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VA Should Let Doctors ‘Verbally’ Recommend Medical Marijuana Amid Coronavirus, Lawmakers Say

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Seven members of the Massachusetts congressional delegation are urging the head of the U.S. Department of Veterans Affairs (VA) to allow VA physicians to verbally recommend medical marijuana to military veterans amid the coronavirus pandemic.

The letter, led by Sen. Elizabeth Warren (D-MA) and shared exclusively with Marijuana Moment, stresses that Massachusetts has shuttered recreational marijuana shops during the COVID-19 crisis, which has driven some to transition to the medical cannabis dispensaries that remain open as essential services under the governor’s order. But because veterans may avoid registering as cannabis patients out of concern that they could lose federal benefits and are now left without access to medicine, the lawmakers want VA to amend its policies, at least on a temporary basis.

“As this global pandemic continues to adversely affect veterans’ behavioral and physical health conditions, we believe that veterans who legally use cannabis in the Commonwealth to treat their ailments deserve to receive more robust assistance from qualified medical personnel at their local VA,” the lawmakers, including House Rules Committee Chairman James McGovern (D-MA), wrote, adding that they feel VA should “consider making this directive the official policy” of VA on a permanent basis once the current health emergency is over.

It’s unclear what the practical impact of allowing VA doctors to make “verbal” recommendations would be, given that state medical marijuana certifications generally require a written component from doctors.

An aide to Warren told Marijuana Moment that the senator would ultimately like to see VA doctors be able to offer written recommendations and that the hope is the incremental reform could provide short-term relief to veterans and set the stage for broader policy changes down the line.

The staffer also noted that Warren is pushing for comprehensive federal marijuana legalization and wants medical cannabis products covered under VA insurance for veterans just like any other legal medication.

VA currently allows and encourages veterans to discuss their use of marijuana as a treatment for various ailments with their government doctors, but it specifically prohibits its physicians from issuing recommendations needed to register as a qualified patient under a state-legal program or from assisting in obtaining medical cannabis in any way.

“Veterans in Massachusetts use medical marijuana to treat a variety of ailments, including post-traumatic stress disorder (PTSD), anxiety, chronic pain, and others,” the Wednesday letter, which was also signed by Sen. Ed Markey and Reps. Katherine Clark, Seth Moulton, Ayanna Pressley and Joseph Kennedy III, all Democrats, states.

“For many veterans in Massachusetts, medical marijuana works in treating their health conditions, which can be exacerbated by the coronavirus pandemic,” they wrote to VA Secretary Robert Wilkie. “Therefore, during this unprecedented public health emergency, VA should issue a directive explicitly authorizing its health care providers to make sensible, clinically sound verbal recommendations to veterans related to participation in state-approved medical marijuana programs and services and to provide advice to veterans as they complete forms and other paperwork reflecting those recommendations.”

States that have medical cannabis programs generally require a licensed doctor’s signature in order for a patient to be certified, so the language around “verbal” recommendations by itself wouldn’t help veterans obtain legally protected patient status. But the letter has a suggestion for how VA personnel could help nonetheless.

“When veterans request advice on paperwork related to participating in a state-approved marijuana program, VA clinicians should be advised that they can make verbal referrals to knowledgeable non-VA providers who are registered with a state-approved program and can offer feasible options that minimize, or completely waive, the cost to the veteran,” the lawmakers wrote.

But veterans are already able to seek out written recommendations from non-VA physicians, and it’s not clear how VA would be able to facilitate a process where those private providers would waive or minimize costs, as the letter encourages.

That said, Debbie Churgai, interim director of Americans for Safe Access, told Marijuana Moment that she does not view the verbal recommendation caveat as “an extra hoop to jump through,” but rather as “an opportunity for many veterans to openly talk with and get acceptance and assistance from their VA physicians.”

If veterans are able to get verbal advice from VA doctors on how to fill out state applications to become registered patients and can be directed on the process of submitting them to relevant agencies, that would represent a positive development compared to the current system, where patients are completely on their own in navigating the process.

