Despite repeated claims to the contrary, the U.S. Department of Veterans Affairs (VA) is now admitting that it “can look at marijuana as an option for treating Veterans.”
The stance, which comes in the form of new content uploaded to a VA webpage last week, contrasts with a letter that Veterans Affairs Sec. David Shulkin sent to members of Congress in December, less than two months ago.
“Federal law restricts VA’s ability to conduct research involving medical marijuana, or to refer veterans to such projects,” he claimed at the time.
There have been no changes to federal cannabis laws in the interim.
The VA Office of Research & Development’s webpage on Post-Traumatic Stress Disorder (PTSD) now says that earlier research on medical cannabis “found limited evidence that marijuana use might alleviate neuropathic pain in some patients, and that it might reduce spasticity associated with multiple sclerosis, but found insufficient evidence to assess the effects of marijuana on PTSD.”
“VA is not currently able to prescribe medical marijuana to Veterans,” it continues, “but can look at marijuana as an option for treating Veterans.”
A cached previous version of the same page doesn’t mention marijuana at all.
The update to the webpage comes as Shulkin and the department are under increasing pressure on medical cannabis and completely unrelated issues.
A group of members of Congress are pushing the VA to allow its physicians to recommend medical cannabis, or at least to refer veterans to studies on the drug’s potential.
And a VA inspector general’s report released last week found that Shulkin made “serious derelictions” that resulted in improper use of taxpayer money to cover portions of an overseas trip he and his wife took to Denmark and the UK last year.
The report, which included portions of Shulkin’s travel agenda, happened to reveal that on July 19 he met with British officials to discuss medical cannabis as part of the trip.
Under an internal VA administrative directive, the department’s policy is that its “providers are prohibited from recommending, making referrals to or completing paperwork for Veteran participation in State marijuana programs.”
Shulkin has repeatedly tried to pass the buck to Congress when asked about the issue.
During a White House briefing last year, for example, 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.”
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.
Shulkin has the unilateral authority to rescind the internal ban and clear the way for VA doctors to recommend medical cannabis to veterans in states where it is legal, but he has repeatedly claimed that federal law — without citing a particular statute — blocks him from doing so.
The secretary’s unwillingness to move on marijuana goes beyond just letting doctors who work for him recommend it. He has also thus far refused to help lift institutional roadblocks preventing the department from participating in scientific research on cannabis’s uses.
In an interview last year, he said that it is “not within our legal scope to study that in formal research programs.”
That position has led to recruitment issues for researchers conducting trials. For example, one such study on marijuana’s effects on PTSD has been prevented from reaching veterans at the Phoenix, Arizona VA 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 [VA] 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.”
And John Hudak, a researcher with the Brookings Institution said that despite Shulkin’s claims, “doctors and researchers at the VA or in VA hospitals could conduct research into the medical efficacy of marijuana while remaining completely compliant with federal laws, regulations, and the United States’ obligations under international agreements.”
In December, VA issued an updated policy offers physicians greater encouragement to discuss cannabis with their patients.
The new 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.”
But it maintains the longstanding departmental ban on physician recommendations.
The new website language, however, and the revelation that Shulkin discussed the issue on his overseas trip, shows that VA’s opposition to cannabis is not necessarily set in stone, at least when it comes to research, though the implications aren’t immediately clear.
“No other arguments have worked in the past so this may be a breakthrough,” Sue Sisley, the researcher running the Arizona PTSD trial, told Marijuana Moment in an interview, referring to the webpage update. “VA can definitely be more helpful if they wanted to. There is nothing blocking them.”
Marijuana Policy Project Welcomes New Executive Director
The Marijuana Policy Project (MPP), the nation’s best-funded cannabis advocacy group, has named long-time social justice reform advocate Steve Hawkins as its next executive director.
Hawkins, who previously served as the executive director of the National Coalition to Abolish the Death Penalty (NCADP) and executive vice president of the NAACP, will assume responsibility for MPP’s national legalization advocacy efforts just months before a number of states vote to enact their own legal systems.
The decision was made after a “months-long candidate search that included several exceptionally qualified candidates,” MPP said in a press release.
“We are still battling the effects of decades of anti-marijuana legislation and propaganda in this country,” Hawkins told Marijuana Moment. “Huge strides have been made when it comes to setting the record straight, but our work is far from over and there is still a lot of misinformation out there that needs to be addressed.”
