FAQ’s

No. VA providers at the current moment cannot officially on the record recommend cannabis usage and cannot prescribe it. This applies to legal states, and even states that may be operating under federal compassionate use laws (also known right to try laws). There is a bill that is expected to be signed by President Joe Biden that has passed both US House and Senate.

This bill may open the law enough that VA providers would be allowed to discuss the benefits and adverse effects of cannabis usage legally with their patients. There is a possibility that this bill would also open the VA up to being able to request doing it’s own studies on cannabis usage.

As well, the VA has not caught up over the last 4 years the federal hemp program has been in place. Despite the legal status of hemp in the US, providers cannot recommend it’s usage as a medical treatment or supplement. You’re outside physician may be able to recommend it, but prescribing it is still yet to be fully tested in a court in Texas or any other state.

Despite not being able to prescribe hemp or other cannabis market items found in dispensaries or over the counter shops under a hemp program, the VA providers can prescribe Epidiolex. Unfortunately the medication is considered non-formulary and the the VA will not dispense the medication to your free of charge under the VA healthcare pharmacy system. Doctors with a capability of writing a prescription in your state can write a physical prescription for the medication. This means that a veteran could have that done and take the script to be filled out in town to pay with cash or their own health insurance.

If a Veteran is on Tricare, they can pick that prescription up free of charge at a Military Treatment Facility (MTF) or they can pay a $38 co-pay to pick up a one-month supply at a retail location. Express Scripts currently does not offer home delivery on the covered 100mg/100ml oral solution.

No. Veterans will not lose disability benefits if they use marijuana. If a veteran participates in a state marijuana program, that does not affect eligibility for VA services and care. This would also include hemp usage in states where the usage has been legalized by the state under the Federal Farm Bill of 2018.

Directly from the VA

• Veterans will not be denied VA benefits because of marijuana use.
• Veterans are encouraged to discuss marijuana use with their VA providers.
• VA health care providers will record marijuana use in the Veteran’s VA medical record in order to have the information available in treatment planning. As with all clinical information, this is part of the confidential medical record and protected under patient privacy and confidentiality laws and regulations.
• VA clinicians may not recommend medical marijuana.
• VA clinicians may only prescribe medications that have been approved by the U.S. Food and Drug Administration (FDA) for medical use. At present most products containing tetrahydrocannabinol (THC), cannabidiol (CBD), or other cannabinoids are not approved for this purpose by the FDA.
• VA clinicians may not complete the paperwork/forms required for Veteran patients to participate in state-approved marijuana programs.
• VA pharmacies may not fill prescriptions for medical marijuana.
• VA will not pay for medical marijuana prescriptions from any source.
• VA scientists may conduct research on marijuana benefits and risks, and potential for abuse, under regulatory approval.
• The use or possession of marijuana is prohibited at all VA medical centers, locations, and grounds. When you are on VA grounds it is federal law that is in force, not the laws of the state.
• Veterans who are VA employees are subject to drug testing under the terms of employment.

When a veteran goes to the VA hospital and/or clinic to see a provider, they will on occasion have routine lab work done such as blood tests or urinalyses, and they may check for drugs. They may be checking for drugs that they have prescribed. Blood tests and urinalyses are usually performed to check for certain conditions and see if there are any abnormalities, not to specifically check for the presence of drugs.

Another reason for a routine blood test and urinalysis is to make sure that a veteran is taking prescribed medications properly. A veteran may be prescribed a medication and that medication may cause side effects that can be detected via blood samples or a urinalysis. An example of urinalysis to check for prescribed drugs includes some mental health medications to include stimulants, or the pain management clinic checking for pain medications. The VA’s current policy states that it is up to each doctor and care provider to decide how to handle a veteran’s marijuana use. A provider can choose to ignore marijuana use if they don’t see a problem.

Yes. The VA can deny access to a medication one of its providers may prescribe in the VA system. A provider can also deny access to medication due to cannabis use.

As mentioned in the previous segment, each doctor has their own choice on how to handle a veteran’s cannabis use, they can deny certain medications.

This means that if they do or claim to see a problem with cannabis use, they most likely would be concerned about a possible interference with using their prescribed medications and marijuana. A veteran would most likely be instructed to choose by using marijuana or prescribed medications. This is strictly a therapeutic decision by the provider. As mentioned above, it should be clear that the VA does not routinely test for illegal drugs.

As well, a provider may be comfortable with both the drug they are willing to prescribe and a veteran’s cannabis usage. But the pharmacist for a VA region may not be okay with that. An example is that in the Central Texas VA Region, the pharmacy guidance to any provider willing to prescribe stimulants to a patient is that they must drug test the veterans after 28 days of usage. If the urinalysis comes back positive for cannabis (THC testing) then the pharmacy will be flagged to not dispense the medication until a clean sample is provided. The pharmacist is allowed to make the call on this and deny a medication option if they feel cannabis is a possible interfering drug.

The VA does not differentiate between legal hemp THC product usage and any legal/illegal marijuana usage.

Yes. But the option may not be available to every veteran due to program restrictions/qualifications of the community care program the VA offers.

Currently, it is understood that the VA doesn’t make the request of drug testing patients seen by community care providers. This would mean that the prescriber may write the script for a formulary prescription that is fillable at the VA and the VA is not likely to deny it. The VA is not currently imposing restrictions and mandates on providers to do drug testing if they are currently a community care provider.

To get into a the community care program some requirements to qualify must be met. From the VA:

• Veteran needs a service not available at a VA medical facility
• Veteran lives in a US State or Territory without a full-service VA Medical facility
• Veteran qualifies under the “Grandfather” provision related to distance eligibility for VCP
• VA cannot provide care within certain designated access standards
• It is in the Veteran’s best medical interest
• A VA Service Line Does Not Meet Certain Quality Standards

A veteran only needs to qualify for one of the six to be eligible.

Another option may be to change regions if a veteran is in a position to do so. An example of this would be that a veteran lives in San Marcos. San Marcos is part of the Central Texas Region and is governed by a hospital in Temple and admin group in Waco, the nearest outpatient clinic is in Austin. It’s a much shorter drive to the hospital in San Antonio which has a completely different take on cannabis than the CenTex region. A veteran can enroll in another region, but it totally upon them to do so and must weigh the pro and cons of doing so.

The answer to this is the same as Will I Lose My Va Disability Benefits if I use Cannabis. The answer is no.

If you are applying for benefits and are using cannabis to treat items, it may be considered part of your disability.