Background: For years, the Department of Veteran Affairs (VA) had a policy that prevented VA physicians from recommending medical cannabis to their patients, causing many VA physicians to also deny prescribed pain medication to state-compliant medical cannabis patients under their care. However, in July 2010, after patient advocates had applied years of political pressure, the VA issued a directive clarifying its position on medical cannabis. The VA policy now states that, “patients participating in state medical cannabis programs must not be denied VHA services,” but still prohibits VA physicians from recommending medical cannabis to their patients based on an erroneous assumption that such actions “could result in the Drug Enforcement Administration’s actual or threatened revocation of the physician’s registration to prescribe controlled substances, as well as criminal charges.”

Findings: Believing that the Department was adhering to federal law, the VA spent years denying patients critically needed pain medication unless all cannabis use was terminated. Patients suffering from chronic pain, many of whom had reduced their intake of strong narcotics as a result of their medical cannabis use, were told to choose between two types of medication that worked well for them even though their combined use had not caused any medical problems. Patients who benefit from the use of medical cannabis must still go outside the VA system to obtain recommendations from physicians who are not bound by the VA policy.

Position: Patient advocates applauded the change in VA policy to prevent its physicians from arbitrarily denying much needed pain medication to veterans who are also lawful medical cannabis patients. This policy of recognizing state medical cannabis programs and the potential of cannabis to benefit veterans under VA care places additional pressure on the rest of the federal government to adequately address this important public health issue. Americans for Safe Access is committed to working with groups like Veterans for Medical Marijuana Access to further change VA policy to enable VA physicians to recommend medical cannabis for their patients, an already established constitutional right in the U.S.