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VA Seeks To ‘Normalize’ Marijuana Conversations With Veteran Patients Though New Research Website

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The Portland branch of the U.S. Department of Veterans Affairs (VA) is teaming up with an Oregon university on a new website that aims to provide resources to make healthcare providers “more comfortable” discussing marijuana treatment with patients.

While VA doctors are permitted to discuss cannabis with patients, many continue to feel reluctant to do so given that marijuana remains strictly prohibited under federal law and they’re barred from issuing medical cannabis recommendations that other non-VA doctors can provide in legal states.

To help assuage those concerns, Oregon Health & Science University’s (OHSU) Center for Evidence-based Policy and Portland VA launched an initiative last month called Systematically Testing the Evidence on Marijuana, or STEM. The website contains information about marijuana studies that have been published, others that are currently underway and additional general clinician resources for physicians.

“Providers have not become familiar with the health effects of cannabis,” principle investigator Devan Kansagara, a professor of medicine at OHSU and a staff physician at the Portland VA, said in a press release. “That’s partly because we’ve lacked the evidence we like to see when recommending treatments to patients, and partly because of a lack of familiarity with terminology and practical issues about cannabis.”

“The STEM site could help providers feel more comfortable discussing cannabis and help normalize conversations, similar to the process we have become so familiar with when talking to patients about alcohol use,” he said.

The new site doesn’t take a specific stand on whether cannabis should be integrated into treatment, but it does highlight news reports on studies showing potential therapeutic applications. It even featured a recent study indicating that cannabis compounds may be effective in preventing COVID infections.

“The new website is designed as an independent, methodologically rigorous resource primarily for health care workers,” a description says.

“The site features living systematic reviews that examine and update evidence about specific cannabis-related topics, such as treatment of chronic pain and post-traumatic stress disorder, exposure during pregnancy and cannabis use disorder. It includes a series of short, focused pieces called clinician briefs, which feature topics like cannabis for chronic pain or cannabis as a substitute for opioids in patients with chronic pain.”

As the site is developed, there are plans to expand it to include “patient-facing material” on cannabis.

VA has historically resisted various congressional legislation aimed at promoting research into marijuana for the military veteran population. Representatives have argued that the proposals from various lawmakers are excessively prescriptive, and they’ve noted ongoing clinical studies that the agency is already funding.

Some advocates had held out hope that the department would back modest reform proposals this session after the sponsor of one key VA research bill, Rep. Lou Correa (D-CA), said that he’d had a conversation with VA Secretary Denis McDonough about the issue of marijuana and veterans.

In December, a VA researcher acknowledged that people with post-traumatic stress disorder (PTSD) who use marijuana experience fewer symptoms and recover more quickly compared to people who don’t use cannabis.

Another VA official said in September that the department is “very closely” following research into the potential therapeutic benefits of psychedelics like MDMA for military veterans with PTSD.

During joint hearings before House and Senate Veterans Affairs Committees last year, three veterans service organizations submitted written testimony backing a policy change to expand access to or increase research on medical cannabis, and one argued in favor of loosening restrictions to enable veterans to utilize psychedelics in their mental health treatment.

A federal commission tasked with developing recommendations to improve mental health treatment for military veterans determined in a report in 2020 that Congress and the executive branch should promote research into the therapeutic potential of marijuana and psychedelics such as psilocybin mushrooms and MDMA.

Separately, a bipartisan coalition of congressional lawmakers said in a letter to McDonough that the department must urgently institute a policy change to ensure that military veterans can access cannabis for therapeutic use.

The letter came weeks after McDonough participated in a Veterans Day Q&A where he said that VA officials are “looking at” the possibility of an internal policy change and have discussed it with the White House and Department of Justice. The secretary also talked about being personally moved by stories from veterans who’ve found relief using medical marijuana.

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