Veterans say that has forced many to suffer, while some researchers suggest the VA also may be ignoring potential ill effects when used inappropriately.
“It’s doing wonders, but also there’s so very little we know about what’s going on,” said Dunlap, who lives in Maryland.
The federal government may be resistant not just because research could open the door to cannabis use by veterans — but lead to wider legalization. The lack of empirical, FDA-approved research is one of the most-cited reasons for many lawmakers, even President Joe Biden, to refrain from taking federal action on cannabis.
Rep. Lou Correa (D-Calif.) has introduced a bill that would instruct the VA to study cannabis for PTSD, depression and a number of other diseases vets often suffer from, just one of multiple proposals in the House and Senate that would expand research into cannabis for vets. Despite broad bipartisan support, however, none has reached a floor vote in either chamber.
“The VA keeps saying, ‘We have the authority, we don’t need you to micromanage us.’ But we do — because they’re not doing their job,” Correa said.
Correa’s bill, which advanced out of the House Veterans’ Affairs Committee on Thursday, is just one of multiple proposals in the House and Senate that would expand research into cannabis for vets. Also on Thursday, Sen. Brian Schatz (D-Hawaii) introduced an amendment to a must-pass defense spending bill that would allow VA physicians to recommend medical marijuana under state-regulated programs and bolster research. Despite broad bipartisan support, however, none of these proposals have reached a floor vote in either chamber.
The recent withdrawal from Afghanistan has exacerbated the demand for more understanding of using cannabis for treatment. Calls to the Veterans Crisis Line, which is operated by the VA, increased by six percent in the weeks immediately following the U.S. withdrawal from Afghanistan, and veterans of America’s longest war use cannabis at the highest rates among veterans to self-medicate their ailments.
Advocates, Hill aides and former VA staff told POLITICO the VA defers on this issue to the Justice Department, which classifies cannabis as a Schedule I drug under the Controlled Substances Act. A Schedule I drug by definition has no medicinal value, which in turn prevents the VA from treating patients with cannabis.
For veterans receiving VA health care, cannabis still occupies a gray area. Official guidance states that veterans can talk to their VA doctor about their cannabis use without repercussions, but many vets say they fear mentioning it because it is still federally illegal. VA doctors, meanwhile, still cannot prescribe cannabis or issue medical marijuana cards in any of the 36 states that have legalized medical marijuana.
An average of 18 veterans a day committed suicide in 2018, according to data from the VA. Dunlap says that some medical dispensaries in Maryland, where he lives, give a 22 percent discount to veterans — an homage to the 22 veterans who committed suicide every day in 2012.
According to the VA, a number of studies have indicated that both PTSD and battlefield trauma contribute to a higher rate of suicidal ideation — and exposure to suicide, such as a friend or family member, can in turn contribute to PTSD. Many veterans and their advocates point to anecdotal evidence that cannabis successfully reduces the effects of PTSD — as well as insomnia, which can worsen PTSD symptoms — but there is yet no clinical evidence.
“The very populations who have the greatest need are often the ones who are the most understudied,” said Staci Gruber, director of the Marijuana Investigations for Neuroscientific Discovery program at McLean Hospital and an associate professor of psychiatry at Harvard Medical School.
Officials from the National Institute on Drug Abuse have testified to Congress that there is “substantial evidence” that cannabis has medicinal value for treating chronic pain, and have urged Congress repeatedly to increase research into a myriad of potential positive and adverse effects of cannabis use.
The VA did not respond to POLITICO’s request for comment for this story. It testified before the House VA Committee in October that it is studying synthetic CBD as a treatment for PTSD, when used alongside psychotherapy. The agency also has approved a study on the efficacy of synthetic THC and CBD for neuropathic pain that will begin in 2022.
But scientists say the VA and the DOJ have a history of stonewalling anyone who wants to conduct trials of plant-derived cannabis for therapeutic purposes, even though the agencies regularly approve studies into the drug’s harmful effects.
“They just hear the word ‘cannabis’ and recoil,” said one scientist who spoke to POLITICO but requested their name be withheld in order to not jeopardize ongoing efforts to do research with the VA. “It’s got to be the VA Secretary ordering his staff to do it, and [the] VA Secretary probably won’t do that unless he gets the political cover from Congress.”
Sen. Dan Sullivan (R-Alaska) says his bill would give the VA that cover. This is the second time he’s introduced the bill in Congress — but it has yet to receive a hearing.
“I think sometimes on something controversial, agencies want to make sure they have legal cover,” said Sullivan, who cosponsors the bill with Sen. Jon Tester (D-Mont.). “That’s what we’re trying to provide them.”
A similar bill was approved by the House VA committee last year and garnered more than 100 co-sponsors from both sides of the aisle, but did not receive a floor vote.
“It drives me crazy,” said Rep. Earl Blumenauer (D-Ore.), the unofficial cannabis czar on Capitol Hill, who has worked on numerous pieces of cannabis legislation that would expand medical marijuana research — one of which passed the House last year but did not make it to the president’s desk. “[The VA] could, and they should.”
Gruber received approval from the FDA for a cannabis study in 2014, but says the DEA turned around and denied the study proposal, and it was another three and a half years before she finally received approval. Other scientists say they’ve been told by state VA medical facilities that they could not post FDA-sanctioned flyers calling for volunteers to participate in FDA-approved cannabis studies.
“There’s an awful lot of gaps in the research,” Gruber said.
She said that cannabis can be a panacea for some — helping with sleep, PTSD and more — but it also has the potential to be a problem for others, especially veterans with a family history of certain mental health disorders. It’s a big problem, she said, that America does not have comprehensive scientific data on something its veterans are using so widely.
”Imagine a world where people are using anything at that level without supporting information from an empirically sound source to guide them,” Gruber added.
Without research, lawmakers don’t have hard facts on the pros and cons of cannabis, and that unknown makes them loathe to back policy changes they believe could come back to bite them.
The VA’s legal standing is also a gray area. The agency already conducts research into synthetic cannabinoids, and holds a Schedule I research license — which theoretically gives it the ability to research any Schedule I drug. But a Schedule I drug has “no medical use,” and therein lies the hangup: If the VA researches cannabis for medical purposes, like the NIH proposes, they could run into conflict with the DOJ’s definition of a Schedule I drug.
“I’d probably stay completely the hell away from it [if I was the VA],” Correa said. “Why would you get in the middle of a dogfight?”