What is the VA’s Position of Medical Marijuana?
Because the VA is a federal agency it adheres to marijuana’s complete illegality as a Schedule 1 controlled substance. The VA position on medical marijuana is documented in VHA Directive 1315. Although VHA Directive 1315 states that veterans must not be denied VA benefits solely due to participation in a state medical marijuana program, marijuana use must be entered into the patient’s electronic medical records. The VA cannot recommend or prescribe medical marijuana under any circumstances.
The VA estimates roughly 15% of Vietnam veterans currently suffer from PTSD, but as many as 30% have experienced PTSD at some point in their lives. About 12% of Desert Storm veterans experience PTSD, and between 11% to 20% of War on Terror (Operation Iraqi Freedom and Operation Enduring Freedom) veterans suffer from the disorder.[iv] By comparison, only about 3.5% of the general adult population suffers from PTSD. Combat stress is a common cause of PTSD, although some veterans suffer as the result of sexual assault while serving in uniform. Sexual assault in the military occurs at a higher rate than the general population.
PTSD was formerly known as “shell shock” or “combat fatigue” during the mid-twentieth century. Many patients with PTSD report having flashbacks or intrusive thoughts which result in involuntarily re-living past traumatic events. Other symptoms include; avoiding reminders, negative thoughts or feelings, and arousal and reactive symptoms.[v] The most common treatments for PTSD are cognitive behavioral therapy or selective serotonin uptake inhibitors (SSRIs) including Paxil, Zoloft, and Prozac.[vi] SSRIs have side effects including insomnia, drowsiness, nausea, dizziness, nervousness, agitation, dry mouth, headache, blurred vision, and sexual problems.[vii]
Veterans suffer from mental illness and suicide at a rate 22% greater than the general population. On average 20 veterans commit suicide every day and 6 of these will have recently used VHA services.
The Opiod Epidemic
The opiod epidemic has affected millions and is still lacking a clear solution. One tool in the fight against opioid addiction is medical marijuana, which has been shown to be effective in reducing opioid use and side effects.
Are there efforts underway to legalize medical cannabis for veterans within VA?
Veterans are increasingly underrepresented in the legislative decision-making progress. The percentage of veterans serving in Congress declined from 81% in 1975 down to approximately 20% today. Still, some efforts to support veterans are moving forward.
VA scientists are able to conduct research on marijuana benefits and risks, and potential for abuse, under regulatory approval. Any questions related to research can be addressed to VHABLRD-CSRD@va.gov.
H.R. 5520, the VA Medicinal Cannabis Research Act of 2018, would promote scientific and medical research into the safety and efficacy of medicinal cannabis usage for veterans diagnosed with PTSD, TBIs, chronic pain and other illnesses and injuries by clarifying that research into medicinal cannabis is well within the authority of the VA.
Additionally, S. 3409, the Veterans Medical Marijuana Safe Harbor Act would empower VA physicians to issue medical cannabis recommendations in accordance with the laws of states where it’s legal. This legislation would also require VA to conduct studies on “the effects of medical marijuana on veterans in pain” and “the relationship between treatment programs involving medical marijuana that are approved by States, the access of veterans to such programs, and a reduction in opioid abuse among veterans.”
Can veterans get medical marijuana through the VA?
While the VA cannot deny veterans access to health care or compensation benefits due to medical marijuana use, its providers are prohibited, by law, to recommend or prescribe cannabis as the Food and Drug Administration (FDA) still classifies it as Schedule 1 drug. VA providers may only prescribe medications approved by the FDA.
VA policy indicates participation in state marijuana programs does not affect eligibility for VA care and services, and VA providers are able to discuss cannabis use with veteran patients and adjust care and treatment plans as needed. Veterans are encouraged to discuss medical marijuana use with their VA providers as part of their confidential medical record.
The VA will not pay for medical marijuana prescriptions from any source, nor will VA providers complete paperwork or forms required for a veteran to participate in a state-approved marijuana program.
Additionally, the use or possession of marijuana is prohibited at all VA medical centers, locations and grounds—even in states in which marijuana use is legal.
However, anecdotal feedback from veterans shows that VA’s directives and actual patient experiences sometimes differ in cases where a prescribed medical marijuana user walks into a federal (VA) facility.
What resources are available to learn more?