“Fundraising and maintaining momentum is also a core challenge for the movement, which is in some ways a victim of its own success. Thanks to the major gains it has made in recent years, many people think legalization is inevitable and that their donations are no longer needed or that they don’t need to take the time to write their elected officials. These laws are not going to change themselves and there is more need than ever for resources and engagement to support federal and state-level reform efforts.”
Hawkins’s experience running successful criminal justice reform campaigns—including a bipartisan effort to end capital punishment for juveniles during his time at the NCADP—made him an apt candidate to spearhead the fight to end prohibition, Troy Dayton, chair of MPP’s board of directors, said in a statement.
“Steve has a strong track record in the field of criminal justice reform, and he knows how to build a movement toward meaningful social change,” Dayton said. “We were not only impressed by his expertise and experience, but also his strong convictions regarding the injustice of marijuana prohibition.”
“The country is moving in the right direction on marijuana policy, but there is still a lot of work to be done.”
Hawkins also previously held leadership positions at Amnesty International and the Coalition for Public Safety.
He told Marijuana Moment that his three decades of experience “defending civil and human rights” has informed his belief that we should “bring an end to marijuana prohibition, which has had a hugely detrimental impact, especially to communities of color,” and that we should “replace it with a more sensible system of regulation.”
“I also believe it is critical we ensure those populations that were so negatively impacted by prohibition are able to participate in and experience the positive impacts of such a regulated system.”
At MPP, Hawkins will succeed Rob Kampia, who late last year left the organization he founded in 1995 to start a for-profit cannabis policy consulting firm called the Marijuana Leadership Campaign. Kampia’s departure was announced shortly after sexual misconduct allegations against him resurfaced amid the #MeToo movement.
Kampia offered some words of advice for the next person to occupy his former seat in a phone interview with Marijuana Moment:
“View yourself as a fundraiser who has to engage in transactional fundraising with the marijuana industry in part, and view yourself as needing to come up with a smart, strategic plan for lobbying in state legislatures rather than doing ballot initiatives where no one else is going to touch it. Do not view yourself as a spokesperson.”
Or in other words, less of a focus on talk, and more on action.
MPP named Matthew Schweich as the interim executive director while the group scouted for a replacement. Scweich will now serve as MPP’s deputy director overseeing marijuana reform initiatives in Michigan and Utah.
In a statement, MPP board member Joby Pritzker said Schweich “provided critical leadership during a challenging transition period for MPP.”
“He maintained the effectiveness of our advocacy operations, managed our fundraising efforts, and oversaw ballot initiative campaigns in multiple states, while at the same time leading our staff and assisting the board with the executive director search.”
The past few years have seen a number of leadership changeups at national pro-legalization groups.
NORML brought on Erik Altieri as executive director in 2016 after Allen St. Pierre left the organization following 11 years of service. And last year, the Drug Policy Alliance announced that it had hired Maria McFarland Sánchez-Moreno, who worked on international and domestic drug policies issues for 13 years at the Human Rights Watch, as the new executive director to replace retiring founder Ethan Nadelmann.
While the objective at all of these groups—promoting equitable drug policy reform in the United States—has remained the same, the nature of the movement has evolved. A majority of states have now legalized cannabis for medical or recreational purposes, and though state-level reform efforts continue, calls for change at the federal level are increasingly resonant.
That is to say, these new executive directors will face a different set of challenges than their predecessors did.
Photo courtesy of Beloit College.
UN Launches First-Ever Full Review Of Marijuana’s Status Under International Law
For the first time ever, the United Nations (UN) is launching an in-depth review of whether marijuana is properly classified under international drug treaties.
In a related development, the UN’s World Health Organization (WHO) has announced that cannabidiol (CBD), a compound in marijuana that is increasingly used for medical purposes, does not warrant being controlled under the global agreements.
“The Committee recommended that preparations considered to be pure CBD should not be scheduled within the International Drug Control Conventions,” WHO Director-General Tedros Adhanom Ghebreyesus wrote in a letter announcing the moves. “The Committee concluded that there is sufficient evidence to proceed to a Critical Review” of marijuana, hashish, cannabis extracts and THC.
