Medical Cannabis for Troubled Veterans? A Congressional Subcommittee Takes Up the Complicated Topic

A Veterans’ Affairs subcommittee discussed three cannabis-related bills as part of a range of efforts to prevent service members from committing suicide, and to treat a number of mental and physical conditions.

May 1, 2019 6:55AM EDT Congress

Jeremy Borden @Jeremy_Borden

Jeremy Borden has worked for the Washington Post, Christian Science Monitor and City Bureau, among other publications.

Around 7,000 military veterans commit suicide each year. Should cannabis be studied and allowed to play a role in combatting the mental and physical health crisis that is plaguing service members who return from war zones and contributing to these devastating suicide rates? That was the argument, at least, that pro-cannabis reform lawmakers made Tuesday during the US House’s second public hearing this year on cannabis-related issues.

The hearing, however, also demonstrated the complications of the issue. For one thing, it revealed a divide about whether a trio of cannabis reform bills being considered by the House Committee on Veterans’ Affairs Health Subcommittee would be effective given that cannabis remains illegal under federal law. Further, Trump Administration officials with the Department of Veterans Affairs voiced their opposition to the efforts, largely because cannabis remains a Schedule I drug under the Controlled Substances Act.

While the hearing focused on a number of efforts related to preventing suicide among veterans returning from combat, lawmakers discussed three cannabis-related bills:

HR 1647, the Veterans Equal Access Act, sponsored by Representative Earl Blumenauer, an Oregon Democrat. The measure would allow VA doctors to recommend cannabis to their patients in states where it is legal without fear of prosecution;
HR 712, the VA Medicinal Cannabis Research Act of 2019, sponsored by Luis Correa, a California Democrat. The bill would task the VA with conducting advanced trials on cannabis’ effectiveness for a range of conditions;
HR 2191, the Veterans Cannabis Use for Safe Healing Act, sponsored by Representative Gregory Steube, a Florida Republican. The measure would not allow Veterans Affairs to strip service members of Department benefits if they are found to use cannabis, even though that is already VA policy.

The state-federal conflict over cannabis poses significant issues for the VA, officials at the hearing said. While research into cannabis and whether it can help medical conditions is not prohibited, it is often difficult. VA officials said there must be smaller studies to measure the medicinal benefits of cannabis before the VA can support Correa’s Research Act, which envisions a wide range of studies to assess cannabis’ effect on myriad conditions.

“You’ve got to start small and grow evidence over time,” Tracy Gaudet, the VA’s Office of Patient Centered Care director, told lawmakers.

Representative Neal Dunn, a Florida Republican and physician, said Congress should focus on changing the status of the drug and moving it out of Schedule I, the most restrictive category, which has not changed even as dozens of states have legalized cannabis for medical use. Two Veterans Affairs health officials, Gaudet and Larry Mole, who monitors health trends among the veteran population, to direct VA efforts that uses data that determines how best to treat service members under the VA’s care, told the subcommittee that the Department’s physicians could be prosecuted under federal law for recommending cannabis—even in states where cannabis is legal. “As long as cannabis or marijuana remains a Schedule 1 drug then we are going to look to the DEA and Department of Justice about what our prescribers are able to do,” he said.

Dunn said later in the hearing: “We need to get this drug into a Schedule II status—it makes everything so much easier.”

Meanwhile, the military rank and file may be making some decisions on its own. Cannabis for medical use is popular among military veterans. In a 2017 American Legion survey, 83 percent said medical cannabis should be legalized nationwide.

VA officials, meanwhile, argued that the Department does support research into the medical benefits of cannabis and CBD oil, and is not prohibited from conducting research trials.

Surprisingly, the Veterans of Foreign Wars, a long-standing veteran support organization, said it does not support Blumenauer’s Equal Access bill, a measure that would allow doctors to recommend cannabis in legal states. Blumenauer’s proposal was the most aggressive reform of the three proposals the subcommittee considered.

Carlos Fuentes, director of the VFW’s national legislative service, said the group can’t support VA doctors recommending cannabis when insufficient research exists for physicians to make responsible recommendations.

VFW’s Fuentes told lawmakers that veterans have benefited from cannabis—even if they have hid it from their VA doctor or avoided the Department’s clinics for fear of losing benefits.

Before doctors can consider cannabis as a replacement, VA doctors need clear guidelines about what to recommend, Fuentes said. Further, even if VA doctors recommended cannabis, veterans put into state-legal medical cannabis programs would have to go outside the VA system and would have to pay the full cost of cannabis, he said.

Still, VFW’s Fuentes told lawmakers that veterans have benefited from cannabis—even if they have hid it from their VA doctor or avoided the Department’s clinics for fear of losing benefits.

“Medicinal cannabis works,” he told lawmakers, even if research into its effects is not sophisticated enough for VA doctors to have clear guidelines recommending its use. “And it is a more suitable option than the drug cocktails VA prescribes.” In recent months, Fuentes said, the Department has made strides to cut opioid prescriptions by around 20%.

VA officials argued that HR 2191—protecting veterans from losing military benefits if they’re caught using cannabis—is not necessary. The Department’s policy is not to punish retired service members who mention cannabis use to their VA doctors or test positive for the drug.

However, Stephanie Mullen, research director of Iraq and Afghanistan Veterans of America, said the VA hasn’t always followed those guidelines. “In practice that doesn’t always occur,” she said. “Having legislation that would protect veterans would be helpful.”

The bill’s sponsor, Steube, the Florida Republican, said testing positive for cannabis is a big concern for veterans he encounters in his state, which legalized medical cannabis in 2017.

“It’s a big issue for Floridians,” Steube said. “Veterans are afraid to go to the VA because if they test positive for THC or marijuana, they’re afraid they’ll lose their benefits.”

There was broad agreement that medical cannabis could play a role in the mental health care of veterans—something Blumenauer said he has been fighting for for years.

“Veterans should not be forced outside the VA to seek a treatment that is legal in their state,” Blumenauer said.