THE USE OF marijuana or cannabis for the treatment of multiple medical conditions was legalized in New Hampshire in 2013. It took several years before rules and dispensaries were functioning but the legislation has been considered a success.
As of this time 33 states and the District of Columbia have passed legislation allowing for the therapeutic use of marijuana. Although each state has differing rules and regulations, in general a physician must prescribe the medication for a specific accepted condition and it is dispensed under strict state guidelines.
In New Hampshire, as in all other states, therapeutic marijuana cannot be prescribed by physicians in the Veterans Administration system.
The Food and Drug Administration (FDA) classifies marijuana as a Schedule I Drug under the Controlled Substance Act of 1970. This legislation defines a Schedule I Drug as a drug having a high potential for abuse, no currently accepted medical use, and lacking accepted safety for use under medical supervision. Efforts over the years to modify the classification in the Congress have failed.
Because of the current Schedule I Drug classification veterans cannot obtain this treatment in the Veterans Administration system in New Hampshire or in any state in the United States even if state legislatures have passed legislation allowing for its use. This creates barriers to appropriate medical care for veterans in New Hampshire.
VA physicians cannot legally discuss the potential treatment or use of therapeutic marijuana in patients who may have conditions that would benefit from this type of treatment regimen. Additionally, veterans who are aware that their condition may respond to medical marijuana treatment, are forced to find a second physician outside the VA system that will prescribe therapeutic marijuana and obtain it from a state dispensary.
The end result is that veterans may either not receive comprehensive appropriate care or have disjointed care because they need to have multiple physicians in and outside the VA system.
The fact that marijuana is classified as a Schedule 1 Drug has an impact on research on the effectiveness of marijuana for therapeutic use in any conditions. All research projects must be approved by the Drug Enforcement Agency (DEA). It requires an individual who wishes to conduct research on substances listed in Schedule I to register with the DEA. Applicants must provide information about their qualifications, research protocol, and institution where the research will take place.
Large scale scientific studies are much more difficult to do and fund as there is no commercial market for the drug.
Since 1970 there have been attempts using small research projects to prove the effectiveness and usefulness of marijuana for multiple medical conditions. The results of these studies suggest that it is a safe, effective treatment for certain medical conditions in some patients, that it can be used safely under medical supervision, and that for most patients there is little abuse potential.
This information was the basis for the legislation that legalized therapeutic marijuana in states throughout the country.
It is apparent that the current classification of marijuana by the Food and Drug Administration as a Schedule I Drug is inappropriate.
It would seem that marijuana should be reclassified by the FDA so that it is legal to prescribe for appropriate conditions as regulated by states and federal health facilities.
The state DHHS Division of Public Health Services Therapeutic Cannabis Program 2018 Data Report reveals that there were 6,480 qualifying patients receiving therapeutic marijuana. There were 22 types of medical conditions being treated. The most common conditions treated were severe pain not responsive to other treatments, chronic pain, spinal injuries, cancer and severe post-traumatic stress disorder.
It is probable that there are veterans included in this group who have had to go outside the Veterans Administration system to obtain their treatment.
Two U.S. senators, Bill Nelson (D-Fla.) and Brian Schatz (D-Hawaii), introduced legislation in Congress in 2018, the Veterans Medical Marijuana Safe Harbor Act, that among other legislative requirements would allow for VA physicians to discuss and prescribe therapeutic marijuana in those states that have made it legal. The legislation was sent to the Judiciary Committee where no hearings or votes have been taken. It is unlikely to pass in this session of Congress.
This issue is not a Democratic or Republican issue. We should be making life easier for veterans, not placing barriers in their way when they try to obtain proper health care.
One would hope that Congress will reintroduce this legislation and vote in 2019 to make therapeutic marijuana available to our veterans through the VA system in those states where it has been made legal.
When that is accomplished they will be able to receive effective comprehensive care in New Hampshire and across the country.