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.
Hemp Farmers Guaranteed Federal Crop Insurance Through Disaster Bill Amendment
The Senate approved a bill on Thursday that is mostly focused on providing relief aid to areas impacted by natural disasters—but it also includes a provision ensuring that hemp farmers qualify for federal crop insurance.
The hemp section was inserted into the legislation at the behest of Senate Majority Leader Mitch McConnell (R-KY). Though similar language already exists in the 2018 Farm Bill, which federally legalized hemp and its derivatives, the senator took an added measure to provide clarity to farmers who want access to the insurance option ahead of the 2020 planting season.
“Beginning not later than the 2020 reinsurance year, the Federal Crop Insurance Corporation shall offer coverage under the wholefarm revenue protection insurance policy (or a successor policy or plan of insurance) for hemp (as defined in section 297A of the Agricultural Marketing Act of 1946 (7 U.S.C. 1639o)),” text of the provision states.
“Provided, That such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985,” it continues.
The Senate passed the bill by a vote of 85 to 8. The House is expected to approve the disaster legislation by unanimous consent by the end of the week, and President Donald Trump has offered assurances that he will sign it into law.
The legalization of hemp has sparked strong interest among farmers in states from Colorado to Kentucky, but it will still be some time until the U.S. Department of Agriculture (USDA) develops and implements its federal regulatory guidelines.
Agriculture Secretary Sonny Perdue said that while his department would not rush its rulemaking process, it still intends to implement the regulations before the 2020 planting season. After that point, USDA would be able to approve regulatory plans submitted by individual states.
McConnell, who championed the hemp legalization provision, has urged the quick and effective implementation of such regulations, and he’s suggested that he’d introduce standalone legislation to resolve any “glitches” in its rollout.
While not a standalone bill, the hemp-focused provision of the disaster legislation seems to indicate he plans to make good on that promise.
The senator has made much of his pro-hemp agenda, arguing last month that his role in reforming hemp laws is at “the top of the list” of reasons why voters should reelect him in 2020. He also cited hemp as an agricultural alternative to tobacco when he introduced a bill this week to raise the minimum age requirement to purchase tobacco products from 18 to 21.
Congressional Report Urges DEA Action On Marijuana Cultivation Applications
A congressional committee report attached a large-scale spending bill containing marijuana-related protections has been amended to include a call for the Drug Enforcement Administration (DEA) to finally act on long-pending applications for federal licenses to grow cannabis for research purposes.
The legislation itself, which was released by a House subcommittee last week, could still be further amended as it goes through the legislative process. But as approved by the full House Appropriations Committee on Wednesday, the bill stipulates that none of the Fiscal Year 2020 funds it allocates may be used by the Justice Department to interfere in state-legal medical marijuana programs.
The provision has been federal law since 2014, but its inclusion in the initial subcommittee proposal as introduced is the earliest it has ever surfaced in the legislative process for the annual spending bill. While advocates hoped broader protections for adult-use cannabis states would also be included in the base legislation, that rider isn’t in the bill—at least not yet.
There was also a technical problem with the legislation that wasn’t resolved by the committee manager’s amendment, the text of which has not been posted but was obtained by Marijuana Moment. The medical cannabis provision lists the states and territories its protections apply to—but it left out the U.S. Virgin Islands, which legalized medical marijuana in January.
Similar errors have occurred in past versions of the legislation, when legal medical cannabis states North Dakota and Indiana were not included in an earlier version of the rider, and advocates hope that the language will be amended on the House floor.
But while that fix didn’t make it into the bill at the committee level, the directive to the DEA about cannabis cultivation licenses was added to the committee report attached to the bill via the manager’s amendment.
“The Committee urges the Drug Enforcement Administration to expeditiously process any pending applications for authorization to produce marijuana exclusively for us in medical research,” the revised report states.
The DEA has faced significant pressure from lawmakers, advocates and scientists to approve applications for additional marijuana manufacturers to produce research-grade cannabis. Currently there is only one federally authorized facility, and the quality of its product has long been criticized.
