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A congressional committee is scheduled to vote on a bill on Thursday that would require the U.S. Department of Veterans Affairs (VA) to conduct clinical trials into the therapeutic potential of marijuana for military veterans.

The House Veterans’ Affairs Committee will hold a markup of the legislation from Rep. Lou Correa (D-CA). His bill, the VA Medicinal Cannabis Research Act, would mandate that the department launch a series of studies on using medical marijuana to treat PTSD and chronic pain. Earlier versions of the measure cleared the panel in 2020 and 2018 but were not enacted into law.

The new action this week comes a month after a subcommittee held a hearing on the proposal, with the Biden administration expressing opposition to the reform.

Correa said at the time that his bill is “a pragmatic and bipartisan piece of legislation that would advance our understanding of the impacts of medicinal cannabis usage and could improve the lives of veterans and other Americans.”

But a VA representative pushed back on the proposal, saying any clinical trials involving human subjects that carries potential risks must use the “smallest number of participants needed to avoid unnecessarily putting subjects at risk.”

With respect to marijuana, some effects “are not known,” VA’s David Carroll said, “thus a circumscribed approach to determine dose, administration modality and best outcome measure must be shown in a proof-of-concept approach to ensure the validity of the research.”

Additionally, Carroll argued that certain requirements stipulated in the bill such as studying seven different cannabis varieties are “not consistent with the current state of scientific evidence, which suggests that smaller, early phase, controlled clinical trials with a focused set of specific aims are optimal to determine proof of concept for using cannabis to treat specific conditions.”

VA is “already dedicating resources and research expertise to study the effects of cannabis on conditions affecting veterans,” Carroll said in the subcommittee hearing—though advocates and key lawmakers don’t view those ongoing studies as sufficient.

The department’s response to the bill is consistent with its past testimony—but it still comes as a disappointment to advocates who had hoped VA under Biden would ultimately embrace the modest reform.

Hopes were raised even higher after the bill sponsor, Correa, recently informed a separate House panel that he’d had a conversation with VA Secretary Denis McDonough about the issue of marijuana and veterans. Groups that represent military veterans, meanwhile, have backed the legislation.

The bill says the VA secretary “shall carry out a series of clinical trials on the effects of medical-grade cannabis on the health outcomes of covered veterans diagnosed with chronic pain and covered veterans diagnosed with post-traumatic stress disorder.”

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It lists both “required elements” of the trials and “optional elements.” When it comes to the chronic pain trials, the agency would have to look at the impact of marijuana consumption on osteopathic pain, opioid use and dosage, benzodiazepine use and dosage, alcohol use, inflammation, sleep quality, agitation and quality of life.

For the PTSD-specific studies, VA would examine the extent to which cannabis affects basic symptoms of the condition, the use and dosage of benzodiazepines, alcohol use, mood, anxiety, social functioning, agitation, suicidal ideation and sleep quality.

Optionally, the clinical trials “may include an evaluation of the effects of the use of cannabis to treat chronic pain and post-traumatic stress disorder on” pulmonary function, cardiovascular events, various forms of cancer, intestinal inflammation, motor vehicle accidents, mania, psychosis, cannabinoid hypermesis syndrome, neuropathy or spasticity.

The bill further details specific methodological standards of the clinical trials that would be required. It would, for example, mandate that researchers use “not fewer than seven unique plant cultivars” with specific ratios of THC and CBD, and says the trials will involve “whole plant raw material and extracts.”

In addition to his standalone bill, Correa has separately proposed requiring VA cannabis studies as an amendment to a defense spending bill that passed the House in September. But he withdrew it prior to a House Rules Committee hearing.

A Senate committee in June held a hearing on a bill to similarly require the department to conduct clinical trials into the therapeutic potential of marijuana for military veterans with PTSD and chronic pain—but a VA representative said that the Biden administration is opposed to the reform. The Senate panel has not yet voted on its version of the legislation.

During the last Congress, in 2019, the VA under President Donald Trump came out against a series of bills that were designed to protect benefits for veterans who use marijuana, allow the department’s doctors to recommend medical cannabis and expand research into the plant’s therapeutic potential.

In 2018, the House Veterans’ Affairs Committee was the first congressional panel to approve a marijuana reform bill by passing an earlier version of legislation to encourage VA to conduct research on the medical benefits of cannabis.

Despite VA’s stated opposition to a variety of marijuana reform proposals in the past, an official with the department did say recently that it is “very closely” following research into the potential therapeutic benefits of psychedelics like MDMA for military veterans.

Earlier this year, a bipartisan coalition of congressional lawmakers reintroduced bills that would federally legalize medical cannabis for military veterans.

Rep. Greg Steube (R-FL) in January introduced a proposal aimed at ensuring that military veterans aren’t penalized for using medical cannabis in compliance with state law. It would also codify that VA doctors are allowed to discuss the risks and benefits of marijuana with their patients.

VA doctors are currently permitted to discuss cannabis with patients and document their usage in medical records, and those veteran patients are already shielded by agency policy from losing their benefits for marijuana use—but the bill would enshrine those policies into federal statute so they could not be administratively changed in the future.

A U.S. military veteran who was deported to Jamaica over a marijuana conviction was recently allowed to return to the country following a concerted push for relief by members of Congress.

Sens. Alex Padilla (D-CA), Tim Kaine (D-VA) and Mark Warner (D-VA) sent a letter to the head of the U.S. Department of Homeland Security (DHS) in July requesting that he reopen the case.

Thirty members of the Congressional Black Caucus separately urged the Biden administration to reopen certain deportation cases, including those involving cannabis such as Bailey’s.

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Photo courtesy of Mike Latimer.