That broader review is set for November, and follows the results of an initial pre-review conducted by WHO’s Expert Committee on Drug Dependence (ECDD) in June.
“A pre-review is the first step of the ECDD’s assessment process, where it is determined whether there is enough robust scientific information to proceed to the next step, called a critical review,” an explanatory document accompanying the new letter reads. “This initial evaluation is also an opportunity to identify gaps in the available scientific data. A critical review is carried out when there is sufficient scientific evidence to allow the ECDD to make informed an recommendation that the substance be placed under international control, or if its level of control should be changed.”
The reviews include analyses of the chemistry, pharmacology, toxicology, epidemiology and therapeutic use of the substances.
If the UN ultimately decides to change marijuana’s status under international law, it would trigger a review on U.S. scheduling, according to provisions of the Controlled Substances Act.
“Thankfully the World Health Organization has accepted the challenge of evaluating the placement of cannabis in the 1962 Single Convention treaty,” Michael Krawitz of Veterans for Medical Cannabis Access told Marijuana Moment. “Cannabis placement in the treaty was done in the absence of scientific evaluation and has provided the basis for a moral campaign against drugs by the USA for many decades. Since our work on medical access to cannabis has been based upon scientific inquiry we know that any rational assessment of the evidence leads the observer to understand cannabis indeed has proven medicinal value and, compared to other medicines, has profoundly fewer negative side effects.”
Here’s what the UN experts have determined so far:
“There are no case reports of abuse or dependence relating to the use of pure CBD. No public health problems have been associated with CBD use,” an annex attached to Ghebreyesus’s letter reads, noting that research has shown it to be effective in treating epilepsy. “CBD has been found to be generally well tolerated with a good safety profile.”
“Cannabidiol (CBD) is not specifically listed in the schedules of the 1961, 1971 or 1988 United Nations International Drug Control Conventions… There is no evidence that CBD as a substance is liable to similar abuse and similar ill-effects as substances in the 1961 or 1971 Conventions such as cannabis or THC, respectively. The Committee recommended that preparations considered to be pure CBD should not be scheduled.”
When it comes to whole-plant marijuana and resin, ECDD’s pre-review found that while “adverse effects” are possible and that cannabis can cause physical dependence, its current categorization in international treaties “may not appear to be consistent with the criteria.”
“Several countries permit the use of cannabis for the treatment of medical conditions such as back pain, sleep disorders, depression, post-injury pain, and multiple sclerosis,” the document says. “The evidence presented to the Committee did not indicate that cannabis plant and cannabis resin were liable to produce ill-effects similar to these other substances that are in Schedule IV of the 1961 Convention on Narcotic Drugs. The inclusion of cannabis and cannabis resin in Schedule IV may not appear to be consistent with the criteria for Schedule IV.”
“The Committee concluded that there is sufficient evidence to proceed to critical review of cannabis plant and cannabis resin at a future ECDD meeting and explore further the appropriateness of their current scheduling within the 1961 Convention.”
With respect to extracts and tinctures of cannabis, the committee similarly identified health issues associated with consumption, but said “there is limited evidence of a withdrawal syndrome upon abrupt cessation.”
The committee also looked at THC itself and isomers of THC, and recommended that both be subject to critical reviews in November.
Ghebreyesus’s letter is addressed to UN Secretary-General Antonio Guterres, who will be the ultimate recipient of WHO’s recommendations on cannabis and related extracts and compounds following the review.
Guterres was prime minister of Portugal when that nation decriminalized all drugs, a move he touted last year in an address to the UN’s Commission on Narcotic Drugs. After the critical reviews are in, that body will vote on whether to alter cannabis’s status under the international treaties.
Marijuana Moment Patreon supporters can see the full text of the new WHO letter on cannabis below:
North Dakota Marijuana Legalization Measure Qualifies For November Ballot
North Dakotans voted to approve medical cannabis two years ago, and now they will get the chance to decide on full marijuana legalization this November.
Activists collected a sufficient number of signatures to qualify a ballot measure that would allow adults over 21 to use and grow marijuana, the secretary of state’s office determined on Monday.
(Marijuana Moment’s editor provides some content to Forbes via a temporary exclusive publishing license arrangement.)
Photo courtesy of Philip Steffan.