Despite increasing legal access to medical and recreational cannabis across the U.S., veterans face unfair treatment and stigmatization. DAV supports researching medical marijuana for veterans' medical needs. More data is needed to assess medical marijuana's uses, including its benefits and harms.
VA sending mixed messages for vets about cannabis use to treat PTSD
Despite increasing legal access to medical and recreational cannabis in states across the U.S., veterans face unfair treatment and stigmatization because the U.S. refuses to recognize marijuana as a viable treatment option.
While the VA has embraced the federally illegal status of the drug, agency policy does not allow discrimination against veterans who acquire medical cards in states where it is allowed, although those who do get their MMJ cards do so with their own resources and at their own risk outside the purview of the Veterans Health Administration.
But that isn’t always the case, said Derek Debus, an Arizona attorney and Marine veteran who now specializes in military law and VA benefit issues. Debus said having rules in place doesn’t guarantee fair treatment for veterans who legally use cannabis.
“I’ve had clients in the past that, if they admit to medical marijuana usage, won’t get any medication at all through the VA,” Debus said. “I’ve had clients that have gone to the VA for acute injuries like kidney stones, or even a broken arm, who were denied pain medication because they tested positive for cannabis and or have a state medical marijuana card.”
According to Debus, the level of stigmatization often correlates with where a veteran might seek treatment, as some state VA’s are run by more progressive leaders than others.
“That prohibition (against denial of benefits) alone doesn’t tell the whole story when you have individual providers who have their own animus towards cannabis use,” he said. “So, even in states that are very permissive with medical marijuana, like Arizona, the fact that the VA won’t assist veterans in obtaining the necessary certification does harm veterans.”
Debus cites the cost of obtaining a medical marijuana card and the stigmatization of cannabis as impediments to veterans gaining access as a reason for the pushback by vets on the issue.
VA policy at odds with VA policy
A recent study published on the U.S. Department of Veterans Affairs website appears to counter the spirit of Directive 1315, VA policy that does not allow discrimination against medical marijuana users, and the issue remains murky for vets with certifications in states where it is legal.
The April 2021 report found “growing interest and concern” over increased usage among veterans, as more states legalize cannabis use. The study — and the VA — states that “research to date does not support cannabis as an effective PTSD treatment, and some studies suggest cannabis can be harmful, particularly when used for long periods of time.”
The issue is growing in the veterans community as more and more states liberalize cannabis laws, either for adult-use recreational purposes or for medical use. There are currently 36 states where medical marijuana is legal and 18 (plus the District of Columbia) that have legalized it for public consumption.
Cannabis is still listed as a Schedule I narcotic by the U.S. government though, meaning it has no “currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse.” Other drugs on that list include heroin, LSD, peyote, methaqualone and methylenedioxymethamphetamine (ecstasy, or MDMA).
Lack of evidence due to dearth of clinical studies
According to the VA, evidence of cannabis as an effective treatment of PTSD is primarily based on “anecdotal evidence from individuals with PTSD who report that cannabis helps with their symptoms or improves their overall life and functioning.”
Citing a lack of randomized controlled trials (RCT) on the drug’s efficacy to relieve the symptoms of PTSD, the report references the only RCT that has been completed on the plant released earlier this year that found “no significant difference in PTSD symptom reduction between placebo and any of the active cannabis preparations.”
The study that the VA cited was conducted in part by Dr. Sue Sisley of the Scottsdale Research Institute and the Multidisciplinary Association for Psychedelic Studies, a nonprofit research and educational organization focusing on psychedelics and marijuana as viable treatment options.
Sisley has spent more than a decade maneuvering the bifurcated system that allows legal use in many states but is heavily restricted by its federal status.
The results of the SRI trials, however, were likely affected by the poor-quality cannabis available for study. Until recently, cannabis researchers were required to only use plants grown at the University of Mississippi.
Often referred to as “lawnmower clippings,” cannabis mandated by the U.S. government through the National Institute on Drug Abuse has been described as sub-standard, usually containing stems and seeds and sometimes even mold. It is often stored in freezers for years at a time. And it has no more than 9% THC, the active compound in cannabis — far less than the 20% to 30% in the cannabis sold at medical and recreational dispensaries. Concentrates can contain even higher amounts of THC.
As a result, SRI/MAPS concluded there was no significant difference found within three groups that used varying levels of THC/CBD versus a group given a placebo.
