Biden Administration Sends Mixed Messages on Marijuana Through VA

The U.S. Department of Veterans Affairs (VA) recently issued a new directive maintaining that VA doctors cannot prescribe medical cannabis to their patients. The updated guideline follows a prior 2017 version, which had allowed VA doctors to discuss marijuana usage with veteran patients, despite prohibiting VA doctors from prescribing or recommending marijuana.

Under the newest guidelines, VA doctors can talk about cannabis use with veterans and document these discussions in patients’ electronic medical records. And importantly, the directive says veterans cannot be denied access to VA healthcare services just because they partake in state-sanctioned marijuana programs or admit to personal marijuana use.

The directive also acknowledges the recently-modified federal classification of marijuana, which distinguishes it from hemp. Under this new classification, cannabis with THC content up to 0.3 percent is no longer considered marijuana at the federal level, in line with the 2018 Farm Bill’s hemp legalization.

Legislative Progress on Veteran Access to Medical Marijuana

As the VA continues forbidding its doctors from recommending or involving themselves in state-approved marijuana programs for veterans, some legislative efforts are making headway. The House recently green-lit a bipartisan reform amendment as part of a spending bill. The amendment would permit VA doctors to advise military veterans on medical cannabis. The Senate Appropriations Committee has already endorsed a similar version of this amendment.

Rep. Brian Mast (R-FL), a key supporter of the House amendment, remarked that the recent VA directive only underscores the urgent need for this change. He stated that the VA’s bureaucratic approach not only sows confusion among providers but also deprives veterans of an evidence-based care alternative. Given that both the House and Senate versions of the legislation contain comparable provisions, proponents are optimistic about the amendment’s potential to challenge and change the current, antiquated rule.

This amendment was introduced jointly by Mast and Reps. Earl Blumenauer (D-OR), Dave Joyce (R-OH), and Barbara Lee (D-CA), all of whom are the collective leaders of the Congressional Cannabis Caucus. Blumenauer pointed out that a fractured Congress has taken steps forward concerning medical cannabis for veterans and suggested it’s time for the Biden administration to do the same.

Understanding Marijuana Policies for VA Patients

Here’s what veterans and VA patients should know about the VA’s policies concerning marijuana use:

• VA benefits will remain intact for veterans, regardless of marijuana usage.
• The VA urges veterans to have open discussions about personal marijuana consumption with their VA doctors.
• The VA will document veterans’ discussions with their VA providers about cannabis use in their VA medical files for care planning purposes. Like all clinical data the VA collects, this information is confidential under patient privacy rules.
• VA medical practitioners are not permitted to endorse medical marijuana.
• VA providers can only recommend and prescribe drugs with U.S. Food and Drug Administration (FDA) approval. Currently, most items with THC, CBD, or other cannabinoids don’t have this FDA nod, meaning VA doctors cannot recommend or prescribe them.
• Veterans who want to take part in state-sanctioned marijuana initiatives cannot get help from VA clinicians in completing necessary applications or other paperwork.
• Prescriptions for medical marijuana cannot be processed at VA pharmacies.
• The VA cannot cover the costs associated with any medical cannabis prescriptions.
• With the proper approvals, VA researchers can study the potential advantages, disadvantages, and abuse risks of marijuana use.
• All VA healthcare facilities, sites, and premises strictly forbid using or possessing marijuana on-site. VA grounds are federal property, so federal laws apply rather than state laws.
• Veteran VA employees are still subject to drug screenings as a condition of employment.

The Biden Administration’s Mixed Messaging on Cannabis Policies for Veterans

So far, the Biden administration has failed to live up to widespread expectations that its VA would modernize cannabis policies for veterans. The department remains resistant to congressional efforts urging VA doctors to recommend medical cannabis. It has also hesitated to launch clinical trials investigating the potential benefits of cannabis for common veteran health issues. This reluctance is evident in the department’s recent guidance to VA doctors, which advises against using cannabis as a treatment option for post-traumatic stress disorder (PTSD).

On a similar front, several Democratic senators have recently aimed to further marijuana reform in their own ways. Some introduced amendments to the chamber’s National Defense Authorization Act (NDAA). One such amendment, which was accepted, would prohibit intelligence agencies like the CIA from rejecting security clearance applicants based solely on prior cannabis use. Sen. Brian Schatz (D-HI) also presented a proposal advocating for veterans’ rights to use medical cannabis in areas where it’s legalized.

A recent poll targeting veterans who consume cannabis yielded encouraging results that could aid future reform efforts. Specifically, many respondents noted an enhanced quality of life and a decline in the use of specific prescription medications, including opioids, following marijuana use.

Delay and Discontent: The Debate over Descheduling Marijuana

During a recent House Judiciary hearing, DEA Administrator Anne Milgram faced questioning by Rep. Matt Gaetz (R-Fla.) and Rep. Steve Cohen (D-Tenn.). These lawmakers were concerned about the Biden administration’s timetable for removing marijuana from the Schedule 1 list of drugs. This category includes substances considered the world’s most dangerous, such as heroin and other opioids, and denotes a lack of accepted medical use and a high potential for abuse.

Milgram informed the committee that the administration hadn’t given the DEA a specific timeline for reviewing and reassessing marijuana’s current scheduling. President Biden previously issued a statement in October 2022, urging the Department of Health and Human Services (HHS) and the attorney general to reconsider federal marijuana scheduling. According to Milgram, the DEA must await HHS’s review and recommendations before conducting its own evaluation and making a final scheduling decision.

Gaetz and Cohen both expressed frustration at the absence of a clear timeline, criticizing the federal conversation on marijuana as “gibberish” and accusing the government of repeated fumbles. The bipartisan agreement on this matter underscores the growing pressure on the DEA and the administration to reconsider marijuana’s classification swiftly. Both representatives conveyed a sense of urgency and disappointment over the delay, reflecting a broader shift in the national conversation around cannabis policy and reform.

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