Can Veterans Affairs chief be voice of reason on medical marijuana in Trump administration?

"I am focused on the health of our veterans," said Veterans Affairs Secretary David Shulkin

WASHINGTON – After Veterans Affairs Secretary David Shulkin delivered his “State of VA” speech, his problem-plagued department was, unexpectedly, connected to two highly contentious political issues – climate change and medical marijuana.

Shulkin didn’t mention either controversy during his prepared remarks, delivered in the White House briefing room Wednesday for increased exposure, but they were raised in back-to-back questions from reporters. Each is a delicate issue for the physician Shulkin. He’s a scientist devoted to improved care for veterans and a top official in a Trump administration that denounces enlightened views on marijuana and the changing climate.

It’s a tough spot, but one where he could be a needed voice for reason.

He cautiously signaled a willingness to advance medical marijuana for veterans, while making it clear that he wants no part of the climate change debate.

“There may be some evidence that this is beginning to be helpful,” Shulkin said about medical cannabis. “And we’re interested in looking at that and learning from that. But until time that federal law changes, we are not able to be able to prescribe, you know, medical marijuana for conditions that – may be helpful.”

Following his frank depiction of VA’s problems, a reporter asked whether “in the spirit of the candid assessment” Shulkin considers climate change a threat to his department’s mission.

This was the day before President Donald Trump exploded the climate change debate by making the United States an international outcast when he withdrew from the Paris climate agreement.

Shulkin dodged, saying he is “focused on those environmental issues that impact veterans . . . beyond that, it really is beyond my scope as secretary.”

Was he “repudiating the multiple reports that have come out of your department that say climate change” is a real issue for vets?” the reporter asked. “That’s not something that you’re even considering at this point?”

Shulkin replied: “Look, I am focused on the health of our veterans. And clearly, there – there’s – there’s a relationship between health and the environment. What I’m not focused on is the bigger political issues about United States policy on – on other types of reform. I’m focused on the health of veterans.”

But, of course, climate change is related to veterans’ health, as reports from his department have said.

“Climate change could have widespread effects on Veterans’ health, including long-lasting chronic effects,” the department declared in a 2014 VA Climate Change Adaptation Plan.

Although candidate Trump called climate change a hoax, the plan said that “Climate change is driving widespread changes to both natural and human systems . . . VA expects to be affected by these changes in a variety of ways,” including infrastructure damage and burdens on its health-care delivery systems.

Getting specific, the Veterans Health Library warns itchy vets suffering from psoriasis that climate change “may cause flare-ups.”

On the marijuana front, the American Legion, the largest veterans’ organization, is pressuring the Trump administration to make cannabis available for medical research.

An article posted by the Legion on Defense One, just days before Shulkin’s speech, carried the headline “What Wounded Veterans Need: Medical Marijuana.”

“Many Afghanistan and Iraq veterans have contacted the American Legion to relay their personal stories about the efficacy of cannabis in significantly improving their quality of life by enabling sleep, decreasing the prevalence of night terrors, mitigating hyper-alertness, reducing chronic pain, and more,” wrote Joe Plenzler and Lou Celli, two Legion officials. It also could help fight opioid abuse, they added.

They cited a finding by the congressionally mandated National Academies of Sciences, Engineering and Medicine that there is “conclusive or substantial evidence that cannabis or cannabinoids are effective for the treatment of chronic pain,” chemotherapy-induced nausea and vomiting, and multiple sclerosis spasms.

Medical marijuana could help “post-traumatic stress disorder, or PTSD, and traumatic brain injury, or TBI, as the ‘signature’ wounds” of the wars in Afghanistan and Iraq, and the “leading causes of death and disability within the veteran community,” Plenzler and Celli said.

In a letter sent Friday to Shulkin, Rep. J. Luis Correa, D-Calif., a member of the House Veterans’ Affairs Committee, said retired service members have “brought to my attention that veterans are denied treatment at VA facilities if they test positive for medical marijuana in states where it is legal and they have a doctor’s prescription. These veterans are not asking the VA for medical marijuana but just for medical services.”

VA’s response: “Veterans will not be denied care for all appropriate conditions including medical, behavioral and substance abuse conditions. Veterans who are participating in state medical marijuana programs can continue getting the treatment based on the medically approved protocols as prescribed by the approved physicians in the respective states. Veterans can concurrently get care at the VA.”

It’s good that Correa’s information was wrong. That leaves, however, this defining inquiry from the American Legion on medical cannabis.

“The only question is will this administration lead? Our veterans suffering from PTSD and TBI lives depend on it.”

This is not a question Shulkin alone can answer. But for the benefit of veterans, it is one he can be a leading voice on within the Trump administration – if he chooses to.