The Trump administration’s top military veterans official says that state marijuana legalization is leading to more research on its medical benefits for veterans suffering from war wounds.
And David Shulkin, the secretary of Veterans Affairs, thinks that’s especially helpful since cannabis’s current classification under federal law has made it difficult to study.
“From the federal government point of view, right now we are prohibited by law from doing research on it or prescribing it,” Shulkin said in an interview on Saturday.
“So this is an area where actually the states are gonna be leading in this, because as it is increasingly being — laws are being passed at the state level to use medical marijuana — we are seeing increasingly not only more clinical data coming out but we are seeing more research that’s being done,” he said, adding that he personally values the new information resulting from the end of prohibition in an increasing number of states.
“As a physician-scientist I am extremely interested in learning from that data and trying to see, is this something that could help and could help veterans?” he said.
Researchers have long complained that marijuana’s status under Schedule I of the Controlled Substances Act — the most restrictive category, which is supposed to be reserved for drugs with a high potential for abuse and no medical value — makes it especially difficult to study. Scientists who wish to examine cannabis’s medical benefits must jump through hoops that don’t exist for studies on other drugs.
A growing number of military veterans are using cannabis to treat physical pain or to manage the symptoms of Post-Traumatic Stress Disorder. The American Legion, which represents more than 2 million veterans, endorsed rescheduling in a resolution adopted at its conference last year, and has pressured the Trump administration to support a change.
“Our top priority — the only clinical priority that we focus on right now as our top priority — is the prevention of veterans suicide,” Shulkin told Politico’s Bryan Bender in an appearance at the George W. Bush Institute. “And we are taking the approach that until we can see results that are decreasing that number, and getting it to zero, we have to be open to new ideas that are out there or therapies that may help.”
But while saying that “we have to be open to all sorts of new ideas,” Shulkin indicated that his department wasn’t going to be participating in studies or helping veterans access cannabis until Congress enacts changes. “We are not going to be out there doing that research or prescribing these different medicinal preparations unless the law is changed,” he said.
It’s true, as Shulkin says, that federal law prevents doctors at the Department of Veterans Affairs from prescribing medical cannabis. But no doctor in the country — V.A. or not — can do so, since prescription if a federally-regulated process.
In the 29 states with comprehensive medical cannabis laws, physicians instead recommend it to patients. Federal law doesn’t actually block V.A. doctors from filling out paperwork for veterans who wish to participate in those state programs — but an internal V.A. administrative policy does.
Under Veterans Health Administration (VHA) Directive 2011-004, “It is VHA policy to prohibit VA providers from completing forms seeking recommendations or opinions regarding a Veteran’s participation in a State marijuana program.”
The policy technically expired on January 31, 2016, but it remains in effect in practice until such time as Shulkin’s V.A. institutes a new one.
The secretary’s comments at the Bush event — and other statements he has made recently — indicate he’s either unaware that his department has the administrative power to begin letting its doctors recommend medical cannabis in states where it is legal, or perhaps he does know but doesn’t wish to potentially anger other elements of the Trump administration, such as U.S. Attorney General Jeff Sessions, by issuing a new directive that would increase veterans’ access to marijuana.
Shulkin, who previously served as the V.A.’s undersecretary of health in the Obama administration, has seemed somewhat open to increasing military veterans’ access to medical marijuana in the past, but has consistently pointed to federal law as standing in the way.
“Some of the states that have put in appropriate controls, there may be some evidence that this is beginning to be helpful, and we’re interested in looking at that and learning from that,” he said in a briefing with reporters at the White House last month.
But “until time the federal law changes,” he added, “we are not able to be able to prescribe medical marijuana for conditions that may be helpful.”
In an interview with Task & Purpose this month, Shulkin said that it is “not within our legal scope to study that in formal research programs or to prescribe medical marijuana, even in states where it’s legal,” adding, “if a law change at the federal level is appropriate, that could happen.”
And in a letter last year he wrote that he “wholeheartedly agree[s] that VA should do all it can to foster open communication between Veterans and their VA providers, including discussion about participation in state marijuana programs.”
While writing that he recognizes “that the disparity between Federal and state laws regarding the use of marijuana creates considerable uncertainty for patients, providers, and Federal, state, and local law enforcement personnel,” he said that V.A. and its providers are “bound” by prohibitions on prescription resulting from cannabis’s Schedule I status.
In addition to V.A.’s internal power to lift its own prohibition on its doctors recommending medical cannabis, the Trump administration also has the ability to reschedule marijuana administratively under the Controlled Substances Act, without action from Congress.
Last year, both the House and the Senate approved measures to prevent the V.A. from barring its doctors from recommending medical cannabis to veterans in states where it is legal. But the provisions were later stripped out by the conference committee that merged both chambers’ separate legislation into a final version of the V.A. funding bill.
It is expected that Congress will vote on similar riders this summer as it considers Fiscal Year 2018 spending legislation covering the V.A.