Since adult-use cannabis passed in Missouri in 2022, the state recently divided $15 million in adult-use sales revenue to fund support services for military veterans and substance abuse treatment programs, as well as the Missouri Public Defenders budget. That amount is projected to increase to $19 million by the time the fiscal year ends on July 1.

Division of Cannabis Regulation (DCR) director Amy Moore recently said that she was pleased with the fund accumulation so far. “It is so rewarding to see the impact of this voter-approved program on organizations that provide vital services to Missourians. We look forward to watching this impact grow and are grateful to be a part of it.” Moore said.

The collection of medical and adult-use cannabis revenue in Missouri differs slightly once operational costs have been paid. The constitutional amendment that legalized medical cannabis five years ago goes directly to the MVC, whereas adult-use cannabis revenue must first pay out any fees relating to cannabis offense expungement, and the leftover amounts are divided up among the three beneficiaries.

These three groups include the Missouri Veterans Commission (MVC), Missouri State Public Defender, and the Missouri Department of Health and Senior Services (DHSS). The MVC is described as a health care and “other services” group that serves both veterans as well as their families, while the Public Defender is a legal option for low-income Missourians. The DHSS’s goal is “to operate a grant program for subrecipients to increase access to evidence-based, low-barrier drug addiction treatment prioritizing medically proven treatment and overdose prevention and reversal methods and public or private treatment options with an emphasis on reintegrating recipients into their local communities, to support overdose prevention education, and to support job placement, housing, and counseling for those with substance use disorders.” This includes maintenance of veterans’ homes and various cemeteries. 

The most recent transfer to these groups on May 17 included a total of $15,229,302 split three ways, with each beneficiary receiving $5,076,434.

In January 2024, Moore gave a presentation in front of the House Veterans Committee showing that the MVC will receive a total of $19 million from cannabis sales revenue by the time that the fiscal year ends on July 1. Furthermore, Moore estimated that next year that amount will increase to approximately $22 million. “The governor’s recommendation is quite a bit more than expected and that is tied to the unexpectedly robust sales, mostly on the adult-use side,” Moore said. 

At the time, Moore’s data showed that Missouri had collected $98,873,147 in medical cannabis revenue ($41,406,336 of which went to DCR operating expenses and $39,978,820 to veterans). The state had also collected a total of $57,743,824 in adult-use revenue so far (split between $8,152,210 for DCR operating expenses, in addition to the three sets of beneficiaries receiving $1,278,973).

The MVC has received a grand total of $39,978,820 in medical cannabis sales revenue funds since the transfer began in September 2020. During that first year, the MVC received $2,135,510, followed by $6,843,310 in September 2021, $5 million in May 2022, $13 million in September 2022, and finally $13 million in October 2023.

Rep. Dave Griffith, who is also the veterans chair committee, commented on the success of legalization so far. “The amount of sales that they’ve had with commercial marijuana has been just record-breaking and exceeded all expectations and projections,” Griffith said. “Because of that, there’s going to be even more money into that pool than what they projected right after [Amendment 3] passed.” Griffith also commented that his goal is to increase the amount of funds given to the MVC to $50 million annually, citing the need for more money to better serve veterans services. “Many of them, they’re so overburdened with their caseloads that it’s hard to get in with them,” said Griffith. “If we can increase the number we have, we can start trying to cut down on that wait time many veterans have.”

During the most recent round of funds transferred, Moore released a statement in October 2023 about the positive growth coming from the adult-use cannabis market. “It is incredible that Missouri voters passed the adult use amendment less than one year ago, and we are now starting to see the financial impact the program’s success will have on multiple organizations and the Missourians they serve,” Moore said.

At the time, MVC executive director Paul Kirchoff also provided a statement about the benefits of the program. “These funds will help MVC continue to support the existing infrastructure of our seven Veterans Homes,” said Kirchoff.

While legal cannabis continues to serve Missouri, the topic of psilocybin continues to evolve. In March, the Missouri House Veterans Committee recently passed a psilocybin legalization bill (Senate Bill 768) which if passed would allow veterans to use psilocybin therapy. 

In April, the Missouri House of Representatives approved a budget bill that sets aside $10 million in psilocybin research grants, which would come from the state opioid settlement funds. The research studies would study how psilocybin affects people with opioid abuse disorder.

Originally this also included the research of ibogaine for treating the disorder but was changed to focus on psilocybin instead. According to Rep. Cody Smith who introduced that budget bill, the switch from ibogaine to psilocybin was due to a discussion he had with the Department of Mental Health the week prior. “They had concerns about the ibogaine research they had read, and there are concerns about the dangers involved in that research,” said Smith. “However, they are interested in the psilocybin piece. And we’ve seen many other states use their opioid settlement funds to that end.”

