Officials with the U.S. Department of Veterans Affairs (V.A.) mistakenly believe that federal law is blocking them from allowing government doctors to recommend medical marijuana or even to conduct research on cannabis, but that’s actually not the case.
“The V.A. is in the position of being required to follow the statutory law, and so as federal employees we are prohibited from recommending marijuana,” Dr. Laurence Meyer, the chief officer for specialty care at the V.A.’s Veterans Health Administration, said on Wednesday. “If Congress would change regulations, we would have more freedom both to investigate and to give therapy.”
He was responding to a question from Sen. Brian Schatz (D-HI) during an Appropriations subcommittee hearing on “V.A. Efforts to Prevent and Combat Opioid Overmedication.”
Schatz cited a 2014 study in the Journal of the American Medical Association which found that opioid overdose death rates are roughly 25 percent lower in states with legal medical cannabis access than in states where marijuana is strictly prohibited. A number of other studies have reported similar results.
Despite Meyer’s contention that V.A. can’t do anything on marijuana until Congress acts, that’s not true, inasmuch as there is no overarching federal law that blocks the department from allowing its doctors to recommend medical cannabis in states where it is legal, even though the drug is still considered illegal under federal law.
The only thing standing in the way is V.A.’s own internal policy, something that Veterans Affairs Secretary David Shulkin can change at any time.
But Shulkin himself has repeatedly tried to pass the buck to Congress when asked about the issue.
During a White House briefing earlier this year, he said that state medical cannabis laws may be providing “some evidence that this is beginning to be helpful, and we’re interested in looking at that and learning from that.” But he added that “until time the federal law changes, we are not able to be able to prescribe medical marijuana for conditions that may be helpful.”
In a separate interview, he said, “From the federal government point of view, right now we are prohibited by law from doing research on it or prescribing it… We are not going to be out there doing that research or prescribing these different medicinal preparations unless the law is changed.”
In another interview, he said that it is “not within our legal scope to study that in formal research programs or to prescribe medical marijuana, even in states where it’s legal.” He added, “if a law change at the federal level is appropriate, that could happen.”
The distinction between recommendation and prescription is an important one.
No physician in the U.S. — government or private — can prescribe marijuana, because prescription is a federally-regulated process and cannabis currently falls under the Controlled Substances Act’s restrictive Schedule I, a category that is supposed to be reserved for drugs with a high potential for abuse and no medical value.
That’s why the 29 states with medical cannabis access allow doctors to simply recommend the drug, circumventing the prescription process.
Under a current internal V.A. administrative directive, the department’s policy is “to prohibit VA providers from completing forms seeking recommendations or opinions regarding a Veteran’s participation in a State marijuana program.” The directive technically expired on January 31, 2016, but remains in force in practice until a new one is instituted to replace it.
Shulkin has the unilateral authority to rescind the ban and clear the way for V.A. doctors to recommend medical cannabis to veterans in states where it is legal.
Congressman Earl Blumenauer (D-OR) told Marijuana Moment last month that V.A.’s position is “disturbing.”
“For years, the V.A. has been throwing up serious barriers to veterans’ safe access to cannabis,” he said. “Yet, it’s had no problem prescribing them highly addictive opioids that have killed thousands. It makes no sense. Our veterans deserve better. They deserve equal treatment from the V.A. doctors who know them best.”
In addition to refusing to let doctors issue recommendations, V.A. has blocked federally-approved researchers from recruiting veterans for research on medical cannabis.
One such study on marijuana’s effects on PTSD has been prevented from reaching veterans at the Phoenix, Arizona V.A. hospital.
“This study needs 50 more participants and the Phoenix V.A. is in the best possible position to assist by simply allowing principle investigators to brief [V.A.] medical staff on the progress of the study, and by allowing clinicians to reveal the existence of the study to potential participants,” the American Legion, which represents more than 2.4 million military veterans, wrote to Shulkin in September. “Your immediate attention in this important matter is greatly appreciated. We ask for your direct involvement to ensure this critical research is fully enabled.”
Shulkin hasn’t yet responded, but the group has been increasing pressure on the recommendation and research issues. This month the organization released a poll finding that 81 percent percent of veterans want marijuana to be a “federally-legal treatment.”
Congresswoman Dina Titus (D-NV) said in an interview with Marijuana Moment this month that she’s “disappointed” in Shulkin for not taking initiative to remove V.A.’s internal ban on medical cannabis recommendations. And last month, a group of ten lawmakers wrote to the secretary asking him to direct the department to increase research on the drug’s potential benefits.
Despite the misunderstanding of federal law, Meyer and another V.A. official testifying at the Wednesday Senate hearing seemed to understand that the potential for cannabis has shown to help veterans warrants further investigation and application.
“I don’t think we can wait to have the perfect evidence for everything,” Meyer said. “If you have evidence that something is working, you don’t need to wait to figure our what it’s working — I’m talking in very general terms here — in order to employ it.”
Dr. Friedhelm Sandbrink, the V.A.’s acting national program director for pain management, testified that it is important to determine what’s behind the correlation between increased legal marijuana access and reduced opioid deaths in the study Schatz cited.
“For those states that have implemented cannabis laws and implemented the availability of cannabis for medical purposes…there has been about a 25 percent reduction of overdose deaths,” he said. “Obviously, that’s a very important finding. We need to understand what is truly providing this what seems to be a protectional reduction of overdose deaths.”
Schatz, who called the existing study “compelling,” pushed the V.A. officials to step up research.
“You need to do the academic and scientific inquiry to try to figure out really what’s going on here,” he said.