“I think having the ability to talk with their primary physician about cannabis and get verbal approval (i.e recommendation) from them is really huge and amazing news for veterans. Or at least it’s a tiny step in the right direction,” Churgai said. “Having a VA physician suggest cannabis as medicine with a verbal recommendation could help many patients open up their minds about cannabis as an option for treatment.”

She added that “this could help in court as well to protect physicians when talking about cannabis” because the current policy of allowing them to discuss it but not endorse it “could be seen as confusing, so for many this may help physicians feel more comfortable talking about cannabis with their patients.”

In their letter, the Massachusetts lawmakers went on to say that “VA clinicians who provide this temporary, limited assistance to veterans should be clearly advised by the VA that they will not be subject to disciplinary action,” and they urged “VA to work with the Justice Department to formally advise VA providers who conduct these clinical activities that they will not face criminal prosecution under federal marijuana laws.”

“By authorizing these tailored, temporary actions, the VA could help Massachusetts veterans who use, or are interested in using, medical marijuana receive more comprehensive clinical advice from their VA providers, reduce opioid addiction and substance use disorders, and achieve better health outcomes,” they concluded. “Finally, when this public health emergency ends, we urge VA to consider making this directive the official policy of the Department going forward.”

Advocates also say that such a policy change would be important because veterans should be empowered to discuss cannabis treatment, get a recommendation and continue that dialogue with a VA clinician they know and have an existing relationship with. It could help that VA doctors would be making referrals to credible non-VA physicians to complete the registration process, as well, instead of having veterans use less trustworthy cannabis-focused physician services that they have to find on their own.

Michael Liszewski, principal of the Enact Group, acknowledged that the move “would not necessarily facilitate a veteran being able to register with a state medical cannabis program” but said that “it does have some practical merit.”

“By encouraging vets to speak with their VA doctors from which they are receiving ongoing care, veterans would receive more fully-informed care,” he said. “While allowing referrals to trusted physicians outside the VA system to complete paperwork means veterans will still be paying out of pocket for the exam, the directive would ease the barrier.”

Clark, one of the representatives signing the new letter, has previously cited veterans’ access to cannabis in urging the Massachusetts government to reverse its decision to close recreational marijuana shops—which the governor said was necessary to prevent out-of-state consumers from visiting and potentially spreading the coronavirus.

A bill to allow VA doctors to issue medical cannabis recommendations (without the “verbal” stipulation) was approved by the House Veterans’ Affairs Committee last month. Rep. Earl Blumenauer (D-OR) is the sponsor of that legislation, which was opposed by a VA official in an earlier hearing. The official said the the Drug Enforcement Administration advised against allowing the policy change.

“I’m appreciative of any attempt to broaden veterans’ access to cannabis. It’s an important step towards removing barriers that many veterans face when seeking care,” Blumenauer told Marijuana Moment in response to the new push from the Massachusetts delegation. “During this time when we are recommending that those at risk distance themselves from others, that includes going to the doctor unnecessarily. Veterans deserve access to medical cannabis treatment at the recommendation of their physician, period. It’s past time we give them that unfettered access.”

The Congressional Budget Office released an analysis last month projecting that Blumenauer’s bill would have zero fiscal impact.

Outside of the veterans-specific issues related to federal marijuana policies during the coronavirus pandemic, there’s also a congressional push in the works to expand disaster relief benefits to marijuana businesses. And eleven senators sent a letter to Appropriations Committee leadership earlier this month, asking for a provision to future spending legislation that would allow cannabis companies to access Small Business Administration (SBA) programs.

SBA has stated that marijuana businesses—as well as those that work “indirectly” with the industry—do not qualify for COVID-related relief while cannabis remains federally prohibited.

Also, in a recent call with the Democratic Caucus, Rep. Ed Perlmutter (D-CO) raised the issue marijuana banking access and, according to the congressman, House Speaker Nancy Pelosi (D-CA) said she wanted to include language ensuring that cannabis businesses can access those financial services in an upcoming coronavirus stimulus package.

Read the lawmakers’ medical marijuana letter to VA below: 

Lawmakers Push VA On Medica… by Marijuana Moment on Scribd

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Marijuana Moment is made possible with support from readers. If you rely on our cannabis advocacy journalism to stay informed, please consider a monthly Patreon pledge.