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The American Nurses Association (ANA) announced last week that it now formally recognizes cannabis nursing as a specialty practice. The professional association, which represents the interests of the more than 5 million nurses in the nation, also noted that cannabis nursing is identified by the American Cannabis Nurses Association (ACNA) as a specialty nursing practice focused on the health care of consumers seeking education and guidance in the therapeutic use of cannabis.

“ANA is pleased to officially recognize cannabis nursing practice as a nursing specialty,” ANA President Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN said in a September 27 statement from the organization. “This recognition highlights the essential role and special contribution of cannabis nurses to the health care system and promotes enhanced integration of cannabis therapies for health care consumers across diverse health care settings.”

Cannabis Nursing’s Mission

The mission of the ACNA is to advance the field of cannabis nursing through advocacy, collaboration, education, research and policy development. The professional association, which was first formally registered as a nonprofit organization in 2010, also works to contribute to the broader areas of nursing practice and patient care.

“We are deeply gratified by the groundbreaking establishment of cannabis nursing as an ANA-recognized nursing specialty. Nurses are the largest group of health professionals, providing an opportunity to change the health care paradigm and include diverse wellness modalities beyond traditional Western medicine,” said ACNA President Rachel Parmelee MSN, RN, CNE, AHN-BC. “Cannabis nursing requires specialized knowledge and competencies to navigate care and address the stigma associated with medical cannabis use to support a healthy society. We seek to create lasting, transformative change that enriches both specialized and general nursing practices, ultimately serving the well-being of patients nationwide.”

The ANA has supported providing safe access to therapeutic marijuana and related cannabinoids for over 20 years. The association is the sole reviewing body of specialty nursing scope of practice and standards of practice, requests for specialty recognition, and affirmation of focused practice competencies. In 2021, the ANA issued an official policy statement affirming that cannabis and cannabis derivatives are used to alleviate disease symptoms and side effects. The position statement called for a scientific review of marijuana’s status as a Schedule I drug under the Controlled Substances Act and suggested that cannabis instead be listed as a Schedule II drug, which would facilitate research into the medical benefits of cannabis.

The ANA’s policy statement also called for the development of prescribing standards including “indications for use, specific dose, route, expected effect and possible side effects, as well as indications for stopping a medication” and evidenced-based standards for the medical use of cannabis and cannabinoids. Additionally, the position statement called for legal protection from criminal or civil penalties for patients who use cannabis and cannabinoids medicinally. Similarly, the statement called for protection from prosecution or civil penalties, as well as freedom from professional sanctions such as the loss of licensing or credentials for healthcare practitioners who discuss treatment alternatives concerning marijuana or who prescribe, dispense or administer marijuana in accordance with professional standards and state laws.

The ANA announcement comes as the benefits of cannabis become more well known among patients and more professionals gain knowledge of the subject. In September, Gonzaga University in Spokane, Washington began offering two cannabis certificate programs including one focusing on cannabis and health care.

“The reason we went into this is because there is an educational gap. We see ourselves as an institution that is here to provide education,” Rachelle Strawther, director of Gonzaga’s Center for Lifelong Learning told the Inlander. “We’re trying to help reduce the stigma surrounding cannabis because people need to have good information to make decisions for themselves.”

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Maryland Governor Wes Moore signed six new bills into law on Wednesday, CBS News reports. The bills, in a win for social liberals across the state and country, collectively cover protections for gender-affirming health care, abortion, and cannabis reform. Let’s start by reviewing the cannabis legislation. 

Back in November, Maryland voters approved an amendment to the state’s constitution to allow adults 21 and older to possess up to 1.5 ounces of cannabis legally. 67% of adults voted in favor of the bill, which creates the licensing and tax rates. The tax rate for adult use in Maryland will be 9%.

Legalization is always wonderful, considering it means fewer people in prison. However, looking at mass legal cannabis exoduses from other states such as California, thanks to the red tape, expenses, and hurdles of setting up legally, such bills also admittingly make one think that sometimes the industry legal cannabis helps the most is the black market. 

Recreational cannabis sets up shop in Maryland starting on July 1. The existing medical cannabis dispensaries will receive dual licenses to enter the adult-use market. In addition, in an effort to make amends for the racist casualties of the War on Drugs, priority for additional recreational licenses will be given to minority business owners in communities that have been negatively affected by past marijuana laws. As data from the ACLU shows, despite equal usage rates, Black people are 3.73 times more likely than whites to be arrested for marijuana. “This will ensure the rollout of recreational cannabis in our state drives opportunity in an equitable way,” Gov. Moore said. “The criminalization of marijuana harmed low-income communities and communities of color in a profound way. We want to make sure the legalization of marijuana lifts those communities now in a profound way.”

Earlier this week, Gov. Moore shut down concerns about his conflicts of interest. He had roughly $1.2 million of stock in a cannabis company, which was transferred into a blind trust managed by Brown Investment Advisory & Trust Company and approved by The State Ethics Commission last week.