But that likely won’t happen until V.A. officials realize that federal law isn’t actually preventing it from participating in such research or increasing veterans’ access to cannabis.
Photo courtesy of U.S. Air Forces Special Operations Command.
GOP Congressman: Legal Marijuana Has “Possibility To Create Jobs”
Legalizing marijuana might be a way to help lift rural areas of Virginia out of poverty, a Republican who represents part of the state in Congress says.
“The lands out in Southwest are conducive to be able to grow that for medicinal purposes, or whatever it is, for other research purposes, and even recreational use for some areas, if Virginia chooses to legalize it in that way,” Congressman Scott Taylor said on Wednesday. “And if Virginia goes that way I think there is the possibility to create jobs down in the Southwest.”
Taylor, who was answering a caller’s question during an appearance on C-SPAN’s Washington Journal, added that he supports letting states set their own cannabis laws without federal interference.
“I think we should decriminalize it and leave it up to the states,” he said. “I do believe it’s a state decision, not a federal decision.”
Taylor, a freshman member of Congress, is a cosponsor of a pending House bill to remove marijuana from the Controlled Substances Act.
“When I was in the state House we voted to legalize industrial hemp, which is also another product that would grow well in Southwest just as tobacco did,” Taylor added. “So I think there’s product there.”
Advocates believe that Virginia has a good chance of decriminalizing cannabis in 2018. Incoming Gov. Ralph Northam, A Democrat, spoke often about cannabis on the campaign trail, consistently describing criminalization’s impact in stark racial justice terms.
Republican Senate Majority Leader Tommy Norment has announced he will file a decriminalization bill when the new legislative session begins in January.
Vermont Will Legalize Marijuana Within Weeks, Officials Indicate
Vermont appears poised to become the next state to legalize marijuana. And, according to top elected officials, it is likely to do so within a matter of weeks.
Last week, House Speaker Mitzi Johnson, a Democrat, said she expects “it likely will pass in early January.” Days earlier, Gov. Phil Scott, a Republican, said he is “comfortable” signing a cannabis legalization bill into law in early 2018. And on Thursday, Senate President Pro Tempore Tim Ashe, a member of the Progressive Party, said he and his colleagues “look forward to working with the governor to make sure that that bill gets to the finish line.”
(Marijuana Moment’s editor provides some content to Forbes via a temporary exclusive publishing license arrangement.)
Photo courtesy of M a n u e l.
Here’s What Jeff Sessions Discussed In Secret With Anti-Marijuana Activists
Last week, U.S. Attorney General Jeff Sessions held a behind-closed-doors meeting about marijuana with anti-legalization activists.
Now, thanks to the fact that Sessions inadvertently showed an agenda for the meeting to a TV camera that was in the room to capture introductions — along with some high-tech sleuthing — we know what the prohibitionists discussed in secret after reporters were kicked out.
A Twitter user with the handle @MentalMocean was able to enhance a screen capture of the document that Marijuana Moment posted.
The document appears to read:
Bertha Madras: Marijuana is not a substitute for opiates as a pain medication.
Dr. Hoover Adger: The harm from today’s marijuana.
Dr. Bob DuPont: The effect of marijuana on drugged driving.
David Evans: The role that the Food and Drug Administration can and should [obscured]
[obscured] The organizations you can speak for and what you and they are [obscured] people from recreational marijuana use.
[obscured] law enforcement thinks of the commercialization of [obscured] law enforcement would support an enforcement initiative.
[obscured] course of marijuana commercialization in the states if the [obscured] not intervene.
The enhanced photo makes clear that the anti-legalization activists made a concerted pitch during meeting to convince Sessions to launch a federal crackdown on states that have ended cannabis prohibition.
Can any tech wizards enhance this screen grab of an agenda that Jeff Sessions was holding before the start of a drug policy meeting today? pic.twitter.com/7FLvjj1AZd
— Tom Angell 🌳📰 (@tomangell) December 8, 2017
— Sam Gold (@MentalMocean) December 13, 2017
In attendance, according to video of the opening introductions captured by a pool photographer and posted by C-SPAN, were:
- Edwin Meese III, U.S. attorney general under the Reagan administration
- Kevin Sabet, president and CEO of Smart Approaches to Marijuana
- Bertha Madras, a former Office of National Drug Control Policy staffer and a member of President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis
- Robert DuPont, former director of the National Institute on Drug Abuse
- David Evans, executive director of the Drug Free Schools Coalition
- Dr. Hoover Adger, Johns Hopkins Hospital
“I think it’s a big issue for America, for the country, and I’m of the general view that this is not a healthy substance,” Sessions said at the beginning of the gathering. “I think that’s pretty clear. And then have the policy response that we and the federal government needs to be prepared to take and do so appropriately and with good sense.”
“I appreciate the opportunity to hear your analysis on marijuana and some of the related issues,” Sessions told the group. “I do believe, and I’m afraid, that the public is not properly educated on some of the issues related to marijuana. And that would be a matter that we could, all of us together, maybe be helpful in working on and that would allow better policy to actually be enacted.”
The group’s roundtable discussion itself, which took place after initial introductions, was closed to the press.
The gathering comes as the Justice Department’s overall position on marijuana policy remains uncertain. Sessions has in recent weeks sent mixed signals about his plans for federal marijuana enforcement under the Trump administration.
Last month, he testified before Congress that an Obama-era Justice Department memo that generally allows states to implement their own marijuana laws without interference remains in effect. But he separately told reporters at a briefing that his department is actively conducting talks about potential changes to the policy.
Photo courtesy of Gage Skidmore.
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