The U.S. Department of Veterans Affairs is looking for contractors to analyze scientific evidence and provide it to the public and clinicians. This includes information about the potential health benefits of medical marijuana for conditions such as PTSD, as well as the potential dangers of cannabis consumption and use during pregnancy.
VA published a notice last week titled “Sources Sought” in which it stated that out of 9 percent of veteran military who have reported cannabis use, approximately 40 percent used the drug to manage or treat symptoms. Veterans have a hard time talking to VA doctors when they try to discuss the use of marijuana.
The notice states that “clinicians will meet patients who use cannabis, or have questions regarding cannabis.” The notice says that discussions about cannabis can be difficult because the evidence on the harms and benefits of cannabis changes rapidly and is constantly growing.
The six-page document states that “currently, there is no independent and comprehensive cannabis evidence resource in the health sector which synthesizes the research findings as well as what remains to be learned.”
The notice on sources wanted is looking for “information concerning the capability and availability of qualified sources to carry out the task, entitled Systematically Test the Evidence of Marijuana” (STEM).
Three main objectives were listed by the department for its STEM project.
-
- In order to help clinicians have a better discussion with their patients about the cannabis benefits and dangers, they should educate themselves on the current evidence and its quality.
- Researchers can design studies with high yields by identifying specific research gaps.
- Resources for the patients and public on cannabis evidence
The contractor will be required to create “living systematic review” over a period of one year on five different topics. These include PTSD, Cannabis use in pregnancy, Cannabis use disorder, treatment for cannabis use disorders, and cannabis as a mood disorder.
“This contract is required to obtain the research and policy staffing services needed to update those reviews and implement best practices for them to be publicly accessible, ‘living systematic reviews,'” the notice explains.
This contractor will also modify the work to “for distribution on the STEM website as well as through other methods (conferences, seminars and journal publication).
A principal investigator from VA would supervise the project. This person has “expertise in the use of evidence-based methods and systematic review reporting,” according to the VA. That person would meet “at least biweekly…to help ensure continued progress and oversee quality assurance.”
Emails must be sent to the VA Contact provided by potential contractors no later than 7 April.
The existing STEM website is a collaborative project between VA and Oregon Health & Science University’s Center for Evidence-Based Policy. This website is funded by the VA Office of Rural Health.
According to the new VA announcement, a quarter (25%) of U.S. Veterans live in rural regions. This means that “a substantial number” of rural Veterans use cannabis. This VA notice also states that many of the reasons given for cannabis usage are relevant to rural Veterans as well as Veterans in general. They include anxiety, insomnia, pain and PTSD.
Separate federally-funded study published this year of veterans found, however, that 40% of veterans with chronic pain used marijuana as a treatment.
Veterans also reported that cannabis helped with PTSD, anxiety, and stress. Nearly 100% of respondents said that health care providers should talk to their patients about natural products.
According to authors at the University of California San Francisco and Yale University, the proportion of respondents that reported using cannabis “may be an underestimate due to VA prohibitions on prescribing cannabis as part of the federal health system”.
Notably, less than half of the respondents reported having discussed their natural product usage with healthcare professionals. The authors noted that, “clinicians, pharmacists and other healthcare professionals are generally unaware of NPs. This may explain why they avoid discussing NPs in their patient’s care.”
In a recent joint hearing, two veteran service organizations expressed their support for increased access to plant medicines including marijuana and psychoactives.
Allison Jaslow said, “At the VA, veterans living in states that have legalized cannabis completely cannot be prescribed medical cannabis by their doctor.”
Jaslow said IAVA is “looking forward” to the reintroduction of a bipartisan bill—the Marijuana Safe Harbor Act—that would temporarily allow veterans to legally possess and use cannabis under federal law, as recommended by doctors in accordance with state law. VA physicians will also have the opportunity to give such recommendations, for the first.
Other cannabis legislation aimed at veterans has been introduced in the 119th Congress. That includes a bill sponsored by Rep. Brian Mast (R-FL), co-chair of the Congressional Cannabis Caucus, whose Veterans Equal Access Act would similarly allow VA doctors to recommend medical marijuana to their patients in states where it’s legal.
Other VSOs also addressed marijuana and psychedelics policy with the bicameral committees at previous hearings last month, urging lawmakers to continue to explore the alternative therapeutic options and expedite access if they’re proven to be efficacious.
Research published in 2023 found that more than 90 percent of U.S. military veterans who use medical marijuana reported that it improved their quality of life, with many using cannabis as an alternative to over-the-counter and prescription medications.
In July of last year, a Senate committee urged the VA to explore medical marijuana as an alternative to opioids for veterans, also asking the agency to consider allowing its doctors to formally recommend cannabis to their patients.