I’ve had clients in the past that, if they admit to medical marijuana usage, won’t get any medication at all through the VA.
– Derek Debus, an Arizona attorney who specializes in military law and VA benefit issues
At the time, Sisley said it was sometimes difficult to get subjects to use the marijuana and much of it was returned unused.
But the tide is turning: In May, the Drug Enforcement Agency announced new regulations allowing the use of commercial-grade cannabis and began the process of certification for a number of growers in the U.S.
SRI recently entered into an agreement with MAPS to do a second FDA-approved clinical trial and has been awarded nearly $13 million in grant funding from the state of Michigan’s 2021 Veteran Marijuana Research Grant Program.
That program is designed to evaluate “the efficacy of marijuana in treating the medical conditions of U.S. armed services veterans and preventing veteran suicide.”
“Suicide among Veterans is an urgent public health crisis, but it’s solvable if we invest in researching new treatments for pain, depression, and PTSD,” Sisley stated in a press release announcing the partnership. “This grant enables more rigorous study, overseen by the FDA, which may lead to cannabis flower becoming prescribable medicine someday. Veterans are demanding objective cannabis drug development research, and the state of Michigan is fulfilling our collective obligation to our beloved Veteran community.”
The study will be the second clinical trial ever that compares the safety and efficacy of cannabis against placebo, and the first to use high-THC cannabis.
Setting up the study has highlighted the differences in VA administration across the country, as SRI and MAPS have enlisted VAs in Tampa, Florida and Ann Arbor, Michigan to identify 320 veterans to participate in the study.
Federal attempts to help veterans in the works.
As the momentum for legalization continues to gain strength on a state level, the U.S. House of Representatives and the Senate have proposed legislation to change marijuana’s legal status federally through bills such as the SAFE Banking Act and the Cannabis Administration and Opportunity Act that have both passed the House, but died in the Senate.
A recent bill proposed by Sen. Mark Schatz, D-Hawaii, the Veterans Medical Marijuana Safe Harbor Act, was introduced in April and would allow the VA to legally prescribe and provide marijuana to veterans in states where it is legal.
The bill is cosponsored by Sens. Tim Kaine, D-Va., Bernie Sanders, I-Vt., Jeff Merkley, D-Ore., Ron Wyden, D-Ore., and Jacky Rosen, D-Nev. There is also a companion bill in the House of Representatives, cosponsored by Representatives Barbara Lee, D-Calif., and Dave Joyce, R-Ohio.
But federal legalization efforts keep running into the same Senate blockade as most other popular legislation, and that is Republican recalcitrance that leads to the inability to pass anything meaningful, including bipartisan bills.
“It seems like every year, every congressional session, more and more bills get introduced to allow the VA to prescribe medical marijuana, to allow the VA to reimburse for medical marijuana and to de-schedule marijuana,” Debus said. “None of these bills ever seem to get any further than being introduced, but simply creating an environment where VA providers can allow their patients to access cannabis is only one step of solving this problem.”
Debus added that while the VA is bound by federal law, there is an overarching culture that resists change and an active vilification of cannabis using decades-old scare tactics.
“Instead of just sitting on the sidelines, the VA is affirmatively pushing this mythology that cannabis has absolutely no benefit for treating PTSD,” he said. “It’s not just that we need to change the laws, we need to change the culture of the institution from the top down.”
Medical cannabis as an alternative to opioids for veterans
Like many veterans, the rigors of military service took a toll on Air Force veteran and DAV life member Jarid Watson’s body. He’s not sure when exactly it happened—perhaps during physical training or while loading and unloading cargo planes as a member of the world-famous U.S. Air Force Thunderbirds—but at some point during his nearly 12 years in uniform, a bone growth on the ball joint of his hip tore his labrum and damaged much of the surrounding cartilage.
The injury brought on chronic pain for Watson and eventually led to his medical retirement from the military in 2016. It also severely affected his sleep, which in turn negatively influenced his motivation and mood. As a father, husband, entrepreneur and student, he knew something had to be done to combat the pain and restore his ability to get a good night’s rest, for the benefit of himself, his family, his career and his studies.
For Watson, there was only one choice.
The Cannabis cure
DAV calls for more research into medical cannabis as an alternative pain relief option for veterans with chronic pain, PTSD and TBIs.
Like many veterans, the rigors of military service took a toll on Air Force veteran Jarid Watson’s body. He’s not sure when exactly it happened-perhaps during physical training or while loading and unloading cargo planes as a member of the world-famous U.S. Air Force Thunderbirds… continue reading
Marijuana’s promising moment
Iraq veteran finds cannabis helpful as Washington debates how to move forward.
