Veterans Affairs Canada is amongst the first government entities in the world to offer coverage for medical marijuana. Being a pioneer in recognizing the plant as an alternative medicine, veterans have turned to marijuana when dealing with PTSD or in order to avoid taking harmful drugs like opioids for pain. VAC covers up to nearly $10,000/year.
History of VAC and Medical Cannabis
Through extensive research, medical cannabis has been identified as a possible remedy for various ailments, especially those affecting veterans and servicemen of the Armed Forces.
Some of these ailments include mental illnesses, such as, post-traumatic stress disorder (PTSD) and traumatic brain injury, neurological problems, such as muscle sclerosis, as well as the treatment of chronic pain and inflammation, which is associated with the use of prosthetic limbs.
According to various clinical trials, cannabis can serve as an option in limited circumstances, for instance, after standard interventions are contraindicated or have been tried and been unsuccessful or shown unacceptable adverse effects.
Following these findings, the VAC introduced the Veterans Reimbursement Program in 2007, as a means that registered veterans could access medical cannabis as a way to help in the treatment or management of their pre-existing conditions.
VAC Medical Cannabis Coverage Policy
The VAC reimbursement policy on cannabis for medical purposes was implemented in 2007, and the body has been reimbursing veterans the cost of medical cannabis since 2008. Anecdotal information was provided by Veterans and their advocates on the relief offered to them by the use of cannabis.
This information, in conjunction with sound clinical practice, available scientific evidence, and the primary concern of the health and well-being of veterans, influenced the decision to implement the VAC reimbursement policy.
According to the policy, the average daily dosage was set to 10 grams. Since then, the total cost of reimbursement has risen from $19,088 in the 2008-2009 financial year to $31 million in 2016. This significant rise in the cost of medical cannabis can be attributed to;-
- Increased access to medical marijuana following the implementation of Marihuana for Medical Purposes Regulations passed in 2008. In 2014 and again in 2016, Health Canada’s regulations were changed to allow veterans and the public greater access to medical cannabis
- More physicians and healthcare practitioners are prescribing medical cannabis for health purposes
- The price per gram of marijuana varied depending on the product being purchased, as well as the licensed producer
Need for caution
The VAC has acknowledged that there is a need for further research on the effectiveness of cannabis as an illness treatment and management option, with a specific call on randomized clinical trials.
In the summer of 2016, the Canadian Centre on Substance Abuse published reports on the medical use of cannabis and cannabinoids, and their effect on cognitive function and mental health.
The findings adopted a cautious view in their stance on the use of cannabis, stating that “there is insufficient evidence to promote cannabis and cannabinoids as first-line solutions to these symptoms”.
VAC Coverage Policy Changes for Medical Marijuana
In May 2017, the VAC announced an amendment to the reimbursement policy on cannabis for medicinal purposes. This was done as a measure to limit the use of medical cannabis until sufficient research in the field can produce conclusive answers. The requirements of the policy are as follows
- An eligible Veteran may be reimbursed for the cost of medical cannabis by the VAC when the health practitioner is authorized under the Access to Cannabis for Medical Purposes Regulation (ACMPR). The authorization document should have the dosage (in grams) per day of dried marihuana.
- The Veteran must produce the following documents
- Copy of authorization document completed by a healthcare practitioner
- Copy of completed and confirmed registration document with a licensed producer
- The VAC will only accept authorization from one healthcare practitioner at a time. Special considerations may be allowed for special conditions, but all authorizations should be from one health practitioner
- The maximum daily reimbursement limit is 3 grams per day of dried marijuana or its equivalent in fresh marijuana or cannabis oil.
- The VAC will reimburse the eligible veteran based on a fixed rate with a maximum of $8.50 per gram, whether as dried marijuana or its equivalent value in fresh marijuana or cannabis oil form.
The VAC has capped the daily usage of medical cannabis but has deferred dosage authorization to medical professionals. It has justified this by the fact that cannabis is not an approved therapeutic drug, and as such, it does not have the same dosage and clinical guidelines as those of prescription medicine.
Medical marijuana dosing guidelines
The College of Family Physicians of Canada recommends low starting dosages and has set the upper level of safe use of dried marijuana to be about 3 grams per day, and this is for extreme conditions.
However, the policy allows for dosages higher than 3 grams daily should the request be accompanied by a medical specialist in the relevant field. The opinion and rationale of the specialist will inform the decision to increase the dosage.
To aid in the transition from 10 grams daily to 3 grams daily, the VAC expanded access to medical services up to December 2017. Some of these services are:
- Treatment services in chronic care, acute care or rehabilitative care hospitals or clinics registered with VAC
- Health services provided by psychologists, psychotherapists or therapists to address various issues that may be brought by the transition to less dosage
- Medical examinations, treatments or reports requested by VAC
- An assistance line by VAC for family members to report to mental health professionals on concerns impacting the Veterans well-being
The reimbursement policy allows eligible Veterans to switch between dried cannabis, fresh marijuana, and cannabis oil, as long as the reimbursement rate for any product is capped at $8.50. The licensed producers are mandated to give the equivalency quantities for the three medicinal cannabis products. For more information about the VAC and its policies, click here.
What is the VAC?
The Veterans Affairs Canada (VAC) is a department within the Canadian Government. This organization is tasked with the responsibility of managing pensions, offering services and benefits for special groups. These include war veterans, retired and serving members of the Canadian Armed Forces and the Royal Canadian Mounted Police, as well as their families and other civilians.
Some of the services offered by VAC include:
- Mental health services and support
- Disability benefits
- Lifetime financial support
- Medical coverage
- Rehabilitation services
- Long-term access to healthcare
- Transition into civilian life