The U.S. Department of Veterans Affairs earlier this month issued a new directive for clinical programs that frees its doctors and pharmacists to discuss marijuana with military vets taking part in state-approved medical marijuana programs.
The directive, dated Dec. 8 and first reported by Forbes, changes policy to support “the Veteran – (health) provider relationship when discussing the use of marijuana and its impact on health, including Veteran-specific treatment plans.”
Doctors and pharmacists may discuss marijuana use with vets requesting information, according to the directive. Those clinical staff need to make decisions on a case-by-case basis when it comes to modifying any treatment plans based on the patient’s marijuana use, it says. As such decisions should be made “in partnership with the Veteran and must be based on concerns regarding Veteran health and safety.”
Two organizations that have demanded increased access to and research of medical marijuana for military veterans had mixed reaction to the VA’s move.
The American Legion, the nation’s largest veterans’ organization, which has been increasingly outspoken in support of medical marijuana research, applauded the new directive.
In a statement sent to The Cannabist, Legion National Commander Denise Rohan said the document helps to clarify access to VA clinical programs for vets taking part in state-approved medical cannabis programs.
“This updated policy will help encourage veterans using medical cannabis to more openly and fully discuss their healthcare options with VA medical providers with full reassurance that their VA benefits remain secure,” she said.
Leaders at Weed For Warriors Project, an organization that educates veterans on the benefits of medical marijuana while providing free cannabis to vets, were unconvinced.
While the group’s president Sean Kiernan welcomed the VA allowing their doctors their First Amendment rights, he questioned what the government might do with information on patients’ marijuana use.
According to the directive, when vets report marijuana use that information is to be entered into the “non-VA/herbal/Over the Counter medication section” of that patients electric medical record. It goes on to state: “Veterans must not be denied VHA services solely because they are participating in State-approved marijuana programs.”
“There are real ramifications to being classified as a cannabis user at the VA,” Kiernan said in an email to The Cannabist. “Your available medical options are curtailed once you are identified as someone with a substance abuse disorder, which is what you are classified as if you use cannabis. It’s not just pain meds that are cut off; it’s any medicine that has addiction issues.”
Kiernan is worried, for example, that a vet with attention deficit disorder who acknowledges using cannabis would be “out of luck, as the medicines used to treat ADD are addictive and that means the VA won’t prescribe them to a cannabis user.”
For The American Legion, the VA’s directive represents an “encouraging step in the right direction” for the groups continuing campaign for “evidence-based, complementary and alternative medicine,” Rohan said.
The Legion has been a vocal advocate for rescheduling marijuana under the Controlled Substances Act to permit research into its medical efficacy for treating vets suffering from chronic pain, post-traumatic stress disorder (PTSD) and other ailments affecting veterans. The group has also called on the VA to clear roadblocks that threaten the completion of a groundbreaking clinical study on the use of medical marijuana to treat PTSD in veterans.
In November, the Legion released a survey that found that 81 percent of veterans and 83 percent of caregivers support the federal legalization of cannabis to treat a physical or mental condition.
More on Schedule I
The new VA directive doesn’t budge on major sticking points in the medical marijuana debate, leaving Weed for Warriors’ Kiernan unimpressed.
For instance, the directive states that to comply with the CSA, which lists marijuana as a schedule I substance with no medical benefits, VA clinicians are prohibited from completing forms or registering veterans for participation in state-approved marijuana programs. The VA will also not provide or pay for medical marijuana for its patients, it says.
“They want us to believe these changes mean progress when all they are is an illusion of change, to pacify the screams for freedom those in charge don’t want us to have,” Kiernan said. “That is the liberty of free-choice; to have control over what we put into our body for medicine.”
Read the U.S. Department of Veterans Affairs, Veterans Health Administration Directive 1315