The Department of Veterans Affairs opposes three legislative proposals that would expand research on medical marijuana at the VA and give veterans access to the drug in states where it is legal.
During a hearing Tuesday on eight VA health-related bills under consideration by Congress, VA officials told House lawmakers that as long as marijuana is illegal under federal law, the department cannot support legislation that promotes its role at the VA.
"[The House Veterans Affairs Committee] can make strong proposals for us to move forward with recommendations of filling out forms and such but, in the end, we need to go back to the [Drug Enforcement Agency] and [Justice Department] for their opinion," said Larry Mole, chief consultant for population health at the VA.
Three of the bills before the House Veterans Affairs health subcommittee relate to medical marijuana. One, the Veterans Equal Access Act, H.R. 1647, sponsored by Rep. Earl Blumenauer, D-Oregon, would allow VA health providers to recommend medical marijuana to their veteran patients and fill out the necessary paperwork for them to enroll in state marijuana programs.
Blumenauer, who has introduced the bill in every Congress since 2014, said that, for some veterans, marijuana and cannabis derivatives are lifesavers that keep them from using addictive medications such as opioids to treat post-traumatic stress disorder, chronic pain, seizures and glaucoma. Yet VA health care providers are not allowed to recommend it.
"Opioids steal the lives of 115 Americans every day ... as veterans with PTSD, chronic pain and any number of ailments are looking for relief, lethal opioid overdoses among VA patients are almost twice the national average. We are doing something wrong," he said.
Another bill, the VA Medicinal Cannabis Research Act, H.R. 712, would direct the VA to conduct a large-scale clinical trial on the effects of cannabis on conditions such as PTSD and chronic pain.
Bill sponsor Rep. Lou Correa, D-California, said the research would examine the effectiveness of cannabis on various health conditions, as well as delivery methods.
"It's time to do research. It's time for veterans to know what cannabis is good for and what cannabis is not good for," Correa said.
A third, the Veterans Cannabis Use for Safe Healing Act, H.R. 2192, would protect veterans' benefits by prohibiting the VA from denying health care and compensation for veterans participating in a state medical marijuana program.
Keita Franklin, the VA's national director of suicide prevention, said that while the department supports medical marijuana research and is currently involved in a trial for treating PTSD, it opposes the bills.
According to Franklin, VA doctors would be subject to criminal prosecution if they recommended medical marijuana or made referrals to state agencies, as specified by DEA guidance.
And Correa's bill, she said, would not follow standard practice in medical research.
"Typically, a smaller early-phase trial would advance our knowledge and the benefits and risks regarding cannabis before moving to the expansive approach described in this legislation," she said. "Any trial involving human subjects must include an evaluation on the risks and the safety, and include the smallest number of participants to avoid putting the subjects at increased risk unnecessarily. For these reasons, we don't support this legislation."
She added that the third piece of legislation is unnecessary because VA policy states that the department cannot deny benefits based on marijuana use, although VA physicians are allowed to tailor a patient's prescription medications based on whether they are using cannabis.
Veterans advocates who testified expressed varying levels of support for the bills.
Carlos Fuentes, director of national legislative service for the Veterans of Foreign Wars, said the VFW does not support the Veterans Equal Access bill because it doesn't think the VA should recommend unproven medical treatments, nor should it authorize a treatment for a veteran that would require the former service member to get it outside the VA, where they would be responsible for finding a quality product and paying for it.
The VFW does, however, support VA research on cannabis.
"VA's overreliance on opioids to treat chronic pain and other conditions has led to addiction and even deaths. To its credit ... VA has reduced the number of patients to whom it has prescribed opioids by 22 percent. Now, VA must expand research on the efficacy of nontraditional alternatives to opioids," Fuentes said.
Joy Ilam, national legislative director for Disabled American Veterans, agreed.
"We want to make sure there is no harm done. Research is the first step in doing that," Ilam said.
Iraq and Afghanistan Veterans of America research director Stephanie Mullen said the IAVA supports cannabis research and access to it.
"It's past time for VA to catch up," Mullen said. "Veterans are suffering from their injuries today."
Among the other bills and draft bills discussed at the hearing was one that seeks to expand complementary and alternative therapies and treatments at VA medical facilities, and another that would require the VA to report suicides and attempts that occur on VA campuses within a week of them happening.
Franklin said the VA supports both proposals.