As more states consider legalizing the use of medical marijuana, a growing number of voices among the veteran community are urging the Department of Veterans Affairs to reconsider VA policy on medical cannabis.
In 2018, former Representatives Phil Roe (R) of Tennessee and Tim Walz (D) of Minnesota introduced House Resolution 5520, The VA Medicinal Cannabis Research Act of 2018, which proposed to authorize the Department of Veterans Affairs to conduct medical marijuana research.
Specifically, Congress.gov says the bill, “authorizes the Department of Veterans Affairs (VA) to conduct and support research on the efficacy and safety of certain forms of cannabis and cannabis delivery for veterans enrolled in the VA health care system diagnosed with conditions such as chronic pain or post-traumatic stress disorder.”
H.R. 5520 died in Congress, but the fact that a bipartisan effort to create this policy happened at all may be an indicator that Americans are ready to discuss an end to the prohibition of cannabis. At a minimum, it suggests that it’s time to approve marijuana and hemp plant derivatives such as cannabidiol (aka CBD) for use as medicine.
Another measure, known as the Marijuana Opportunity Reinvestment and Expungement Act (MORE) passed the House in December 2020. .
The bill did not pass the Senate, but, its significance shouldn’t be underestimated. The MORE Act does many things at once, including removing cannabis from the Controlled Substance Act as a Schedule 1 Controlled Substances rosters as a federally regulated substance.
“Schedule 1” means the substance listed is thought by the government to have no medical value, coupled with a high potential for misuse. The MORE Act has other effects on American law and adds a taxation element. MORE prevents denial of public benefits to those who use cannabis, including to those who live in public housing. It also prevents discrimination (for cannabis use) against those who apply for citizenship or other immigration statues. MORE also seeks to establish a $5 tax to provide money for community reinvestment.
Official Defense Department Policy on Marijuana
VA policy on the use of cannabis by the veteran population is not connected with the official Department of Defense policies.
The DoD maintains its marijuana prohibition on currently serving military members, and military recruiters are required to use discretion when interviewing potential new recruits about possible drug use prior to military service.
At one time, the recreational use of marijuana or its derivatives could be grounds to reject a new recruit. However, at the time of this writing, recruiters do not have to bar the enlistment of those with minor pot experimentation. Instead, the recruiter may, at their discretion, apply for a waiver for such recruits.
All new recruits are advised that there is zero tolerance for any illegal substance abuse issues in the military. Those who test positive for illegal drugs or illegally used prescription drugs are subject to punishment and possible discharge from the military.
Department of Veterans Affairs Policy pn Medical Marijuana
The issues facing veterans who use pot while seeking treatment from the VA are more complex.
Those who use marijuana to relieve symptoms of post-traumatic stress disorder or other service-connected medical issues may be afraid to discuss this with a VA care provider out of fear that it may jeopardize their VA benefits.
What is the reality? The VA official site states that any illegal substance on the federal level is NOT permitted to be used, recommended, prescribed, or endorsed by the Department of Veterans Affairs, up to and including the recommendation that veterans use pot to alleviate symptoms or pain. However, the site also recommends veterans disclose their marijuana use to their provider, knowing that information will remain private and will not put their benefits in jeopardy.
Should the MORE Act, or something like it, pass into law, that situation would change, theoretically opening a greater conversation about, and potential recommendations for, medical cannabis by Department of Veterans Affairs medical providers.
But can the VA simply begin recommending pot to VA patients if MORE becomes law?
Likely not overnight. The VA may be directed by a Senate version of the bill to take steps in a prescribed fashion. It would not be surprising to learn that the final version of the bill includes a phased introduction to medical cannabis for VA patients.
Military members should not assume that passage of any marijuana legalization or decriminalization at the federal level gives them permission to use cannabis products. In the same way military leadership has the power to ban non-controlled substances such as Spice, salvia divinorum, bath salts and others through an off-limits order, cannabis may also be subject to such treatment, even if it is legal.
Under the policies active at the time of this writing, any substance listed by the U.S. Food and Drug Administration as a Schedule One controlled substance is subject to the same prohibition at the VA level.
Veterans Will Not Lose VA Benefits for Discussing Medical Marijuana With VA Care Providers
The VA official site makes it clear that veterans who use cannabis are not in danger of losing VA benefits:
Veteran participation in state marijuana programs does not affect eligibility for VA care and services. VA providers can and do discuss marijuana use with Veterans as part of comprehensive care planning, and adjust treatment plans as necessary.
It is safe for veterans to discuss marijuana use with VA staff. Veterans do not need to be concerned with or anticipate punitive measures as a result of informing VA staff of pot use. It is very important to note that this applies to retired or separated military members only.
Currently serving troops, including members of the Guard/Reserve are still subject to DoD policy on drug use, not VA policy.
Why is this policy important? VA caregivers need to make decisions about a veteran’s continued health care in an informed way, including the patient’s lifestyle choices and possible drug interactions with alcohol, cannabis or other substances.
A doctor who knows the veteran’s marijuana use may or may not advise an adjusted course of treatment depending on circumstances.
Specific VA Policy Regarding the Discussion of Medical Marijuana Use With Patients
The VA official site has a list of rules, information and reassurances for veterans concerned about being forthright about their medical pot use with a VA caregiver. Specifically:
- Veterans will not be denied VA benefits because of marijuana use.
- Veterans are encouraged to discuss marijuana use with their VA providers.
- VA health care providers will record marijuana use in the veteran’s 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.
- VA clinicians may not recommend medical marijuana.
- VA clinicians may not prescribe products containing tetrahydrocannabinol (THC), cannabidiol (CBD) or any other cannabinoids.
- VA clinicians may not complete paperwork/forms required for veteran patients to participate in state-approved marijuana programs.
VA Medical Marijuana Policies for State-Level MMJ Card/Medical Cannabis Card Approval
In states where medical marijuana is approved, some kind of screening process is usually required in order to allow patients to legally buy pot from a state-licensed medical marijuana dispensary. In Illinois, for example, the applicant must be screened for any one of a list of symptoms, including certain types of chronic pain, PTSD and debilitating conditions such as fibromyalgia.
Illinois requires the applicant to have a physician’s approval for marijuana, and many veterans would naturally turn to their VA caregivers for this certification. However, VA policy does not permit VA doctors or care providers to participate in this process in any way, including helping with the paperwork required by the state for medical cannabis (MMJ) cards. VA patients would need to use a non-VA facility to be certified by a clinician.
VA Policy on Medical Marijuana Prescriptions
The term “prescription” is used loosely here. Many states do not require a prescription for medical cannabis per se, and patients who use legal medical pot are often “authorized” to possess cannabis instead. In any case, the Department of Veterans Affairs does not permit VA clinics or staff to prescribe or fill prescriptions for medical marijuana.
The VA will not pay for such prescriptions, regardless of the source and VA rules forbid the use or possession of pot on any VA facility.
VA Employment Policies for Veterans Who Use Medical Marijuana
The Department of Veterans Affairs, like all federal agencies, observes the Food and Drug Administration’s prohibition on marijuana, as it is understood at the time of this writing.
Because marijuana is still classified as a Schedule One controlled substance, veterans who use medical marijuana would technically be ineligible for VA employment or would be rendered ineligible should they fail to pass a drug test issued as a condition of employment or as a condition of continued employment.
This may be true of both marijuana and marijuana derivatives such as cannabidiol, which are themselves not illegal but may cause a positive result for marijuana on a drug test.
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