an evaluation of the risks and safety and include the smallest number of participants to avoid putting subjects at increased risk unnecessarily so,” she said. “For these reasons, we don’t support this proposed legislation.”
Franklin said the department opposes allowing VA clinicians to recommend medical cannabis because of guidance it’s received from the Drug Enforcement Administration (DEA). VA doctors are prohibited from recommending cannabis in legal states because the DEA “advised VA that no provision of the controlled substances act would be exempt from criminal sanctions as a VA physician who acts with intent to provide a patient with means to obtain marijuana.”
Finally, the VA opposes Steube’s bill, she said, because there is already a VA policy stating that veterans won’t lose their benefits for using cannabis or discussing their usage with a VA health care provider.
The congressman, however, has said his bill is needed to codify the protection into law so that a future administration could not reverse it.
Among the advocacy groups—the Iraq and Afghanistan Veterans of America (IAVA), Veterans of Foreign Wars (VFW) and Disabled American Veterans (DAV)—there was particularly strong interest in advancing the legislation to mandate VA research into medical marijuana.
Joy Ilem, national legislative director of DAV, said the group concurs “that research is necessary to help clinicians better understand the safety and efficacy of cannabis use for specific conditions that often cooccur in the veteran population such as chronic pain and post-traumatic stress.”
Carlos Fuentes, director of national legislative services at VFW, also endorsed that bill. He said that “VFW members tell us medicinal cannabis works, and it is a more suitable option than the drug cocktails VA prescribes” and that “VA must research how medicinal cannabis can help veterans cope with PTSD and other conditions such as chronic pain.”
"The VFW is proud to support the VA Medicinal Cannabis Research Act of 2019 … VA must expand research on the efficacy of non-traditional alternatives to opioids, such as medicinal cannabis and other holistic approaches." #VFWTestimony
— VFW National HQ (@VFWHQ) April 30, 2019
But while VFW supports the “intent of the Veterans Equal Access Act”—Blumenauer’s bill to allow recommendations from VA physicians—Fuentes said the group “cannot offer its support at this time.” At issue is the fact that the VA wouldn’t be able to provide medical marijuana at its pharmacies if a VA doctor issued a recommendation.
The VFW agrees with the intent of the Veterans Equal Access Act, but cannot offer its support at this time. #VFWTestimony
— VFW National HQ (@VFWHQ) April 30, 2019
“The VFW agrees that veterans relying on the VA health care system must have access to medicinal cannabis if such therapies are proven to be effective in assisting and treating certain health conditions,” he said. “Without such evidence, VA would not have the ability to prescribe or provide medicinal cannabis to veterans. It is unacceptable for VA providers to recommend a treatment that is unavailable to veterans at their VA medical facilities.”
Vets who participate in such programs must not fear VA will take away benefits they earned & deserve. However, we cannot support requiring VA providers to recommend participation in state-approved marijuana programs if VA is unable to provide such recommended course of treatment
— VFW National HQ (@VFWHQ) April 30, 2019
IAVA voiced support for both the Veterans Equal Access Act and the Veterans Cannabis Use for Safe Healing Act.
@StephMuls before @VetAffairsDems @HouseVetAffairs Health Subcommittee: Says 90% of @IAVA Members support research into medicinal cannabis research, calls on Congress to pass the VA Medicinal Cannabis Research Act (HR 712).
— Tom Porter (@TomPorterDC) April 30, 2019
Addressing the second panel, Franklin, the committee chairwoman, spoke strongly about the “frustration” created by VA’s ongoing resistance to policies that veterans support.
“We’ve got a couple of bills before us, which I think are good bills. And the VA doesn’t support those bills,” she said. “We have [veteran services organizations] speaking in favor of these bills. This seems to be an issue that has been going on now for a while—this schism between what the VA believes and what the VSOs want.”
“This is a big frustration for me because I think it’s overwhelmingly clear amongst the American people and amongst our veterans across the country that this is an issue that they are keenly interested in and want to have access to,” she said. “I guess my question is, how are we going to reconcile this?”
Larry Mole, the VA’s chief consultant on population health, pinned the blame on the Justice Department. He said that the committee “could make strong proposals” in support of reforming VA cannabis policy, but that “at the end, we will need to go back to DEA and the Department of Justice for their opinion.”
“I’ve not seen anything myself that suggests their opinion will change,” Mole said.
Be that as it may, the Republican ranking member of the subcommittee did propose one possible solution: rescheduling marijuana under the Controlled Substance Act.
“We’re not I think in a position here to protect the VA physicians who want to disperse or prescribe cannabis unless we change that law,” Rep. Neal Dunn (R-FL) said. “So we might be looking at the wrong leverage point when we address these laws without addressing the scheduling of the drug.”
“I could not agree with you more that we ought to be doing research on this,” he said. “I think we ought to change the schedule to Schedule II. It seems like every committee I go in we have another discussion about cannabis.”
Brownley concluded the hearing by saying that she believes there is a “nexus” between cannabis reform and suicide prevention among veterans.
“I think we just have to really be committed to the cannabis issue and to the suicide issue, but where this nexus is.”
Marijuana reform advocates celebrated the hearing and urged lawmakers to move the bills forward. Tuesday’s hearing was the second in the 116th Congress to address cannabis legislation after a separate committee debated a marijuana banking bill in February before voting to approve it last month.
“As the largest healthcare provider in the country, the VA must adopt its polices to appropriately serve the needs veteran community, especially when it comes to providing access to medical cannabis,” David Mangone, director of government affairs at Americans for Safe Access, told Marijuana Moment. “After returning from war, America’s heroes are faced with another battle at home against pills and suicide, and the trio of medical cannabis bills would give them the tools they need to help win this battle by providing less dangerous, non-addictive methods for symptom management.”
Don Murphy, director of federal policies for the Marijuana Policy Project (MPP), noted that in “more than 30 states, members of Congress and their staff can use their federally subsidized health insurance to discuss the benefits of medical cannabis with their doctors.”
“Shamefully our veterans do not have this same right. MPP appreciates the effort of today’s bill sponsors to end this hero double-standard,” he said.
Doug Distaso, executive director of the Veterans Cannabis Project, said in a statement that “President Trump and Congress could literally save veterans’ lives by enacting these bills into law.”
“With opioid overdoses and a suicide crisis hitting our veterans, they deserve legal access to medical cannabis through their VA doctors as a safer alternative to the highly addictive and often deadly opioids and other pills the VA readily gives them,” he said. “These bills would provide the kind of research, legal access through VA doctors, and protection of earned benefits that veterans overwhelmingly want and deserve.”