Kyle Jaeger is Marijuana Moment's Los Angeles-based associate editor. His work has also appeared in High Times, VICE and attn.

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New Mexico Governor And Senate Leader Say Marijuana Legalization Can Pass This Year

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The governor of New Mexico and a top Senate leader are bullish about getting marijuana legalization passed this session, with both making recent comments about what they hope the soon-to-be-introduced legislation will accomplish.

Gov. Michelle Lujan Grisham (D), who included the reform as part of her 2021 legislative agenda she released this month, said in a TV interview that she’s “optimistic” about cannabis reform adding that projections show the state gaining thousands of jobs and raising hundreds of millions of dollars in tax revenue.

“I’m still really optimistic about cannabis, which is 12,000 jobs,” she told KOB-TV, “and you know by the fifth year in operation, the projections are we would make $600 million a year.”

But while the “large economic boost” that the governor expects legalization to bring is an important component, especially amid the coronavirus pandemic, lawmakers are also taking seriously the need to address social equity.

Watch the governor talk about cannabis reform, starting around 4:40 into the video below: 

Meanwhile, Senate Majority Leader Peter Wirth (D) said last week that he’s having ongoing conversations with multiple legislators who plan to sponsor legalization bills, and he’s conveyed to them that whatever piece of legislation advances must “address those fundamental underlying issues” of social justice.

In terms of process, the top lawmaker said it’s important for legislators to be talking about their respective bills early on to resolve as many differences as possible before the issue reaches committee or the floor. The failure to get those issues taken care of in a timely manner is partly why the legislature wasn’t able to pass legalization during last year’s short session.

A bill to legalize cannabis for adult use passed one Senate committee last year only to be rejected in another before the end of the 30-day session. Earlier, in 2019, the House approved a legalization bill that included provisions to put marijuana sales mostly in state-run stores, but it later died in the Senate.

“This year I know the legislators have been working very hard, shaping and crafting these bills, and that kind of from the ground up versus the top down approach that I think is needed for a legislation of this kind,” Wirth told the Growing Forward podcast that’s a joint project of NM Political Report and New Mexico PBS. “Again, we just can’t get it into a final committee in a place where it’s not really ready to go.”

Watch the senator majority leader discuss the legislature’s work to legalize marijuana below: 

The new, post-election makeup of key committees has been helping to facilitate this dialogue and get ahead of disagreements, he said.

While Wirth said he expects some of the same voices coming out in opposition to the legislature’s push to enact legalization this session, he’s “feeling more confident” about passing the reform in the Senate this year.

Several anti-legalization Democrats, including the Senate president pro tem and the Finance Committee chair, were ousted by progressive primary challengers last year.

Additional pressure to end cannabis prohibition this year is coming from neighboring Arizona, where voters approved legalization in November and where sales officially launched last week. New Mexico shares another border with Colorado, one of the first states to legalize for adult use. Cannabis is also expected to be legalized across the southern border in Mexico, with lawmakers facing a Supreme Court mandate to end prohibition by April 2021.

Wirth said it’s important to make sure that adult-use legalization doesn’t come at the peril of the state’s existing medical cannabis program.

“I just think that it’s a program that’s really been a model for how it’s been rolled out, how it’s worked, and we want to make sure that it stays intact and is still a functioning program,” he said. “That’ll be another a big issue.”

With at least five legalization bills being prepared in the state, Wirth said, there will be plenty for lawmakers to sift through and negotiate this session. The majority leader noted that another question is whether to put marijuana tax dollars in the state’s general fund or to earmark it for specific programs.

Rep. Javier Martinez (D), who has consistently sponsored cannabis reform bills in past sessions, said recently that the “biggest change you’ll see in this bill, which is one of the main points of contention last year, was the creation of a number of different funds, earmarks, tax coming in from cannabis.”

In any case, there’s economic urgency to pass and implement a legal cannabis program. And while no bills have been introduced so far this session, lawmakers expect several to be released as early as this week.

“I’m hopeful that this is the year to get this done,” Wirth said. “I just think the longer we wait, the less of an economic impact it’s going to have, as all of our sister states around us in the country really reach in this direction at pretty high speed.”

