Late last week, Oregon’s U.S. Senator Jeff Merkley today led a group of senators seeking medical cannabis benefits for veterans in need.
The senators joining Merkley were Senators Kirsten Gillibrand (D-NY), Elizabeth Warren (D-MA), Bernie Sanders (I-VT), John Fetterman (D-PA), Peter Welch (D-VT), Ron Wyden (D-OR), Tina Smith (D-MN), and Jacky Rosen (D-NV).
Together, the senators joined in a letter to U.S. Secretary of Veterans Affairs (VA) Denis McDonough urging the agency to swiftly expand access to medical cannabis treatment options for veterans who live in states that have state-legal medical cannabis programs.
The Senators also called for the agency to produce a VA-approved standard of care for medical cannabis and issue clear guidelines for Veterans Health Administration (VHA) providers regarding the benefits of and potential access to state-legal medical cannabis programs.
“Millions of Americans, including millions of veterans, live in states that have legalized the use of medical cannabis,” wrote the Senators. “[This increases] the likelihood that veterans seeking care through the VHA are considering, or already utilizing, medical cannabis treatments. Yet, given cannabis’ current placement in Schedule I, veterans living in any of these states or territories currently lack parity with their non-veteran counterparts. Veterans must instead seek a new, trusted medical system and provider outside of the VA to have a productive conversation about the benefits of, and potential access to, medical cannabis.”
In May 2024, the U.S. Drug Enforcement Administration (DEA) took historic action and recommended that cannabis be rescheduled from Schedule I — the most restrictive schedule reserved for dangerous drugs without any medical use — to Schedule III — a less restrictive schedule that would recognize the medical benefits of cannabis. This has the potential to open up treatment options for people across the United States, including veterans.
Rescheduling cannabis
“The DEA’s recommendation to reschedule cannabis to Schedule III also has the potential to decrease the prescription and use of more dangerous pain relief methods,” the Senators continued. “Studies have shown that cannabis has significantly fewer addictive properties and is much less likely to result in dependency than other forms of pain relief, such as opioids.”
They concluded, “We strongly urge the VA to recognize the established benefits of medical cannabis and to fulfill its duty to our nation’s heroes by ensuring the best quality of care through VHA. This must include facilitating legal access to medical cannabis for veterans by developing a VA-approved standard of care and issuing clear guidance allowing and preparing VHA providers to discuss, recommend, and assist patients in qualifying for enrollment in state-legal medical cannabis programs following cannabis’ official rescheduling. Our nation’s heroes deserve access to all federally-legal treatment options to meet their healthcare needs.”
Merkley has been a fierce, longtime leader advocating for sensible cannabis reforms. Merkley is the lead sponsor of the SAFER Banking Act and was also the author of its predecessor, the SAFE Banking Act, to ensure legal cannabis businesses are able to access banking and financial services. Previously, Merkley joined colleagues from the House and Senate in signing a letter urging Attorney General Merrick Garland and DEA Administrator Anne Milgram to remove cannabis’ Schedule I status. And in January, Merkley joined Senate colleagues in signing a letter urging the DEA to remove cannabis from the Controlled Substances Act. Additionally, Merkley is a cosponsor of the Cannabis Administration and Opportunity Act to decriminalize cannabis and empower states to create their own cannabis laws.
Full text of the letter
Dear Secretary McDonough,
On May 21, 2024, the Drug Enforcement Administration (DEA) made the historic and science-based decision to recommend the rescheduling of cannabis. Once complete, cannabis would move from a Schedule I to a Schedule III substance under the Controlled Substances Act (CSA), recognizing the medical benefits of cannabis. In response, we urge the Department of Veterans’ Affairs (VA) to expeditiously produce a VA-approved standard of care for medical cannabis. We also strongly recommend issuing clear guidance allowing and preparing Veterans Health Administration (VHA) providers to discuss, recommend, and assist patients in qualifying for enrollment in state-legal medical cannabis programs following cannabis’ official rescheduling.
Millions of Americans, including millions of veterans, live in states that have legalized the use of medical cannabis. As of 2023, 39 states, plus the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands, and the U.S. Virgin Islands, have legalized cannabis for medical use. This shift increases the likelihood that veterans seeking care through the VHA are considering, or already utilizing, medical cannabis treatments. Yet, given cannabis’ current placement in Schedule I, veterans living in any of these states or territories currently lack parity with their non-veteran counterparts. Veterans must instead seek a new, trusted medical system and provider outside of the VA to have a productive conversation about the benefits of, and potential access to, medical cannabis.
The DEA’s recommendation to reschedule cannabis to Schedule III also has the potential to decrease the prescription and use of more dangerous pain relief methods. Studies have shown that cannabis has significantly fewer addictive properties and is much less likely to result in dependency than other forms of pain relief, such as opioids. Tragically, a 2011 VA study found that veterans were twice as likely as the rest of the population to die from an opioid overdose.
Since the release of this study, almost every VA facility has experienced a 41 percent decline in its opioid prescription rates. However, the decline in opioid prescription rates has not seen a corresponding decline in veteran overdose or suicide rates, with veteran overdose mortality rates increasing by 53 percent from 2010 to 2019. As you know, the wounds of war are not always visible. Leaving our nation’s heroes without access to effective pain management methods is unconscionable. The Institute of Medicine found that, “Scientific data indicate the potential therapeutic value of cannabinoid drugs, primarily THC, for pain relief, control of nausea and vomiting, and appetite stimulation.” The demonstrated medical benefits of cannabis are especially relevant for countless veterans who experience chronic pain and struggle with post-traumatic stress disorder.
