The U.S. Department of Veterans Affairs really wants the military veterans it is charged with serving to know that it isn’t going to do anything to help them access medical marijuana.
While longstanding VA policy has been to disallow government physicians from helping veterans qualify for state medical cannabis programs, a new update to the department’s website sends the message even more clearly — even though it misstates what the law actually is.
“Veterans should know that federal law classifies marijuana – including all derivative products – as a Schedule One controlled substance. This makes it illegal in the eyes of the federal government,” the department’s VA and Medical Marijuana webpage was updated to read this week. “The U.S. Department of Veterans Affairs is required to follow all federal laws including those regarding marijuana. As long as the Food and Drug Administration classifies marijuana as Schedule One VA health care providers may not recommend it or assist Veterans to obtain it.”
That’s not true, at least inasmuch as there is no overarching federal law that prevents V.A. from allowing its doctors to recommend medical cannabis, even though the drug is still considered illegal under federal law.
A leading Congressional champion of veterans’ medical cannabis access told Marijuana Moment that he’s concerned about the new VA website edit.
“This new language is very disturbing, but sadly, comes to no surprise. For years, the VA has been throwing up serious barriers to veterans’ safe access to cannabis,” Congressman Earl Blumenauer (D-OR) said in an emailed statement. “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 VA doctors who know them best.”
“VA clinicians may not recommend medical marijuana,” the newly update page says. The older version more correctly, though somewhat misleadingly, said, “VA clinicians may not prescribe medical marijuana.” [Italicized emphasis added.]
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. That category 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.
Even with marijuana’s Schedule I status, there is nothing in federal law that prevents V.A. from allowing its doctors to fill out medical cannabis recommendation forms in states where it is legal.
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.
VA SECRETARY MISSTATES FEDERAL LAW
Shulkin has on a number of occasions indicated that he does see medical potential for marijuana but has consistently falsely claimed that Congressional action is needed before he can do anything to increase veterans’ access. And he has often used the term “prescribe” — intentionally or not — as something of a distraction from the real issue of recommendations. But the new VA website update addresses recommendations, albeit incorrectly.
During a White House briefing earlier this year, Shulkin 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.”
Shulkin, who previously served in the Obama administration as V.A.’s undersecretary of health, wrote in a letter last year that he “wholeheartedly agree[s] that VA should do all it can to foster open communication between Veterans and their VA providers, including discussion about participation in state marijuana programs.” He went so far as to say that he “recognize[s] that the disparity between Federal and state laws regarding the use of marijuana creates considerable uncertainty for patients, providers, and Federal, state, and local law enforcement personnel.”
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.
In July, Shulkin announced that a new directive is in the final stages of internal review. While he didn’t reveal what it will say, he wrote in a letter to a U.S. House member that it would “maintain the same policy” as the earlier directive.
A bipartisan group of members of the House and Senate has tried over the years to pass legislation forcing the VA’s hand on medical cannabis, but has been consistently blocked by Congressional leadership.
Most recently, Republican-controlled House Rules Committee blocked an amendment on the issue from even being considered on the floor this summer. But a rider preventing VA from spending money to enforce its existing internal ban is in the Senate version of 2018 spending legislation, and so the issue will be decided by a conference committee that later merges both chambers’ bills into a single proposal.
Last year, however, both the House and Senate approved different version of the medical cannabis language but the conference committee removed both of them from the final bill.
VETERANS ADVOCATES PUSH FOR CHANGE
The American Legion, which represents more than 2.4 million military veterans, has been pressuring the federal government to evolve on medical cannabis. Most recently, in August, it adopted a resolution calling on VA to let its doctors write medical marijuana recommendations.
“More than half the states in the union have passed medical marijuana laws to date,” the group’s resolution reads. “The American Legion urge the United States government to permit VA medical providers to be able to discuss with veterans the use of marijuana for medical purposes and recommend it in those states where medical marijuana laws exist.”
The Legion and other medical cannabis advocates have also called for rescheduling and pressed VA to stop blocking 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 VA hospital.
“This study needs 50 more participants and the Phoenix VA 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 Legion wrote to Shulkin last month. “Your immediate attention in this important matter is greatly appreciated. We ask for your direct involvement to ensure this critical research is fully enabled.”
