Despite the legal medical and recreational status of cannabis in several states, federal law classifies it as a Schedule 1 Controlled Substance, regarding it as a drug with no accepted medical uses. According to the U.S. Department of Veterans Affairs (VA) public health guide on marijuana, the VA is required to “follow all federal laws including those regarding marijuana.” What does that mean exactly? The VA isn't allowed to prescribe cannabis to veterans, who could greatly benefit from its therapeutic properties. 

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Veterans Could Greatly Benefit From Cannabis Treatments

Veterans suffer from chronic, severe pain and PTSD at significantly higher rates than the rest of the population. According to the VA, between 11 and 20 percent of veterans who served in OIF or OEF were diagnosed with PTSD within a year. Over $3 billion is spent annually by the VA on treating PTSD in veterans, with primary treatments being cognitive processing therapy (CPT), prolonged exposure (PE) therapy, and Eye Movement Desensitization and Reprocessing (EMDR) therapy.

Sometimes, patients are prescribed SSRI medications. The VA lists medical marijuana under “other” treatments, noting that they are “not currently able to prescribe medical marijuana to Veterans, but can look at marijuana as an option for treating Veterans.”

Cannabis as a treatment for conditions veterans face at high rates is difficult to access with current federal laws. With Missouri’s recent banning of medical cannabis in veteran’s nursing homes, a lack of access to medical treatment for chronic conditions is continuing to hurt veterans.

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VA bus for veterans health appointments iStock / Christine_Kohler

Federal Laws Prevent VA Doctors From Recommending Cannabis

VA doctors are allowed to discuss the use of cannabis with their patients, though recommending it remains illegal due to the federally-illegal status of the plant. Pushes for more research on the medical use of cannabis in veteran conditions have been occurring for a long time, with many veterans cannabis advocacy groups existing across the nation.

The VA began funding a study in 2017 for research into cannabis use and its effect on primary care patients in the Veteran’s Health Association. The study is expected to extend until 2021. They recognize that “more than 1 million Veterans regularly use cannabis,” while very little research has been conducted on its effects.

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Chronic pain is a condition known to increase the risk of suicide in veterans, making management of pain a crucial part of their treatments. Many veterans are affected by the nationwide opioid crisis, as prescribing these types of painkillers is a common practice. Prescription opioid painkillers can be useful in the right situations, but the risks can outweigh the benefits when dependence, addiction, and overdoses become common results of their use. Veterans are twice as likely to accidentally overdose from opioids than non-veterans, a harrowing number that shows veterans are at risk no matter what they do about their intractable pain.

Cannabis is a well-known pain reliever and its medical use is a viable alternative to prescription painkillers in some cases. The use of legal cannabis is proving to help fight against the opioid crisis, with legal medical marijuana states experiencing less opioid use amongst the population compared to those without access. While treatment for chronic pain is a common use for cannabis, the Schedule 1 status of the drug prevents veterans from being recommended cannabis by their VA doctors, regardless of the legal status within the state.

Cannabis Could Be The Solution To PTSD

Soldier sitting and talking to his therapist iStock / KatarzynaBialasiewicz

Marijuana has the potential to offer relief to sufferers of PTSD. With so many veterans experiencing long-lasting effects from their service, including flashbacks, intrusive thoughts, anger, sleep problems and more, the use of cannabis as an alternative to popular CPT, PE or EMDR therapy is possible. Veterans receiving care through VA doctors may receive therapy or be placed on medication, instead. Currently, the FDA has only approved two approved medications for PTSD: sertraline (Zoloft) and paroxetine (Paxil).

The National Center for PTSD’s PTSD Treatment Decision Aid Tool states that out of 100 patients receiving either CPT, PE or EMDR therapy, 53 of the patients will be cleared of their PTSD. With medication, 42 out of 100 patients achieve remission with their PTSD. These numbers are low, a major reason so many advocates are pushing to allow veteran access to cannabis for treating PTSD. Organizations like the American Legion have been urging the government to budge on letting VA providers recommend medical marijuana in legal states.

The American Legion also shared results from an independent study, finding 82 percent of respondents support the use of cannabis as a federally-legal treatment for physical and mental conditions. The study surveyed 513 veterans and 289 family members or caregivers. With such overwhelming support, the acceptance of cannabis as a medical treatment for veterans is a logical and beneficial move. But until the government budges, it remains impossible.

The VA has no choice but to comply with federal law, otherwise, like in the case of the Missouri nursing homes, they risk losing their funding. Although they are funding research to gain a better understanding of the plant’s effects on conditions like PTSD and chronic pain, they will remain at a stand-still until federal law changes. The organization is not anti-cannabis, and they clearly state that veterans will not lose their VA benefits if they are known to use marijuana.

The VA is only allowed to prescribe drugs approved by the FDA, and they are prohibited from making a recommendation for medical marijuana use. However, if patients use marijuana as a treatment, they are encouraged to tell their providers. All of the information is recorded in a confidential record and is necessary for understanding the patient’s needs. The only time a veteran would face penalties for marijuana use in relation to the VA is if they used or possessed marijuana at a VA medical center, or if they are employed by the VA and found to fail a drug test.

VA spokesman Terrence Hayes offered The Stash their official statement on the state of cannabis use for veterans: “Marijuana is illegal under federal law, and until federal law changes, VA is not able to prescribe it.” Unfortunately, this means veterans who experience disproportionate levels of pain and trauma will continue to have limited access to effective alternative treatments.