Congress tasked the VA with providing the best quality health options for our veterans and the Department has repeatedly affirmed that suicide prevention is its top clinical priority. To fulfill these obligations, VHA providers must be able to discuss the full range of legal treatment options with their VA patients. This requires the VA to commit to robust research to analyze, integrate, and coordinate cannabis care, to develop a VA-approved standard of care. This is essential to adequately prepare VHA providers to discuss, recommend, and assist patients in qualifying for enrollment in state-legal medical cannabis programs.
This standard of care must, at a minimum, include sufficient education for VHA providers on the endocannabinoid system and the benefits and risks of medical cannabis use. This includes their existing rights as state-licensed physicians under Section 301 of the Medical Marijuana and Cannabidiol Research Act of 2022 to discuss medical cannabis as a treatment without risk of violating the CSA. It must also include state-specific instructions for enrolling patients in state-legal medical cannabis programs. Updates to the VHA’s electronic medical record system to include a code for “medical cannabis use” separate from the only current cannabis code, “cannabis use disorder,” are also essential.
The DEA’s recommendation to reschedule cannabis is based on consensus with the Department of Health and Human Services and the Food and Drug Administration that cannabis has accepted medical use in treatment. This finding, in addition to the rights already granted to state-licensed physicians under the Medical Marijuana and Cannabidiol Research Act of 2022, enable VHA providers in states with state-legal medical cannabis programs to discuss, recommend, and assist patients in qualifying for enrollment in state-legal medical cannabis programs, once a patient and their provider agree that medical cannabis is a suitable treatment option.
We strongly urge the VA to recognize the established benefits of medical cannabis and to fulfill its duty to our nation’s heroes by ensuring the best quality of care through VHA. This must include facilitating legal access to medical cannabis for veterans by developing a VA-approved standard of care and issuing clear guidance allowing and preparing VHA providers to discuss, recommend, and assist patients in qualifying for enrollment in state-legal medical cannabis programs following cannabis’ official rescheduling. Our nation’s heroes deserve access to all federally-legal treatment options to meet their healthcare needs.
MERKLEY’S TIBETAN SELF-DETERMINATION SUPPORT BILL, NOW LAW
Earlier in the week, Merkley announced his bipartisan bill—the Promoting a Resolution to the Tibet-China Dispute Act—has been signed into law. Merkey’s bill, which he co-authored with Indiana’s U.S. Senator Todd Young, supports Tibetan self-determination and promotes dialogue between the People’s Republic of China (PRC) and the Dalai Lama toward a peaceful resolution of the long-standing dispute between Tibet and China.
“The people of Tibet have an inalienable right to self-determination. As the Chinese government continues to ignore the rights of Tibet under international law, my bill sends a powerful, bipartisan message: we must protect basic human rights,” said Merkley, co-chair of the Congressional-Executive Commission on China. “Now that this bill has been signed into law, the United States has made it unmistakably clear that we stand with Tibet. I look forward to the Biden Administration’s prompt implementation.”
The Promoting a Resolution to the Tibet-China Dispute Act states that it is U.S. policy that the dispute between Tibet and China remains unresolved in accordance with international law. The legislation also:
- Empowers the Special Coordinator for Tibet to actively and directly counter disinformation about Tibet from the Chinese government and Communist Party, including working to ensure that U.S. government statements and documents counter disinformation about Tibet.
- Rejects as “inaccurate” China’s false claims that Tibet has been part of China since “ancient times.”
- Promotes substantive dialogue without preconditions between the Chinese government and the Dalai Lama or his representatives or the democratically elected leaders of the Tibetan community. The U.S. could also explore activities to improve prospects for dialogue leading to a negotiated agreement on Tibet.
- Affirms the State Department’s responsibility to coordinate with other governments in multilateral efforts toward the goal of a negotiated agreement on Tibet.
- Encourages China’s government to address the aspirations of the Tibetan people regarding their distinct historical, cultural, religious, and linguistic identity.
The Promoting a Resolution to the Tibet-China Dispute Act passed the Senate unanimously and passed the House with a bipartisan vote of 391-26. The bill was cosponsored by Senate Foreign Relations Committee Chairman Ben Cardin (D-MD) and U.S. Senators Richard Blumenthal (D-CT), Mike Braun (R-IN), Christopher Coons (D-DE), Mitt Romney (R-UT), Tina Smith (D-MN), Tim Kaine (D-VA), Jim Risch (R-ID), Mike Crapo (R-ID), Chris Van Hollen (D-MD), Laphonza Butler (D-CA), Peter Welch (D-VT), Marco Rubio (R-FL), and Bob Casey (D-PA). The House version of the bill was led by U.S. Representative Jim McGovern (D-MA-02)—Ranking Member of the House Rules Committee and of the Congressional-Executive Commission on China—and House Foreign Affairs Committee Chairman Michael McCaul (R-TX-10).
Do you have a story for The Advocate? Email editor@corvallisadvocate.com