Polling indicates that voters are ready for the policy change. A survey released in October found that a strong majority of New Mexico residents are in favor of legalization with social equity provisions in place, and about half support decriminalizing drug possession more broadly.

In May, the governor signaled that she was considering actively campaigning against lawmakers who blocked her legalization bill in 2020. She also said that she’s open to letting voters decide on the policy change via a ballot referendum if lawmakers can’t send a legalization bill to her desk.

Anti-Marijuana Lawmaker Files Legalization Bill In North Dakota To Avoid Activist Ballot Measure

Photo by Kyle Jaeger.

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GOP Congressman Files Bill To Protect Veterans Who Use Medical Marijuana From Losing Benefits

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A Republican congressman has filed the second piece of marijuana reform legislation to be introduced so far in the new 117th Congress—this one aimed at ensuring that military veterans aren’t penalized for using medical cannabis in compliance with state law.

The proposal from Rep. Greg Steube (R-FL), who filed a more expansive version of the measure last year, would also codify that U.S. Department of Veterans Affairs (VA) doctors are allowed to discuss the risks and benefits of marijuana with their patients.

VA doctors are currently permitted to discuss cannabis with patients and document their usage in medical records, and those veteran patients are already shielded by agency policy from losing their benefits for marijuana use—but the new bill would enshrine these policies into federal statute so they could not be administratively changed in the future.

That said, the version Steube introduced last year contained a notable provision that further allowed VA physicians to formally fill out written recommendations for marijuana.

But that language was omitted from this year’s bill, which could create barriers to access given that most state medical cannabis programs require a written recommendation, meaning many veterans would have to outsource their healthcare to a non-VA provider in order to qualify for legal access to marijuana.

Carson Steelman, communications director in Steube’s office, told Marijuana Moment that removing that component was politically necessary to advance the previous version through a House committee last year as an amendment to another bill.

“This bill was able to pass through markup with the removal of that portion,” he said. “Many members had concerns regarding it so in order to move this bill swiftly this Congress, we introduced it without that portion.”

Doug Distaso, executive director of the Veterans Cannabis Project, applauded Steube for the overall bill, saying that  “we consistently see, on a daily basis, a denial of veteran benefits ranging from medical prescriptions to VA loans, solely because a veteran is participating in a state-approved marijuana program or working in the cannabis industry.”

“However, we are disappointed that specific language on Veterans Affairs provider-issued cannabis recommendations was removed from this bill, since these are the providers upon whom veterans rely for full, integrated treatment and care—including cannabis,” he told Marijuana Moment.

But while the absence of language around discussing and recommending medical marijuana isn’t ideal from advocates’ perspective, the bill would still be a modest step for veterans, making it so VA could not move to deny them benefits for using cannabis in accordance with state law.

The Veterans Cannabis Use for Safe Healing Act had 19 cosponsors last session, including eight Republicans and 11 Democrats.

This is the second piece of marijuana reform legislation that’s been introduced so far in the new Congress, both of which are sponsored by Steube. His first bill would simply require that cannabis be moved from Schedule I to Schedule III of the Controlled Substances Act—a move that the congressman said would free up research into the plant.

That proposal is identical to legislation he filed last year.

While rescheduling is backed by President Joe Biden, who remains opposed to adult-use legalization, it’s not the reform that advocates are getting behind. There are high hopes that a more comprehensive completely remove marijuana from the CSA—while promoting social equity—will move through the 117th Congress.

A bill to accomplish that cleared the U.S. House of Representatives last year, but it died in the GOP-controlled Senate. Now that Democrats have control of both chambers, activists are waiting for the legislation to be taken back up with a better chance of making it to Biden’s desk.

That bill—the Marijuana Opportunity, Reinvestment and Expungement (MORE) Act—was sponsored by now-Vice President Kamala Harris, though she’s indicated that she would not necessarily push the president to adopt a pro-legalization position.

Read the text of the veterans-focused marijuana bill below: 

Marijuana veterans bill by Marijuana Moment

Washington Lawmakers Approve Marijuana Homegrow Bill In Committee

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Anti-Marijuana Lawmaker Files Legalization Bill In North Dakota To Avoid Activist Ballot Measure

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North Dakota’s secretary of state on Friday approved the format of a proposed marijuana initiative, clearing the way for activists to collect signatures to place it on the 2022 ballot. Meanwhile, a Republican lawmaker is pushing a cannabis legalization bill he introduced even though he does not support the underling policy change.

