Bipartisan congressional lawmakers are demanding that the U.S. Department of Veterans Affairs (VA) rescind a directive preventing its doctors from recommending medical cannabis to veterans in legal states, arguing that the administration’s recent rescheduling move underscores the need to withdraw the “antiquated marijuana restrictions rooted in the racist drug policy.”
In a letter sent to VA Secretary Denis McDonough on Thursday, three co-chairs of the Congressional Cannabis Caucus—Reps. Earl Blumenauer (D-OR), Dave Joyce (R-OH) and Barbara Lee (D-CA)—said the “negative ramifications of VHA Directive 1315 expand far beyond prescriptions,” as it “also prohibits providers from giving recommendations, referrals, and forms in compliance with state medical marijuana regulations.”
“Without their VA provider’s honest recommendations and option to provide referrals and registration forms, veterans are left to seek care outside of the VA system to participate in state-legal medical marijuana programs,” the letter says. “This disrupts veterans’ continuity of care and unfairly bars veterans from accessing treatment their states have legalized.”
To the frustration of advocates, VA released its updated directive reaffirming its doctors are barred from issuing medical cannabis recommendations to their military veterans patients late last year, drawing initial criticism from the three bipartisan members.
In a response to the lawmakers’ letter last year, VA told the members that they “appreciate” Blumenauer’s “continued efforts to ensure patients can participate in research specific to medical cannabis,” noting the enactment of a bill he sponsored that’s aimed at streamlining marijuana studies. However, the department said cannabis “is still classified as a Schedule I controlled substances,” and so “VA cannot prescribe marijuana as a clinical treatment option.”
“Although VA providers cannot currently prescribe marijuana as a treatment, VA is interested, consistent with existing authorities, in studying the effects of marijuana and cannabis products on health outcomes and exploring if the research points to a clear benefit for Veterans who have been diagnosed with PTSD,” the department’s letter said.
The new letter from lawmakers to the VA secretary also comes on the heels of the House passage of an amendment to a large-scale spending bill that would prevent the agency from using its funds to enforce the directive. That measure was led by the three signatories, as well as fellow Cannabis Caucus co-chair Rep. Brian Mast (R-FL).
The amendment is based on a standalone bill, the Veterans Equal Access Act, that Blumenauer has championed across multiple sessions. It’s advanced several times in committee and on the floor but has yet to be enacted into law.
The lawmakers behind the letter emphasized that “the discussion has also shifted significantly” since they first reached out about the latest directive last year in light of the U.S. Department of Health and Human Services (HHS) and Justice Department proposing to move cannabis from Schedule I to Schedule III of the Controlled Substances Act (CSA).
“While the rulemaking process is ongoing, the federal government has formally recognized that marijuana has an accepted medical use in the United States, which must be factored into VA’s considerations,” they said.
“Continuing to deny the medical use of marijuana in 38 states by prohibiting care for veterans that others access outside the VA system is an antiquated and harmful practice,” the letter says. “No one is better qualified to make recommendations on care for veterans than veterans working with their VA health care providers. Placing arbitrary restrictions on those decisions is a disservice to our veterans.”
“HHS’ and DOJ’s formal recognition of marijuana’s accepted medical benefit presents an opportunity to reevaluate the VA’s prohibition on honest consideration of medical marijuana from VA health care providers. I hope you will take this opportunity in stride to end the VA’s outdated restrictions on medical marijuana.”
If the department doesn’t proactively end the policy, however, the amendment the signatories attached to the House-passed Military Construction, Veterans Affairs and Related Agencies (MilConVA) appropriations bill would force a change. Here’s the text:
SEC. 419. None of the funds appropriated or other wise made available to the Department of Veterans Affairs in this Act may be used to enforce Veterans Health Directive 1315 as it relates to—
(1) the policy stating that ‘‘VHA providers are prohibited from completing forms or registering Veterans for participation in a State-approved marijuana program’’;
(2) the directive for the ‘‘Deputy Under Secretary for Health for Operations and Management’’ to ensure that ‘‘medical facility Directors are aware that it is VHA policy for providers to assess Veteran use of marijuana but providers are prohibited from recommending, making referrals to or completing paperwork for Veteran participation in State marijuana programs’’; and
(3) the directive for the ‘‘VA Medical Facility Director’’ to ensure that ‘‘VA facility staff are aware of the following’’ ‘‘[t]he prohibition on recommending, making referrals to or completing forms and registering Veterans for participation in State approved marijuana programs’’.
Both the House and Senate included provisions in their respective MilConVA measures last year that would permit VA doctors to make the medical cannabis recommendations, but they were not included in the final package for the 2024 version that was signed into law in March.