As for marijuana and chronic pain, a recently published scientific review concluded that cannabinoids may be useful treatments for various types of chronic pain, in some cases helping to reduce the use of other medications. In the paper, it was also stated that certain mixtures of cannabinoids may help reduce undesirable effects such as THC’s psychoactivity.
This paper, published in Medical Cannabis and Cannabinoids and written by Penn State College of Medicine researchers, reviewed the “most recent evidence” supporting cannabis’ use in treating chronic pain disorders, including cancer-induced neuropathy pain, chronic musculoskeletal and headaches, and chronic migraines.
Research published earlier this year in the journal Pain also found that marijuana was “comparatively more effective than prescription medications” for treating chronic pain after a three-month period, and that many patients reduced their use of opioid painkillers while using cannabis.
According to the authors of the National Cancer Institute, Harvard Medical School, and University of Pittsburgh report, the analysis was able “to determine using causal inference methods that the use of medical cannabis for chronic pain is at least equally effective, and possibly more effective, in relation to patients who have chronic pain and are treated with prescription medication (nonopioid and opioid).
A separate federally funded study found that legalization of marijuana in U.S. states is associated with reduced prescriptions for opioid pain medications among commercially insured adults—indicating a possible substitution effect where patients are choosing to use cannabis instead of prescription drugs to treat pain.
The authors wrote that “these results indicate that the substitution of marijuana for pain medication increases with increased availability of recreational cannabis.” They noted that “there appears to be a slight shift when recreational cannabis is legalized, but that we see better results after users are able to purchase cannabis from recreational dispensaries.”
Another recent study also found a decrease in opioid fatal overdoses when marijuana for adults was legalized. That study found a “consistent negative relationship” between legalization and fatal overdoses, with more significant effects in states that legalized cannabis earlier in the opioid crisis. The authors estimated that legalizing recreational marijuana “is associated” with a reduction of about 3.5 fatalities per 100,000 people.
Another recently published report into prescription opioid use in Utah following the state’s legalization of medical marijuana found that the availability of legal cannabis both reduced opioid use by patients with chronic pain and helped drive down prescription overdose deaths statewide. The study concluded that cannabis has an important role in the management of pain and reduction of opioid usage.
Yet another study, published in 2023, linked medical marijuana use to lower pain levels and reduced dependence on opioids and other prescription medications. And another, published by the American Medical Association (AMA) last February, found that chronic pain patients who received medical marijuana for longer than a month saw significant reductions in prescribed opioids.
About one in three chronic pain patients reported using cannabis as a treatment option, according to a 2023 AMA-published report. The majority of those in that group reported using cannabis to replace other pain medication, such as opioids.
Other research published that year found that letting people buy CBD legally significantly reduced opioid prescription rates, leading to 6.6 percent to 8.1 percent fewer opioid prescriptions.
A 2022 research paper that analyzed Medicaid data on prescription drugs, meanwhile, found that legalizing marijuana for adult use was associated with “significant reductions” in the use of prescription drugs for the treatment of multiple conditions.
A 2023 report linked state-level medical marijuana legalization to reduced opioid payouts to doctors—another datapoint suggesting that patients use cannabis as an alternative to prescription drugs when given legal access.
Researchers in another study, published last year, looked at opioid prescription and mortality rates in Oregon, finding that nearby access to retail marijuana moderately reduced opioid prescriptions, though they observed no corresponding drop in opioid-related deaths.
Recent research has also shown that cannabis can be an alternative to opioids for pain relief.
A report published recently in the journal BMJ Open, for instance, compared medical marijuana and opioids for chronic non-cancer pain and found that cannabis “may be similarly effective and result in fewer discontinuations than opioids,” potentially offering comparable relief with a lower likelihood of adverse effects.
Separate research published found that more than half (57 percent) of patients with chronic musculoskeletal pain said cannabis was more effective than other analgesic medications, while 40 percent reported reducing their use of other painkillers since they began using marijuana.
In Minnesota, meanwhile, a state government report this year on chronic pain patients enrolled in the state’s medical marijuana program said recently that participants “are finding a noticeable change in pain relief” within a few months of starting cannabis treatment.
In a large-scale, nearly 10,000 patient study, nearly a quarter of patients who previously took painkillers reduced their usage after using medical cannabis.
Another new study on the use of medical marijuana by older patients—age 50 and above—concluded that “cannabis seemed to be a safe and effective treatment” for pain and other conditions.
Trump’s New White House Drug Czar Called Medical Marijuana A ‘Fantastic’ Treatment For Cancer Patients