U.S. VETERANS GETTING CLOSER TO ACCESSING MEDICAL MARIJUANA

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The U.S. Congress is making important if not snail-paced strides toward helping to make medical cannabis accessible to military veterans. First, Congressman Earl Blumenauer (D-OR) recently reintroduced the Veterans Equal Access Act, which would expand medical cannabis access to eligible veterans.

Secondly, on May 8, 2018, members of the House Veterans Affairs’ Committee approved H.R. 5520. This combined with S. 2796, a Senate companion legislation, that was introduced on May 7, 2018, and referred to the Senate Committee on Veterans’ Affairs, would work toward facilitating the necessary research regarding medical marijuana and its affects in treating multiple symptoms suffered by military veterans.

EXPAND VETERANS’ ACCESS

H.R. 1820 would expand medical cannabis access to eligible veterans. In its language The Veterans Equal Access Act authorizes physicians and other health care providers employed by the Department of Veterans Affairs to “provide recommendations and opinions” to veterans “who are residents of States with State marijuana programs” regarding the participation in said medical cannabis programs. The bill further authorizes the VA to complete any forms necessary to reflect such recommendations and opinions.

In further effort to reverse the VA’s decades long attitude against medical cannabis, Representative Blumenauer also filed an amendment that would forbade the VA from utilizing any of the funds derived from this bill for the purpose of prohibiting “VA providers from completing forms seeking recommendations or opinions regarding a Veteran’s participation in a State marijuana program.”

The two bills add up to major steps toward overcoming legal hurdles that have been used to outright prohibit VA doctors from making recommendations to veterans for medical marijuana use, even if compliant under state law.

The above-mentioned legislative attempts to change the law are important because the U.S. Veterans Affairs Department has a lengthy history of withholding support for medicinal cannabis access by military veterans. In October 2017, Tom Angell, writing at marijuanamoment.net, recorded how a new update to the VA’s Website had confirmed the longstanding agency policy of disallowing government physicians from helping veterans qualify for state medical cannabis programs.

“Veterans should know that federal law classifies marijuana – including all derivative products – as a Schedule One controlled substance,” Angell writes of the VA department Website page that can no longer be accessed. “This makes it illegal in the eyes of the federal government. The U.S. Department of Veterans Affairs is required to follow all federal laws including those regarding marijuana. As long as the Food and Drug Administration classifies marijuana as Schedule One VA health care providers may not recommend it or assist Veterans to obtain it.”

The FDA could take forever on that one. Angell wonders what if VA doctors were still allowed to recommend medical cannabis to veterans, even though it is considered illegal under federal law? Wouldn’t that still be a benefit to a veteran’s health if a VA doctor believed as much? And what about the fact that the above referred to VA Website page has been taken down? Might that be proof that the VA is changing their prohibitive stance against medical cannabis?

For many years the VA has thrown up major obstacles to American veterans’ safe access to medicinal cannabis as a treatment option for veterans suffering from PTSD, chronic pain, and other post-war ailments. Yet VA doctors have had no problem prescribing seriously addictive opioids that have been attributed to thousands of American deaths. It’s time for this treatment model to change. Our veterans deserve the opportunity to exercise their free will and have more equal treatment from their treating physicians who know them best, to wit their VA doctors.

What is important for the VA administrators and doctors to understand is that we are talking about “recommendations” or “opinions” of VA doctors for the use of medicinal cannabis. We are not talking about prescriptions. The law is very clear in states and nationally. No physician in the United States, whether paid by the U.S. government or in private practice, can prescribe pot to patients. It’s against the law because the prescription process is federally-regulated and cannabis currently falls under the Controlled Substances Act’s restrictive Schedule I. Schedule I drugs are those considered to have a high potential for abuse without any currently accepted medical value.

Even with marijuana’s Schedule I status, there is nothing in federal law that prevents VA from allowing its doctors to recommend or give their opinion on their patients’ usage of medicinal cannabis in the states where it is legal to do so. It’s now time for VA doctors to do so as well.

THE STUDIES MUST BE DONE

The medicinal cannabis studies have to be done, for the benefit of military veterans and the greater civilian public, and H.R. 5520 is a good place to start. This new legislation seeks to authorize and instruct the U.S. Department of Veterans Affairs to research medical marijuana for use in the treatment of post-traumatic stress disorder and chronic pain in American soldiers returning from war.

As ordered and reported by the House Committee on Veterans Affairs on May 8, 2018, H.R. 5520, The Veterans Affairs Medicinal Cannabis Research Act of 2018, would act to codify VA’s existing authority to conduct such research. On that basis, CBO estimates that implementing H.R. 5520 would cost less than $500,000 over the 2019-2023 period, primarily to prepare and submit the necessary reports to the Congress. That spending would be subject to the availability of appropriated funds.

FACILITATE MEDICAL MARIJUANA RESEARCH

The road to progress has not always been paved for success by the VA, which is another reason S. 2796, the Senate companion bill to H.R. 5520, was introduced in Senate on May 7, 2018, after which it was referred to the Senate Committee on Veterans’ Affairs. Regarding The VA Medicinal Cannabis Research Act of 2018, this bill (1) authorizes the VA to conduct and support research on the efficacy and safety of certain forms of cannabis and cannabis delivery for veterans enrolled in the VA health care system diagnosed with conditions such as chronic pain or post-traumatic stress disorder, and (2) Collected data shall be preserved in a manner that facilitates further research.