Regarding the other bills signed into effect, two measures intend to expand access to affordable health insurance. One will automatically enroll folks into Medicaid who are eligible but not yet signed up in an effort to reduce paperwork and give insurance to an estimated 65,000 uninsured Marylanders. Another bill includes a package of mental health care that aims to get folks help before their mental health concerns become an emergency, such as setting up a suicide and crisis prevention hotline. 

Regarding abortion, in light of Roe v. Wade being overturned, one Maryland bill aims to protect patients and providers from criminal, civil, and administrative penalties relating to abortion bans or restrictions in other states, CBS reports. Another is a data-privacy bill that protects medical and insurance records in electronic health information sharing. Additionally, Gov. Moore signed a bill to ensure that Maryland’s public colleges and universities have a viable plan to give students easy access to emergency contraception and medical abortion (abortion pills). 

Because of restrictive abortion laws in other states, Maryland is becoming a “safe haven state” where people travel to obtain reproductive care unavailable in their hometown. 

And as for gender-affirming health care, one of the six bills regards The Trans Health Equity Act and expands on how many gender-affirming procedures will be covered by Maryland’s Medicaid program. Under the legislation, which goes into effect on January 1, Medicaid will cover additional gender-affirming treatments.

All of the six bills, from cannabis to gender-affirming health care, tie together in a cohesive wellness package. For example, research shows that access to gender-affirming care reduces suicide rates, so ideally, all six bills will make Maryland a safer and healthier place for its residents. 

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Two House lawmakers on Thursday refiled bipartisan legislation to provide military veterans access to medical marijuana. The bill, the Veterans Equal Access Act, was reintroduced in the House by Representative Earl Blumenauer, a Democrat from Oregon, and Florida Republican Representative Brian Mast, who lost both legs while serving in the Army in Afghanistan.

“I woke up in a situation where I was probably on 20 different narcotics of various kinds. I was, I had Dilaudid drip, I had oral morphines and [oxycodones] and an epidural,” Mast told Spectrum News. “I had anti-inflammatories, heavy sleep sedatives, antidepressant stuff that I never been on or even thought about, or you could even say the names of before in my life.”

If passed by Congress and signed into law by the president, the Veterans Equal Access Act would permit doctors at the U.S. Department of Veterans Affairs (VA) healthcare facilities to issue recommendations for state-legal medical cannabis. Under current regulations, VA doctors are not allowed to complete the paperwork necessary for military veterans to use medical marijuana in states that have legalized the medicinal use of cannabis. 

“We lose almost two dozen veterans a day taking their own life,” said Blumenauer. “We’ve seen a situation where, sadly, the VA, which is not on board, [with] giving access to medical marijuana, was handing out opioids like Tic Tacs. I think there’s some changes that are taking place. I’ve had conversations with the Secretary of Veterans Affairs, but this is a long overdue step.”

The Veterans Equal Access Act has been introduced in Congress with bipartisan support several times over recent years, and the legislation has gained approval at the committee level. But so far, backers of the bill have been unable to get the measure passed. 

“Today was a monumental day for our veterans. We have been working for years to reform this counterproductive policy that forces veterans outside of the VA to receive legal medical cannabis treatment for chronic pain and PTSD,” Blumenauer said when the bill was approved by the House Veterans Affairs Committee in March 2020. “This is the culmination of the tremendous work of our movement, but we will not be finished until this becomes the law of the land. We must reform our federal cannabis policy.”

Bill Has Broad Bipartisan Support

Blumenauer said that the VA does not support the legislation to give veterans access to medical cannabis. But veterans groups including AMVETS and Veterans of Foreign Wars (VFW) are backing the bill.

“Some veterans across the country are hesitant to even use VA health care because they’re concerned about having to discuss the cannabis products they’re legally putting in their bodies with VA doctors,” said Brittany Dymond, an associate director with the VFW.

The Veterans Equal Access Act is also supported by cannabis policy reform groups including the National Organization for the Reform of Marijuana Laws (NORML) and the Drug Policy Alliance, as well as representatives of the regulated cannabis industry. Saphira Galoob, the executive director of the National Cannabis Roundtable, said that the bill will open up new treatment options to veterans in states that have legalized medical marijuana.

“It is unconscionable to deny our veterans equal access to the full array of medical treatments and options that all other adults in the 37 states with medical cannabis programs have available,” Galoob said in a statement from the cannabis industry trade group. “VA doctors must be allowed to discuss medical cannabis and provide recommendations on state-legal programs to the veterans they serve, and we thank Congressman Blumenauer and Congressman Mast for their dedication to moving this important measure forward in the 118th Congress. NCR was honored to be present for today’s announcement, and to support this much-needed, bipartisan bill.”

The Veterans Equal Access Act was referred to the House Committee on Veterans Affairs, where it awaits further consideration. The full text of the bill is available online.

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