U.S. Department of Veterans Affairs Reaffirms Prohibition on Medical Cannabis Recommendations to Veterans

LOS ANGELES— The U.S. Department of Veterans Affairs (VA) has recently issued an updated directive reiterating its doctors’ prohibition from issuing medical cannabis recommendations to military veterans. The revised Veterans Health Administration (VHA) guidance aligns closely with a previous version from 2017, which was updated at the end of 2022 to encourage VA doctors to discuss veterans’ marijuana use. The new directive aims to clarify the VA’s stance on medical cannabis, as well as address the federal definition of marijuana following the legalization of hemp.

Despite continuous advocacy and efforts from lawmakers, the VA has maintained its resistance to allowing doctors to provide medical cannabis recommendations to veterans residing in states with legal cannabis programs. The revised VHA directive explicitly states that “VA health care providers are prohibited from recommending, making referrals to, completing forms, or registering Veterans for participation in a State-approved marijuana program.”

A bipartisan amendment was recently passed by the House, seeking to permit VA doctors to recommend medical cannabis to military veterans. The Senate Appropriations Committee also approved a similar reform as part of its version of the appropriations legislation.

Representative Brian Mast (R-FL), who led the House amendment, expressed the necessity of this provision, citing the VA’s bureaucracy as a hindrance to veterans’ access to a proven treatment option. The amendment was co-sponsored by Representatives Earl Blumenauer (D-OR), Dave Joyce (R-OH), and Barbara Lee (D-CA), all co-chairs of the Congressional Cannabis Caucus.

In light of the updated directive, VA providers can still discuss relevant clinical information regarding marijuana use with veterans upon request or when veterans report marijuana use. Such discussions will be documented in the veteran’s electronic health record. The guidance emphasizes that veterans should not be denied VHA services solely based on their participation in state-approved marijuana programs or their acknowledgment of marijuana use.

Notably, the directive recognizes the revised federal definition of marijuana, differentiating it from hemp, which became legal under the 2018 Farm Bill. Cannabis containing up to 0.3 percent THC is now exempt from the marijuana definition according to the new guidelines.

Although some hoped for modernization of the VA’s marijuana policy under the Biden administration, the department has resisted congressional efforts to allow doctors to recommend medical cannabis or mandate clinical trials into the effectiveness of marijuana for various health conditions that veterans commonly experience.

The VA has also faced criticism for recently updated guidance that strongly discourages the use of marijuana in the treatment of post-traumatic stress disorder (PTSD).

Meanwhile, an attached report to the House spending legislation by the Appropriations Committee clarifies that veterans whose income is derived from state-legalized cannabis activities are not specifically prohibited from obtaining a certificate of eligibility for VA home loan benefits.

In the Senate’s version of the National Defense Authorization Act (NDAA), Democratic senators sought to pass a series of marijuana reform amendments. One successful provision prevents intelligence agencies like the CIA and NSA from denying security clearances to applicants solely based on their past marijuana use. Another proposal led by Senator Brian Schatz (D-HI) aimed to allow veterans to use medical cannabis in states and territories where it is legal but was not brought up for consideration.

According to a recent survey of veterans who use cannabis, respondents reported an improved quality of life and reduced use of certain prescription drugs, including opioids. The debate over medical cannabis for veterans continues to be a topic of interest and discussion in Congress and the VA.