MORE VA WEBSITE CHANGES
Other new changes to the V.A. webpage include the removal of bullet points that read, “VA doctors and clinical teams may advise Veterans who use marijuana of the drug’s impact on other aspects of the Veterans’ care such as pain management, PTSD or substance use disorder treatment” and “VA doctors and clinical staff will record marijuana use in the Veterans VA medical record along with its impact on the Veterans treatment plan.”
In their place, the page now says, “VA health care providers will record marijuana use in the Veterans VA medical record in order to have the information available in treatment planning. As with all clinical information, this is part of the confidential medical record and protected under patient privacy and confidentiality laws and regulations.”
An existing point reading, “The use or possession of marijuana is prohibited at all VA medical centers, locations and grounds,” was followed up with a new clarification that says, “When you are on VA grounds it is federal law that is in force, not the laws of the state.”
The department does make it clear that “veteran participation in State medical marijuana program does not affect eligibility for VA care and services.” That longstanding policy means that patients won’t lose access to their government-provided healthcare just because they use medical cannabis.
But, until Shulkin acts to change the internal prohibition or Congress steps in and forces his hand, the VA isn’t going to do anything to help veterans get medical cannabis.
Photo courtesy of U.S. Air Forces Special Operations Command.
AOC Calls For Decriminalizing The Use Of All Drugs
Rep. Alexandria Ocasio-Cortez (D-NY) voiced support for decriminalizing the use of all drugs on Sunday.
The freshman congresswoman tweeted that drug decriminalization, as well as marijuana legalization, are “matters of public health.”
Marijuana should be legalized, and drug consumption should be decriminalized.
These are matters of public health.
— Alexandria Ocasio-Cortez (@AOC) November 18, 2019
This marks a development in Ocasio-Cortez’s drug policy platform. Previously, she called for decriminalizing the use and research of psychedelics, emphasizing the therapeutic potential of the substances.
To that end, she introduced an amendment to a spending bill in June that would remove a rider that advocates argue has inhibited research into the potential therapeutic benefits of Schedule I drugs such as psilocybin and LSD. The House rejected that measure in a floor vote, however.
There’s a growing push to decriminalize the personal possession of drugs beyond cannabis. South Bend, Indiana Mayor Pete Buttigieg and Rep. Tulsi Gabbard (D-HI), both Democratic presidential candidates, are in favor of the policy. Entrepreneur Andrew Yang supports decriminalizing opioids as a means to combat the drug overdose crisis.
Ocasio-Cortez recently gave her endorsement to Sen. Bernie Sanders (I-VT). But while the senator was the first major presidential candidate to back marijuana legalization during his 2016 run, he said this year he’s “not there yet” on broader drug decriminalization. It’s not clear if the congresswoman’s role as a surrogate on his campaign will ultimately influence him to adopt the policy.
But as more candidates debate the best way forward on various drug reform proposals, with cannabis legalization being a given for almost all contenders, former Vice President Joe Biden remains several paces behind. He opposes adult-use legalization and said on Saturday that marijuana may be a gateway to other, more dangerous substances.
Photo courtesy of C-SPAN.
Key Congressional Committee Officially Schedules Vote On Marijuana Legalization Bill
A key House committee has officially announced that a vote on a comprehensive marijuana legalization bill is scheduled for this week.
The House Judiciary Committee said on Monday that the panel will mark up legislation introduced by Chairman Jerrold Nadler (D-NY), which would federally deschedule cannabis and address social equity, on Wednesday at 10:00 AM ET. The announcement confirms what sources familiar with the planned development told Marijuana Moment last week.
Nadler’s Marijuana Opportunity Reinvestment and Expungement (MORE) Act has been lauded by advocates for its emphasis on restorative justice for communities most impacted by the drug war.
It calls for a five percent federal tax on marijuana sales, and that revenue would be used to fund programs such as job training, legal aid for those affected by prohibition and small business loans for individuals who are socially and economically disadvantaged. The bill also seeks to lift barriers to licensing and employment in the industry.
Additionally, the legislation would expunge the records of those with prior cannabis convictions, provide for resentencing, block federal agencies from denying public benefits or security clearances as a result of marijuana use and protect immigrants from being denied citizenship over cannabis.
