Doctors with the U.S. Department of Veterans Affairs still can’t recommend medical marijuana, but they are being encouraged to talk more about it with military veterans.
That’s what a new V.A. policy being rolled out this month says.
The directive urges government doctors to “discuss with the Veteran marijuana use, due to its clinical relevance to patient care, and discuss marijuana use with any Veterans requesting information about marijuana.”
However, the policy reiterates the department’s long-held position that “to comply with Federal laws such as the Controlled Substances Act…providers are prohibited from completing forms or registering Veterans for participation in a State-approved marijuana program.”
V.A. Misstates Federal Law
In fact, no provision of federal law blocks the department from allowing its doctors to fill out medical cannabis recommendation forms in states where it is legal, even under continued federal prohibition.
In 2003, the U.S. Supreme Court let stand a federal ruling finding that doctors have a First Amendment right to recommend medical cannabis to patients, as long as they don’t actually provide marijuana.
The only thing standing in the way of government doctors recommending medical cannabis to veterans is the V.A.’s own internal policy, which the the department’s Veterans Health Administration just extended with the new directive.
V.A. Sec. David Shulkin has repeatedly tried to pass the buck to Congress when asked about the issue in interviews.
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.”
Shulkin has even gone so far as to allege that the agency can’t even participate in research on medical cannabis.
From the federal government point of view, right now we are prohibited by law from doing research on it or prescribing it,” he said in one interview. “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, Shulkin 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.”
Medical Marijuana Recommendations Vs. Prescriptions
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, within the scope of the protections of the 2003 federal case mentioned above.
Other Details Of New V.A. Policy
In addition to the “prohibition on recommending, making referrals to or completing forms and registering Veterans for participation in State-approved marijuana programs,” the new V.A. directive continues a policy that the government won’t pay for veterans’ medical cannabis.
It also specifies that the directive only prohibits use of medical marijuana by V.A. employees, not patients who don’t work for the department.
“Veterans must not be denied VHA services solely because they are participating in State-approved marijuana programs,” it says.
Those patients just have to get their cannabis recommendations from physicians outside the V.A., which can be costly and confusing for some veterans.
The new policy also seems to further encourage government doctors to more closely track and record information about veterans’ use of medical marijuana.
“Clinical staff may discuss with Veterans relevant clinical information regarding marijuana and when this is discussed it must be documented in the Veteran’s medical record,” it says. “Providers need to make decisions to modify treatment plans based on marijuana use on a case-by-case basis, such decisions need to be made in partnership with the Veteran and must be based on concerns regarding Veteran health and safety.”
The V.A.’s previous medical cannabis policy, enacted in 2011, technically expired on January 31, 2016, but remained in place until the enactment of the new directive, effective this month. The new policy is set to expire at the end of 2022.
Read the full new V.A. policy below:
Berkeley City Council Considers Decriminalizing Psychedelics This Week
A resolution to decriminalize psilocybin and other psychedelics will go before a Berkeley, California City Council committee on Wednesday.
Decriminalize Nature, the group behind the measure, also led the charge to successfully get a measure decriminalizing entheogenic plants and fungi approved by the City Council in neighboring Oakland last month.
In Berkeley, the Public Safety Committee will discuss the proposal and can either decide to hold it for a future meeting or advance it to the full Council. The public is able to attend Wednesday’s special meeting and share their perspective on the resolution, but Decriminalize Nature stressed in a tweet that this “is a small meeting, so you do NOT need to attend.”
Is it time for #DecriminalizeNature #Berkeley? Agenda 4 at the public safety meeting this Wed. July 17, with the Decriminalize Nature team! This is a small meeting, so you do NOT need to attend. But if you live in Berkeley, write your City Council! https://t.co/gMSDkegMPU
— Decriminalize Nature (@DecrimNature) July 15, 2019
However, city residents are being encouraged to write to their Council members and urge them to vote in favor of the measure, which would codify that “no department, agency, board, commission, officer or employee of the city, including without limitation, Berkeley Police Department personnel, shall use any city funds or resources to assist in the enforcement of laws imposing criminal penalties for the use and possession of Entheogenic Plants by adults of at least 21 years of age.”
The resolution defines the covered substances as “plants and natural sources such as mushrooms, cacti, iboga containing plants and/or extracted combinations of plants similar to ayahuasca; and limited to those containing the following types of compounds: indoleamines, tryptamines, phenethylamines.”
Councilmembers Rigel Robinson and Cheryl Davila are sponsoring the resolution, which does not allow for commercial sales or manufacturing.
The lawmakers provided background information on the measure in a report to their colleagues and the mayor, describing the medical potential of various psychedelics as well as the success of decriminalization measures in Denver and Oakland.
“It is intended that this resolution empowers Berkeley residents to be able to grow their own entheogens, share them with their community, and choose the appropriate setting for their intentions instead of having to rely exclusively on the medical establishment, which is slow to adapt and difficult to navigate for many,” they wrote.
While efforts to eliminate criminal penalties associated with psilocybin and other psychedelics have so far centered in jurisdictions that have historically embraced marijuana legalization and broader drug reform, the conversation around decriminalizing psychedelics is spreading nationally.
Shortly after Oakland approved its measure, Decriminalize Nature received inquiries from activities in cities from across the country. The group has kept track of each city where organizers are pursuing decriminalization.