DEA announced a process to license additional cultivators during the final months of the Obama administration in 2016, but the Justice Department under then-Attorney General Jeff Sessions refused to act on more than two dozen pending applications. Current Attorney General William Barr has pledged to look into the matter, and has said he agrees that approving additional manufacturers is necessary.
Advocates hope that the new committee report language could help to finally spur movement at the department.
“The DEA is a disaster on marijuana and they need to stop obstructing research ASAP,” Michael Collins, director of national affairs for the Drug Policy Alliance, told Marijuana Moment.
“It’s beyond ridiculous that they won’t act on these applications. Even prohibitionists like Project SAM agree,” he added, referring to the anti-legalization group Smart Approaches to Marijuana. “And when the guys who get their drug policy from the 1920s say you’re behind the times, that’s pretty embarrassing.”
Justin Strekal, political director for NORML, said that Sessions “was the only government official opposed to cannabis research, and he is no longer employed.”
“Now is the time for AG Barr to follow through on his commitment and allow researchers pathways to consumer-grade cannabis,” he said.
Another provision included in the appropriations bill would offer protections for states that have implemented industrial hemp pilot programs under the 2014 Farm Bill. The Justice Department wouldn’t be allowed to use its funds to interfere in such programs under the proposal.
Of course, the 2018 version of the agriculture legislation removed hemp and its derivatives from the Controlled Substances Act, shifting regulatory responsibility onto the U.S. Department of Agriculture instead of the Justice Department, so that provision may not be especially relevant going forward.
The bill will next head to the Rules Committee, which will decide the list of amendments—potentially including additional cannabis-related ones—that can be considered on the House floor.
Read the text of the manager’s amendment with the DEA marijuana language below:
Managers Amendment FINAL by on Scribd
Photo courtesy of Mike Latimer.
House Committee Approves Immigration Bill With Marijuana Protections
A congressional committee voted in favor of a wide-ranging immigration bill on Wednesday, and the legislation includes marijuana-related protections for people who were brought to the U.S. as children.
Under the DREAM Act as approved, having low-level cannabis convictions, or engaging in state-legal cannabis-related activities such as working in the regulated marijuana industry, would not be counted against applications for permanent resident status for so-called Dreamers.
The House Judiciary Committee advanced the bill in a 19-10 vote, without specific discussion about the cannabis provisions.
The section concerning eligibility for permanent status stipules that having three or more misdemeanor convictions could be grounds for ineligibility—but the bill creates an exemption for “simple possession of cannabis or cannabis-related paraphernalia” or “any offense involving cannabis or cannabis-related paraphernalia which is no longer prosecutable in the State in which the conviction was entered.”
The text seems to indicate that immigrants who engaged in cannabis-related activities prior to a state reforming its marijuana laws would still be protected even if that activity was not state-legal at the time.
Similar language appears under a separate section about grounds for a provisional denial of an application for adjustment of status. Applicants would be exempted from such a denial if their conviction was for “simple possession of cannabis or cannabis-related paraphernalia” or “any offense involving cannabis or cannabis-related paraphernalia which is no longer prosecutable in the State in which the conviction was entered.”
A previous version of the legislation, filed in March, didn’t include the specific eligibility requirements related to certain criminal activity, nor did it contain any explicit marijuana protections. It’s possible that House Democrats thought up the exemptions during a brainstorming session earlier this month about potential bill revisions aimed at building more support.
The next likely stop for the DREAM Act will be the House Rules Committee before heading to a full floor vote.
There’s been growing interest in reforming marijuana policies as they apply to immigrants and visitors to the U.S.
Earlier this month, four congressional Democrats sent a letter to the head of the Justice Department and Department of Homeland Security to end the practice of rejecting naturalization applications solely because the applicant worked in a state-legal marijuana market. That came after the U.S. Citizenship and Immigration Services (USCIS) released a memo specifying that such activity could render them morally unfit for citizenship.
And last week, Rep. Earl Blumenauer (D-OR) introduced legislation aimed at resolving marijuana-related border issues, whereby visitors who admit to using cannabis or working in their country’s legal industry can be denied entrance.
Photo courtesy of Philip Steffan.