Committee on the Judiciary – DemocratsH.R. 5038, the “Farm Workforce Modernization Act of 2019”; H.R. 3884, the “Marijuana Opportunity Reinvestment and Expungement Act of 2019” or the “MORE Act of 2019”; H.R. ___, the “Satellite Television Community Prot… https://t.co/v4pSa4OVgR
— House Committee Press Releases (@PressreleaseB) November 18, 2019
“A supermajority of Americans, including majorities of Democrats, Republicans, and independents, support regulating the use of marijuana by responsible adults,” NORML Political Director Justin Strekal said in a press release. “Thanks to the leadership of the House Judiciary chairman, never in history have we been closer to ending the failed policy of marijuana criminalization and providing pathways to opportunity for our brothers and sisters who have suffered under its oppressive reign.”
“The MORE Act is the most comprehensive marijuana policy reform bill ever introduced in Congress and is backed by a broad coalition of civil rights, criminal justice, drug policy, and immigration groups. Those who oppose this legislation moving forward are defenders of a failed status-quo that ruins the lives of otherwise law-abiding adults on a daily basis, overwhelming enforced against the poor and communities of color.”
Text of an amendment in the nature of a substitute from Nadler that Judiciary members will take up was also released on Monday. It includes a new “findings” section that discusses racial disparities in marijuana enforcement, the growing state-level legalization movement and the challenges that individuals from disadvantaged communities face in participating in the market.
“The communities that have been most harmed by cannabis prohibition are benefiting the least from the legal marijuana marketplace,” one provision reads. “A legacy of racial and ethnic injustices, compounded by the disproportionate collateral consequences of 80 years of cannabis prohibition enforcement, now limits participation in the industry.
Much of the language of the new section is borrowed from a resolution that Rep. Barbara Lee (D-CA), co-chair of the Congressional Cannabis Caucus, introduced last year.
“The data speaks for itself—low-income communities and communities of color have disproportionately borne the brunt of the devastation brought on by marijuana prohibition,” Queen Adesuyi, policy manager of national affairs for the Drug Policy Alliance, said in a press release. “The MORE Act is the most robust bipartisan legislation so far not only to end federal marijuana prohibition, but also to ensure that the communities that have been hardest hit by prohibition are not left behind.”
“It would be a tragic mistake to have the only marijuana reform bill that passes this Congress be one that solely benefits the industry, despite both the unprecedented support for legalization nationally amongst Americans and all the harm that we know federal prohibition has caused to individuals and communities across this country,” she said. “Fortunately, by ensuring the MORE Act moves forward, several leaders in the House are showing that they understand that this is a matter of fundamental justice that the US Congress needs to address.”
BIG NEWS: @HouseJudiciary will meet Wednesday to vote on the Marijuana Opportunity Reinvestment & Expungement Act.
Good. It's past time to address the decades of harm faced by communities of color & low-income communities due to failed marijuana policies. https://t.co/4glbu733Dq
— The Leadership Conference (@civilrightsorg) November 18, 2019
Advocates have been eagerly awaiting a committee vote on the MORE Act, especially since the House overwhelmingly passed a bill to protect banks that service the cannabis industry in September. Some groups, including the ACLU, had implored leadership to delay the banking vote until the chamber passed legislation like the MORE Act that addresses social equity.
Committee members on both sides of the aisle will be able to introduce amendments to the legislation, but it’s generally expected to advance out of the panel and onto the floor. That said, its fate in the Republican-controlled Senate is far from certain.
Read the full text of the new amendment to the MORE Act below:
Photo courtesy of Philip Steffan.
Biden Says Marijuana Might Be A Gateway Drug
Former Vice President Joe Biden (D) said on Saturday that he’s not sure if marijuana is a gateway drug that leads to the use of other, more dangerous substances.
“The truth of the matter is, there’s not nearly been enough evidence that has been acquired as to whether or not it is a gateway drug,” the 2020 presidential candidate claimed at a town hall meeting in Las Vegas. “It’s a debate, and I want a lot more before I legalize it nationally. I want to make sure we know a lot more about the science behind it.”
(Marijuana Moment’s editor provides some content to Forbes via a temporary exclusive publishing license arrangement.)