Nature lovers are organizing coast to coast (and Hawaii)! Is your city on the map? Connect to join with your local community, or if you have the motivation to propose a similar initiative in your city/town/county, let’s start growing! contact [email protected] #DNUSA pic.twitter.com/38UxLKK9RN
— Decriminalize Nature (@DecrimNature) July 2, 2019
On Monday, a conversation around changing laws governing psychedelics reared during a City Council meeting in Columbia, Missouri. One resident implored the body to take up a resolution to decriminalize the natural substances, pointing to their therapeutic benefits.
Councilmember Mike Trapp said that the student’s proposal should be considered and that a government advisory board on public health should provide input on the medical potential of psychedelics, describing it as “very promising.”
Colorado Governor And USDA Official To Discuss CBD At Hemp Event
Colorado Gov. Jared Polis (D) and a U.S. Department of Agriculture (USDA) official will speak at a hemp conference next month to discuss policy and regulations concerning hemp-derived dietary supplements.
The American Herbal Products Association (AHPA) announced the lineup of their first-ever hemp and CBD conference last week. The two-day event is meant to “provide critical information for companies navigating the rapidly evolving legal, regulatory and financial landscapes to manufacture and market dietary supplement products with hemp or hemp-derived ingredients including cannabidiol (CBD).”
Following the legalization of hemp and its derivatives under the 2018 Farm Bill, lawmakers and stakeholders have been quick to highlight the industry’s potential and to call for an expedited rulemaking process so that CBD can be lawfully marketed in food items and dietary supplements.
This conference will focus on dietary supplements in particular, with presentations on the current regulatory landscape for such products, compliance issues for hemp businesses and market analysis.
Polis has been a vocal advocate for marijuana reform and pledged in his State of the State address in January that he would make “good on the promise of industrial hemp in Colorado.”
Longtime hemp industry supporter, former U.S. Congressman and current Colorado Governor Jared Polis to present at AHPA Hemp-CBD Supplement Congress — https://t.co/2wPOcvdkHr — #supplement #cbd #hemp #hempindustry @GovofCO pic.twitter.com/tYhqj8HFlx
— AHPA (@AHPAssociation) July 10, 2019
“With our world class universities like Colorado State and Adams State, which are at the forefront of hemp innovation with the leading hemp manufacturers and cultivators already here, we want to seize on this opportunity under the most recent national Farm Bill to help make Colorado the national leader in industrial hemp production,” Polis said at the time.
AHPA’s two-day event will also feature USDA Senior Marketing Specialist William Richmond, who will brief attendees with an update on the department’s progress developing regulations for CBD. The department said last month that it is aiming to release an interim final rule on hemp in August.
But while USDA has regulatory authority over hemp, businesses will also have to await guidance from the Food and Drug Administration (FDA) on marketing consumable CBD products. FDA said last week that it is “expediting” its rulemaking process and will release a report on its progress by early fall.
Former FDA Commissioner Scott Gottlieb said that because CBD exists as an FDA-approved drug and hasn’t previously been added to the food supply or in dietary supplements, the agency will have to create an alternative regulatory pathway for the compounds, which could take years without congressional action.
In the meantime, it appears that both federal agencies are taking steps to increase transparency around their regulatory progress. Two days before the USDA official is set to appear at the AHPA conference, an FDA representative is scheduled to keynote a separate hemp industry summit to discuss related issues.
Marijuana Legalization Could Be On The Horizon For British Virgin Islands
The British Virgin Islands (BVI) could soon have a bill to legalize marijuana before the legislature, according to a government official.
Details are sparse, but Agriculture Minister Natalio Wheatley said on Saturday that the draft legislation under consideration would address concerns about youth consumption and impaired driving while ensuring that adults no longer face jail time for simple possession.
“We certainly know that marijuana, which contains THC, has an impact on your disposition. It has an impact on you being able to complete certain tasks,” he said, according to BVI News. “We don’t want to fool everyone into thinking that we think persons should be up and down smoking marijuana through the streets without any sort of regulation.”
He added that he hoped the legislation would make BVI a global model for legalization.
“We certainly support having a well-regulated industry, and the fact that we’re coming in late into this whole discussion of marijuana means that we don’t have to repeat the mistakes that some of our brothers and sisters made in other places,” he said.
The draft bill being circulated reportedly originated under the previous administration and is being improved upon. Wheatley said that residents, who he believes support legalization, should expect community meetings to be scheduled to discuss the proposal.
“Persons will no longer be incarcerated for the possession and consumption of something that is recognized to be a lot less detrimental to your health,” he said. “In fact, we’re speaking about the medicinal value of it than something like alcohol. It’s proven that alcohol is much more damaging to your health than marijuana.”
BVI’s cousin, the U.S. Virgin Islands (USVI), hasn’t taken the step to allow adult use of marijuana, but the territory’s governor did sign a bill legalizing medical cannabis in January.
The sponsor of the USVI legislation, former senator and current Agriculture Commissioner Terrance “Positive” Nelson, said that he plans to continue to pursue broader reform, and he commended BVI for moving toward a commercial cannabis model.
“I told you already it is not easy to stand up for cannabis. I still have some scars on my back relative to the push in [USVI],” he said. “Here in the British Virgin Islands, you are talking about legalization and I want for local leaders here to continue to be brave enough to move forward.”
“Yes, there is going to be pushbacks. But the truth in the matter is this: the truth is on your side,” he said. “The truth is on our side.”
Photo courtesy of Philip Steffan.