Like many veterans, service took a toll on Ryan Rasnick.
While he was driving in western Anbar Province in Iraq in 2009, an RKG-3—a Russian-made anti-tank hand grenade—was hurled directly in front of his vehicle. Rasnick quickly slammed on the brakes. And while the maneuver likely saved his and other lives, it violently jostled his neck causing longterm damage… continue reading
Is medical cannabis legal?
Over the past two decades, the legal status of medical marijuana in many states has evolved to reflect the shifting attitude towards cannabis as a viable medicine.
Currently, 33 states and the District of Columbia have state-approved medical marijuana programs, as do Guam, Puerto Rico and the U.S. Virgin Islands. Two additional states have passed medical cannabis legislation that is expected to be fully implemented at a later date, while seven states permit cannabinol (CBD) oil—the non-psychoactive component in cannabis—for medical purposes only.
Visit the National Conference of State Legislatures to find which states have medical marijuana programs.
However, physicians face ethical and legal barriers when deciding to recommend medical marijuana for veterans—while it may be permitted where they live, it remains a federally prohibited drug.
What types of conditions can medical marijuana treat?
The FDA notes increasing interest in the use of cannabis to treat a variety of medical conditions, including glaucoma, cancer, multiple sclerosis, chemotherapy-induced nausea, and certain seizure disorders. Of the states that allow medical marijuana, chronic pain, traumatic brain injury and post-traumatic stress disorder are often qualifying medical ailments.
What are other possible benefits?
Advocates and researchers believe that legal access to medical cannabis could potentially alleviate the opioid addiction crisis that has been reported among veterans.
According to the Department of Veterans Affairs, an estimated 65% of veterans suffer from chronic pain and are twice as likely to die from an accidental prescription opioid overdose as non-veterans. As such, many veterans are looking for alternatives to highly addictive and potentially dangerous opioid medications—like medical marijuana.
According to USA Today, almost every VA facility has experienced a steady drop in its opioid prescription rates since 2012, with an overall decline of 41 percent. The VA is also continuing its efforts to promote safe prescribing practices and to address the broader opioid epidemic in the United States, which includes alternative therapies for its patients.
Are there efforts underway to legalize medical cannabis for veterans within VA?
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 [email protected] .
Several bills introduced in the 116 th Congress, including the VA Medicinal Cannabis Research Act of 2018 (H.R. 5520), the Veterans Medical Marijuana Safe Harbor Act (S. 3409), and the Veterans Equal Access Act (H.R. 1647) sought reforms concerning medical marijuana for veterans. While these bills did not ultimately make it into law, new legislation is likely to be introduced in the 117 th Congress.
What is DAV’s stance on medical cannabis for veterans?
DAV Resolution 023, passed by DAV members in 2018, calls for research into the medical efficacy of medical cannabis for treating conditions of service-disabled veterans. Additionally, as mentioned above, DAV has supported legislation which seeks to do this. This is an important issue for many disabled veterans and DAV members—and leadership believes it is critical to enhance the base of knowledge surrounding the potential benefits and risks.
Can veterans get medical marijuana through the VA?
Currently, VA doctors cannot provide or recommend medical marijuana for veterans as the federal status for cannabis remains a Schedule 1 substance, making the drug illegal in the federal government’s eyes. Because of this, veterans should never bring any type of marijuana into a VA facility, even when provided through a state-sanctioned medical marijuana program.
However, veterans participating in a state-sanctioned medical marijuana program will not be denied VA benefits, according to the Department of Veterans Affairs. 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 medical marijuana program.
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.
View VA’s full directive on medical marijuana here. If you have questions regarding this policy please contact [email protected] .
Is it true that I could lose the right to buy or own firearms if I use medical cannabis?
Marijuana, despite medical and recreational legalization in some states, is still illegal under federal law.
According to the Bureau of Alcohol, Tobacco and Firearms, “Any person who uses or is addicted to marijuana, regardless of whether his or her state has passed legislation authorizing marijuana for medicinal purposes is an unlawful user of or addicted to a controlled substance and is prohibited by Federal law from possessing firearms or ammunition.”
Some states have remedial steps to restore 2 nd Amendment rights for registered medical marijuana users. But it is important to remember that even in states where it is legal, the federal law still applies.