SOLUTIONS

The bottom line is the VA must act to change the internal prohibition of medical access for veterans to cannabis. Congress will have to continue to force the issue if the VA isn’t going to do anything to help veterans have access to medicinal cannabis.

House Committee on Veterans’ Affairs Chairman Phil Roe, M.D. calls the VA Medicinal Cannabis Research Act of 2018 a “pragmatic and bipartisan piece of legislation that would advance our understanding of the impacts of medicinal marijuana usage and could improve the lives of veterans and other Americans.” But it’s just a start. We need to push harder for federal government evolution on the issue of medicinal cannabis research and access for military veterans.

The government must permit VA medical providers to be able to discuss with U.S. veterans the use of cannabis for medicinal purposes and to be able to give recommendations and opinions in those states where medical marijuana laws exist.

We need to keep pushing for rescheduling of marijuana.

The VA needs to stop blocking federally-approved researchers from recruiting veterans for research on medical cannabis.

Studies must be performed regarding medicinal cannabis’ effects on veterans with PTSD issues. Such studies need to be performed and veterans must be given access to them.

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MORE CHOICES AND FEWER BARRIERS; DOORS OPEN FOR MORE PRIVATE HEALTH CARE FOR AMERICA’S MILITARY VETERANS

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There are doctors and alternative methods to the art of healing that have proven track
records and military veterans deserve access to them should their health condition call for it. That’s why it was a big step when a deal was made calling for major reform that will soon take place within the United States VA. All that awaits is a President’s signature.

On May 23, the U.S. Senate passed with overwhelming approval by a vote of 92 to 5 the VA Mission Act of 2018 (S. 2372), which acts to combine the U.S. Department of
Veterans Affairs’ (VA’s) seven community care programs into one. The bill would also
extend the VA “Choice Program” for one year while the VA implements the new
consolidated community care program.

According to an article written by Lisa Rein of The Washington Post, the massive bill promises to expand access for military veterans to private doctors at taxpayer expense, which is another victory for President Trump as it helps to cement one of his biggest campaign promises. The $55 billion package makes a five-year commitment to addressing the many shortcomings in America’s largest health system, which still struggles with delays after a 2014 scandal in which VA employees were found to have fudged patient wait-lists.

The bill acts to inject an additional $5.2 billion into the “Choice Program.” The “Choice Program” allows veterans to obtain care from non-VA care providers. Presently, about one-third of veterans in the system see outside doctors through the program, which Congress hastily approved as a temporary remedy in response to the above scandal. But the program – designed to serve the overflow at VA facilities both of aging Vietnam-era veterans and younger service members returning from the wars in Iraq and Afghanistan – is “fragmented and unwieldy,” Rein writes. Doctors have complained of slow or nonexistent payments, and veterans say there’s insurmountable red tape involved.

The new measure passed the House on May 16 by a vote of 347 to 70 and now heads to
President Trump’s desk where it is expected to soon be signed, before funding for the
“Choice Program” runs out.

The “Choice Program” has been declared a wreck from day one and dramatic changes
have been anticipated ever since. According to The Washington Post article the
Congressional Budget Office estimates that as a result of the bill an additional 640,000
veterans will seek medical help outside the system each year. For the first time the VA
will have to negotiate contracts for veterans to seek care at private walk-in clinics.

The bill was negotiated between Congress, the White House, and veterans groups over
the past year. Negotiations were reportedly often contentious between widely divergent
competing financial interests running down party lines. During this time Trump fired his
VA secretary and nominated a White House physician as a replacement, only to have the
nomination disintegrate after claims of misconduct surfaced. That turmoil slowed
progress of the legislation.

MORE CHOICES AND FEWER BARRIERS FOR VETERANS

One of President Trump’s key campaign promises had been to allow for more private
medical care to military veterans. Veterans can expect to benefit from the bill through
more choice of doctors and fewer barriers to health care.

According to a blog written by Austin Igleheart, the measure also expands
the circumstances under which veterans can obtain non-VA health care. Currently,
veterans may seek third-party care if they face a wait of at least 30 days for a VA
appointment or live more than 40 miles from a VA facility. The VA Mission Act will
remove these limitations and allow veterans access to non-VA care if they require
services not offered by VA or if their doctor decides it is in their best interest. The bill
will also boost funding to recruit more doctors to VA in an effort to improve capacity.

Additionally, the VA Mission Act includes a provision that would expand VA’s Program
of Comprehensive Assistance for Family Caregivers to all veterans over the course of
two years. Currently, “monthly stipends, health insurance, medical training and access to home health aides are available to family caregivers for post 9/11 veterans”, Ingleheart writes, “but not to veterans from other eras and their families.”

IN THEIR OWN HOMES, AN ALTERNATIVE TO INSTITUTIONALIZED HEALTH
CARE

The program allows family caregivers to provide care for veterans in their own homes, offering an alternative to institutionalized care and reducing the costs to local governments associated with providing health care and other services to our nation’s veterans. Ingleheart writes that by allowing VA to contract with other entities to provide supportive services for family caregivers, and authorizing VA to compensate these entities for the services they provide, the VA Mission Act can help reduce costs for counties that provide such services.

The blog further notes that the bill intends to establish a prompt payment standard to
ensure reimbursements from VA to third-party care providers. This measure will help
ensure that health care providers are able to continue serving VA-eligible veterans in a
timely manner while avoiding unnecessary delays or added costs. This is all a blessing to
help bring greater qualify of life to a vastly underrepresented, exploited, and important
minority segment of our society, our military veterans.