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Seven members of the Massachusetts congressional delegation are urging the head of the US Department of Veterans Affairs to allow VA physicians to verbally recommend medical marijuana to military veterans amid the coronavirus pandemic.
The letter, led by Senator Elizabeth Warren, emphasizes that Massachusetts has shuttered recreational marijuana shops during the COVID-19 crisis, which has driven some to transition to the medical dispensaries that remain open as essential services under the governor’s order.
But veterans often avoid registering as cannabis patients out of concern that they could lose federal benefits, leaving them now without access to medicine, so the lawmakers want the VA to amend its policies, at least on a temporary basis.
“As this global pandemic continues to adversely affect veterans’ behavioral and physical health conditions, we believe that veterans who legally use cannabis in the Commonwealth to treat their ailments deserve to receive more robust assistance from qualified medical personnel at their local VA,” the lawmakers wrote, adding that they feel VA should “consider making this directive the official policy” of agency on a permanent basis once the current health emergency is over.
In addition to Warren, the letter was signed by US Senator Ed Markey and US Representatives Jim McGovern, Katherine Clark, Seth Moulton, Ayanna Pressley, and Joseph P. Kennedy III.
It’s unclear what the practical impact of allowing VA doctors to make “verbal” recommendations would be, given that state medical marijuana certifications generally require a written component from doctors.
An aide to Warren said the senator would ultimately like to see VA doctors be able to offer written recommendations, but the hope is that the incremental reform could provide short-term relief to veterans and set the stage for broader policy changes down the line.
The staffer also noted that Warren is pushing for comprehensive federal marijuana legalization and wants medical cannabis products covered under VA insurance for veterans, just like any other legal medication.
The VA currently allows and encourages veterans to discuss their use of marijuana as a treatment for various ailments with their government doctors, but it specifically prohibits its physicians from issuing the recommendations needed to register as a qualified patient under a state-legal program or from assisting in obtaining medical cannabis in any way.
“Veterans in Massachusetts use medical marijuana to treat a variety of ailments, including post-traumatic stress disorder (PTSD), anxiety, chronic pain, and others,” the lawmakers wrote in their letter, addressed to VA Secretary Robert Wilkie.
“For many veterans in Massachusetts, medical marijuana works in treating their health conditions, which can be exacerbated by the coronavirus pandemic,” they wrote. “Therefore, during this unprecedented public health emergency, VA should issue a directive explicitly authorizing its health care providers to make sensible, clinically sound verbal recommendations to veterans related to participation in state-approved medical marijuana programs and services and to provide advice to veterans as they complete forms and other paperwork reflecting those recommendations.”
States that have medical cannabis programs generally require a licensed doctor’s signature for a patient to be certified, so the language around “verbal” recommendations by itself wouldn’t help veterans obtain legally protected patient status. But the letter has a suggestion for how VA personnel could help nonetheless.
“When veterans request advice on paperwork related to participating in a state-approved marijuana program, VA clinicians should be advised that they can make verbal referrals to knowledgeable non-VA providers who are registered with a state-approved program and can offer feasible options that minimize, or completely waive, the cost to the veteran,” the lawmakers wrote.
Veterans are already able to seek out written recommendations from non-VA physicians, and it’s not clear how the VA would be able to facilitate a process where those private providers would waive or minimize costs, as the letter encourages.
That said, Debbie Churgai, interim director of Americans for Safe Access, said she does not view the verbal recommendation caveat as “an extra hoop to jump through,” but rather as “an opportunity for many veterans to openly talk with and get acceptance and assistance from their VA physicians.”
If veterans are able to get verbal advice from VA doctors on how to fill out state applications to become registered patients, that would represent a positive development compared to the current system, where patients are completely on their own in navigating the process, Churgai said.
“I think having the ability to talk with their primary physician about cannabis and get verbal approval (i.e recommendation) from them is really huge and amazing news for veterans. Or at least it’s a tiny step in the right direction,” Churgai said. “Having a VA physician suggest cannabis as medicine with a verbal recommendation could help many patients open up their minds about cannabis as an option for treatment.”
In their letter, the Massachusetts lawmakers went on to say that “VA clinicians who provide this temporary, limited assistance to veterans should be clearly advised by the VA that they will not be subject to disciplinary action,” and they urged the “VA to work with the Justice Department to formally advise VA providers who conduct these clinical activities that they will not face criminal prosecution under federal marijuana laws.”
“By authorizing these tailored, temporary actions, the VA could help Massachusetts veterans who use, or are interested in using, medical marijuana receive more comprehensive clinical advice from their VA providers, reduce opioid addiction and substance use disorders, and achieve better health outcomes,” they concluded. “Finally, when this public health emergency ends, we urge VA to consider making this directive the official policy of the Department going forward.”
Michael Liszewski, principal of the Enact Group, acknowledged that the move “would not necessarily facilitate a veteran being able to register with a state medical cannabis program” but said that “it does have some practical merit.”
“By encouraging vets to speak with their VA doctors from which they are receiving ongoing care, veterans would receive more fully-informed care,” he said. “While allowing referrals to trusted physicians outside the VA system to complete paperwork means veterans will still be paying out of pocket for the exam, the directive would ease the barrier.”
Clark, one of the representatives who signed the letter, has previously cited veterans’ access to cannabis in urging the Massachusetts government to reverse its decision to close recreational marijuana shops, which the governor said was necessary to prevent out-of-state consumers from visiting and potentially spreading the coronavirus.
Read the lawmakers’ letter to the VA below: