According to The New York Times, the last time that Veterans Affairs (VA) explored psychedelics as a medical treatment was in 1963. This was around the same time that the Central Intelligence Agency and U.S. Army was testing LSD as a way to “mind-control” enemies. Many decades later, these four researchers are bridging the gap between veteran mental health and psychedelic-assisted therapy. These studies are being conducted by VA clinicians, and the results could lead the way to more studies in the future.

Dr. Shannon Remick, is conducting a study with 10 veterans in a VA clinic in Loma Linda, California. She became one of the first doctors since the 1960s to be allowed to use psychedelics as a treatment in that clinic, which is overseeing the progress of combat veterans suffering from post-traumatic stress disorder (PTSD). Each volunteer will experience three sessions using MDMA as a way to explore their condition, and begin each session with calming activities (such as breathing exercises or poem readings). Sessions are led by the patient, but assisted through the process with the help of a therapist who mainly listens, rather than directs.

“We are alongside and with the patient as they are exploring a kind of excavation site,” Dr. Remick said. “Ultimately, it’s not for us to point and say, ‘Hey, look at that,’ because what I’m seeing may not be the same from their angle.”

Dr. Rachel Yehuda actually delayed her retirement to dedicate herself to psychedelic-assisted therapy. She sought out permission to help PTSD sufferers with MDMA, and began the study earlier this year in January. Her study is examining the effects of MDMA on PTSD patients, specifically to determine whether two or three sessions are more beneficial overall.

Yehuda herself participated in an MDMA trip in 2019 for therapist training. “It made me really understand what it is you’re supposed to be doing in psychotherapy,” Dr. Yehuda said. “I’ve never quite understood what it means to have a breakthrough.” She also noted the importance of doing such a process with “the right therapists.”

Dr. Leslie Morland has over two decades worth of experience with PTSD therapies, and is also exploring how MDMA could help veterans after they return home from duty—specifically as a way to make couples therapy more successful. Her clinical study is expected to begin at the end of 2022, and will study eight participants and their respective partners in San Diego.

“A lot of our military learn to emotionally disconnect in order to be effective in combat,” Dr. Morland said. “And then we’re bringing them back and saying: Now we need you to open up with our talk therapy.” With the help of MDMA, Morland hopes to see an increase in bonding and empathy in her patients. “How do they work together to really sustain the improvements that have been achieved in therapy?”

Finally, Dr. Christopher Stauffer has previously explored the effectiveness of psilocybin as a way to combat substance abuse. One of his studies will review how psilocybin can assist 30 veterans who are addicted to methamphetamine. Half of them will receive conventional therapy plus two psilocybin therapies, and the other half will only receive conventional therapy.

Another study led by Stauffer will review how MDMA can help group therapy sessions for veterans. “[MDMA is] brand-new to a lot of people and yet it’s been around longer than most of our psychiatric medications have been around,” Dr. Stauffer said. “But it feels like we’re approaching it this time with a lot more knowledge and a lot of more rigorous research practices that didn’t really exist back in the ’50s and ’60s.”

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The Department of Veterans Affairs (VA) published a notice on March 10 on the Federal Register, introducing a new effort to help prevent veteran suicide. The Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program is a three-year program created for “eligible entities to provide or coordinate the provision of suicide prevention services to eligible individuals and their families for the purpose of reducing veteran suicide.”

However, the program the VA specifically states that program benefits will not be provided for medical cannabis, as it is still illegal under federal law. “It is also important for VA to note that any approaches and treatment practices approved will need to be consistent with applicable Federal law,” the article states. “For example, the use of grant funds to provide or coordinate the provision of marijuana to eligible individuals and their families will be prohibited, as marijuana is currently illegal under Federal law.”

Multiple organizations participated in crafting the program, including the Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration and the President’s Roadmap to Empower Veterans and End a National Tragedy of Suicide. These organizations helped shape “various aspects” of the program. In total, the VA notes that it received 124 public comments as well, which provided feedback on eligibility “…such as distribution and selection of grants; administration of the grant program, including development of measures and metrics; training and technical assistance; referrals for care; degrees of risk of suicide and processes for determining degrees of risk of suicide; and nontraditional and innovative approaches and treatment practices that may be appropriate under this grant program.”

Although cannabis fits under the category of “nontraditional and innovative” treatments, its federal illegality makes it off limits to those who want to apply for the program. However, public comments will still be accepted until May 9, although the final rule will begin starting on April 11.

It is not surprising that the VA has limited access to the program for those who seek cannabis as a treatment. Putting the program aside, the VA recently clarified that cannabis use would not cause a veteran to be denied eligibility for VA benefits. “Veteran participation in state marijuana programs does not affect eligibility for VA care and services,” the VA wrote on its website. “VA providers can and do discuss marijuana use with veterans as part of comprehensive care planning, and adjust treatment plans as necessary.”

Despite cannabis treatment not being included in the new grant program, that doesn’t stop the cannabis industry from showing support. The Veterans Cannabis Project, Weed for Warriors Project, the Veterans Cannabis Coalition and the Santa Cruz Veterans Alliance all fight for awareness of veteran suicides and find ways to assist those in need. A variety of cannabis brands also contribute portions of profits or have held events in the past to continually help veterans.

On March 14, the Veterans Action Council (VAC) asked US Attorney General Merrick Garland to remove cannabis as a Schedule I and II controlled substance. “Removing cannabis from schedule 1 & 2 will solve many serious issues facing Americans. Veterans will get cannabis recommendations from their federal government doctors. Medical patients will no longer be kicked out of their federal housing, medical cannabis patients will no longer be kicked off of transplant lists,” the VAC wrote. “Cannabis will be scheduled on par with its own ‘active ingredient’ ending the decades old disparity. Medical cannabis patients will begin to have their second amendment rights respected. Legal cannabis businesses will no longer be punished by the IRS and will begin to be able to make normal business expense deductions and will be able to put their money in banks like they do in civilized societies.”

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On November 4, the House Veterans Affairs Committee passed a bill that would allow the U.S. Department of Veterans Affairs (VA) to study medical cannabis as a treatment option for military veterans.

Sponsored by Representative Lou Correa and Peter Meijer, HR-2916, also called the VA Medicinal Cannabis Research Act of 2021, instructs the VA to study medical cannabis research. “This bill requires the Department of Veterans Affairs (VA) to conduct clinical trials of the effects of medical-grade cannabis on the health outcomes of covered veterans diagnosed with chronic pain and those diagnosed with post-traumatic stress disorder. Covered veterans are those who are enrolled in the VA health care system,” the bill summary reads.

The bill also states that the trials must include both a control group and an experimental group that include a balanced representation of the veteran community (similar size, structure and demographics). Most importantly, any veteran who chooses to participate in these trials would not have to worry about their VA benefits or eligibility.

At the November 4 meeting, Chairman Mark Takano spoke briefly about HR-2916. “Veterans and veteran service organizations have told us that they overwhelmingly support medical cannabis research at VA. So many veterans already use cannabis to ease their suffering. Veterans can purchase medical cannabis in 36 states and recreational cannabis in 19 states,” Takano said.

Takano continued, “We simply must equip VA and its healthcare providers with scientific guidance about the potential impacts, benefits and/or dangers of cannabis use to treat chronic pain and PTSD. Now VA tells us that it is monitoring smaller research projects on cannabis outside VA. This really is not sufficient. The bill directs VA to bring the important methodological rigor with a clinical trial framework to bear on these important questions. We owe our veterans no less.”

Representative Mariannette Miller-Meeks proposed an amendment at the meeting in response. She proposed the replacement of HR-2916 with her own bill, HR-2932, which she calls the Veterans Cannabis Analysis Research and Effectiveness, or Veterans Care Act. Although she acknowledges that her and Correa’s bill share some goals, she believes Correa’s bill is not the ideal way to assist veterans. “…his bill takes an overly prescriptive approach to requiring the VA conduct research on medical marijuana,” she began. “I am sure that it is well-intentioned. However, what that would do is unfairly tie the hands of the VA researchers who are responsible for designing and conducting these studies and undermine their work to such an extent as to render it meaningless.”

“That is why my amendment, in the nature of a substitute, would replace the text of Congressman Correa’s bill, with the text of my bill which would also require VA to conduct research regarding medical marijuana but would also give VA researchers the flexibility to design that research for themselves,” Miller-Meeks continued. “This would help ensure that politics plays no role in the results of this research and that scientists and researchers, not politicians, inform the VA’s work on medicinal marijuana research so that it yields the best and most useful research results for veterans.”

Chairman Mark Takano stated that, “Unfortunately, I cannot support your amendment which would give VA far more leeway in determining how to study the possible use of cannabis and treating pain and PTSD and veterans,” Takano said. “With all due respect, VA could be doing that level of research now and simply has chosen not to. VA’s Office of Research and Development can absolutely handle a clinical trial. It already conducts many of them. And it’s time to bring the scientific weight of that gold standard approach to the issue of cannabis use.”

There was continued discussion on Miller-Meek’s bill by Ranking Member Mike Bost, but ultimately her bill was not agreed to by the committee. The committee did, however, agree to recommend HR-2916 to the House of Representatives for further consideration.

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