Rather, Rep. Jason Dockter (R) said he recognizes the seeming inevitability of legal marijuana reaching the state as more neighboring jurisdictions enact reform and as activists gain momentum for their agenda. If the state is going to enact legalization, he wants the legislature to dictate what that program looks like instead of leaving it in the hands of advocacy groups.

Dockter’s House Bill 1420 would allow adults 21 and older to possess and purchase up to one ounce of cannabis for personal use, but home cultivation would not be allowed.

Licensed cultivation facilities that provide cannabis products to retailers “may grow an amount of marijuana sufficient to meet the demands of the public.”

Under the proposal, legal cannabis sales would begin on February 1, 2022.

The bill is being supported by the pro-reform campaign Legalize ND. The group placed a legalization measure on the 2018 ballot that was defeated by voters. They tried to qualify another initiative last year but signature gathering complications caused by the coronavirus pandemic got in the way.

It’s not clear if they will now still pursue previously announced plans for 2022 in light of the new bill, which they said they are “proud of” and is the result of engaging lawmakers in more than six months’ worth of conversations.

Meanwhile, a separate activist group has already filed its own 2022 legal marijuana measure that would make it so adults could possess marijuana and grow up to 12 plants (up to six of which could be mature). Secretary of State Al Jaeger said on Friday that the group can begin working to gather the 26,904 valid signatures from registered voters they will need to place the measure on the ballot.

“I am glad the North Dakota legislature is coming to the realization that legalization will move forward with or without them,” Jody Vetter, chairwoman for that effort, the ND for Freedom of Cannabis Act, told Marijuana Moment.

She added that while the Dockter’s bill is “a step in the right direction toward ending prohibition, there are concerns,” pointing to the lack of legal home cultivation and remaining criminal charges for certain cannabis-related activity.

“Criminal charges surrounding possession should only apply if someone is found to be selling cannabis without proper license or contributing to minors,” Vetter said. “We are moving forward with the ND For Freedom of Cannabis Act. Home growing is essential for any legal program and an overwhelming majority of North Dakotans are ready to stop criminally charging citizens for simply possessing cannabis.”

Jared Moffat, state campaigns manager for the national Marijuana Policy Project, told Marijuana Moment that “though this isn’t an ideal legalization bill, it’s a significant testament to the strength of our movement that legalization opponents are now preemptively filing their own legislation to legalize and regulate marijuana for adults.”

“These lawmakers are aware that a majority of their constituents support legalization, and you have to give them some credit for acknowledging that,” he said.

The bill contains a number of restrictions on labeling and advertising, as well as penalties for impaired driving. A health council would be tasked with developing further regulations on issues such as the allowable amount of THC in edibles and testing standards.

“I’m not for [legalization] at all, but I understand that it’s coming, and we have to address the issue,” Dockter told Inforum. “I’m trying something different in government—we’re trying to be proactive and not be reactive.”

House Majority Leader Chet Pollert said that he’s not “a marijuana person,” but he acknowledged that cannabis legalization is coming. While he would have previously been inclined to oppose Dockter’s bill, Pollert said voter approval of a legalization initiative in South Dakota has given him pause, adding that the legislature should “take a long, hard look” at the policy change.

Neighboring Montana also moved to legalize marijuana for adult use during the November election, adding to the regional pressure to get on board. Canada, which also borders the state, has a national legal cannabis market.

North Dakota voters approved a medical cannabis ballot measure in 2016.

Aside from the new broad legalization legislation, state lawmakers also recently introduced a separate bill to significantly expand the decriminalization of marijuana possession in the state. The proposal, which was filed last week, would build on an initial cannabis decriminalization law that was enacted in 2019.

Read the North Dakota cannabis legalization bill below: 

North Dakota marijuana lega… by Marijuana Moment

Virginia Marijuana Legalization Bill Approved By Senate Committee, With Home Cultivation Provisions Intact

Photo courtesy of Philip Steffan.

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