VA clears path for medical marijuana use in some states
DENVER — The Department of Veterans Affairs will formally allow patients treated at its hospitals and clinics to use medical marijuana in states where it is legal, a policy clarification that veterans have sought for several years.
A department directive, expected to take effect next week, resolves the conflict in veterans facilities between federal law, which outlaws marijuana, and the 14 states that allow medicinal use of the drug — in effect, deferring to the states.
The policy will not permit department doctors to prescribe marijuana. But it will address the concern of many patients who use the drug that they could lose access to their prescription pain medication if caught.
Under department rules, veterans can be denied pain medications if they are found to be using illegal drugs. Until now, the department had no written exception for medical marijuana.
This has led many patients to distrust their doctors, veterans say. With doctors and patients pressing the veterans department for
formal guidance, agency officials began drafting a policy last fall.
“When states start legalizing marijuana we are put in a bit of a unique position because as a federal agency, we are beholden to federal law,” said Dr. Robert Jesse, the principal deputy under secretary for health in the veterans department.
At the same time, Jesse said, “We didn’t want patients who were legally using marijuana to be administratively denied access to pain management programs.”
The new, written policy applies only to veterans using medical marijuana in states where it is legal. Doctors may still modify a veteran’s treatment plan if the veteran is using marijuana, or decide not to prescribe pain medicine altogether if there is a risk of a drug interaction. That decision will be made on a case-by-case basis, not as blanket policy, Jesse said.
Although veterans of the Vietnam War were the first group to use marijuana widely for medical purposes, the population of veterans using it now spans generations, said Michael Krawitz, executive director of Veterans for Medical Marijuana Access, which worked with the department on formulating a policy.
Veterans, some of whom have been at the forefront of the medical marijuana movement, praised the department’s decision. They say cannabis helps sooth physical and psychological pain and can alleviate the side effects of some treatments.
“By creating a directive on medical marijuana, the VA ensures that throughout its vast hospital network, it will be well understood that legal medical marijuana use will not be the basis for the denial of services,” Krawitz said.
Although the Obama administration has not embraced medical marijuana, in a policy shift in October, the Justice Department announced that it would not prosecute people who used or distributed it in states where it was legal.
Advocates of medical marijuana use say that in the past, the patchwork of veterans hospitals and clinics around the country were sometimes unclear how to deal with veterans who needed pain medications and were legally using medical marijuana. The department’s emphasis on keeping patients off illegal drugs and from abusing their medication “gave many practitioners the feeling that they are supposed to police marijuana out of the system,” Krawitz said.
“Many medical-marijuanausing veterans have just abandoned the VA hospital system completely for this reason,” he said.
This month, Dr. Robert A. Petzel, the under secretary for health for the veterans department, sent a letter to Krawitz laying out the department’s policy. If a veteran obtains and uses medical marijuana in accordance with state law, Petzel wrote, he should not be precluded from receiving opioids for pain management at a veterans facility.
Petzel also said that pain management agreements between clinicians and patients, which are used as guidelines for courses of treatment, “should draw a clear distinction between the use of illegal drugs, and legal medical marijuana.”
Steve Fox, director of government relations for the Marijuana Policy Project, which favors the legal regulation of the drug, called the decision historic.
“We now have a branch of the federal government accepting marijuana as a legal medicine,” he said.