[House Report 115-690]
[From the U.S. Government Publishing Office]
115th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 115-690
======================================================================
VA MEDICINAL CANNABIS RESEARCH ACT OF 2018
_______
May 18, 2018.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Roe of Tennessee, from the Committee on Veterans' Affairs,
submitted the following
R E P O R T
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred
the bill (H.R. 5520) to authorize the Secretary of Veterans
Affairs to use the authority of the Secretary to conduct and
support research on the efficacy and safety of medicinal
cannabis, and for other purposes, having considered the same,
report favorably thereon with an amendment and recommend that
the bill as amended do pass.
CONTENTS
Page
Purpose and Summary.............................................. 3
Background and Need for Legislation.............................. 3
Hearings......................................................... 4
Subcommittee Consideration....................................... 4
Committee Consideration.......................................... 4
Committee Votes.................................................. 4
Committee Oversight Findings..................................... 4
Statement of General Performance Goals and Objectives............ 4
New Budget Authority, Entitlement Authority, and Tax Expenditures 5
Earmarks and Tax and Tariff Benefits............................. 5
Committee Cost Estimate.......................................... 5
Congressional Budget Office Estimate............................. 5
Federal Mandates Statement....................................... 6
Advisory Committee Statement..................................... 6
Constitutional Authority Statement............................... 6
Applicability to Legislative Branch.............................. 6
Statement on Duplication of Federal Programs..................... 6
Disclosure of Directed Rulemaking................................ 6
Section-by-Section Analysis of the Legislation................... 7
Changes in Existing Law Made by the Bill as Reported............. 7
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``VA Medicinal Cannabis Research Act of
2018''.
SEC. 2. CONDUCT OF RESEARCH INTO EFFECTS OF CANNABIS ON HEALTH OUTCOMES
OF CERTAIN VETERANS.
(a) Research.--In carrying out the responsibilities of the Secretary
of Veterans Affairs under section 7303 of title 38, United States Code,
the Secretary may conduct and support research relating to the efficacy
and safety of forms of cannabis described in subsection (c) on the
health outcomes of covered veterans diagnosed with chronic pain, post-
traumatic stress disorder, and other conditions the Secretary
determines appropriate. The Secretary shall ensure that such research
is conducted in accordance with applicable regulations relating to the
oversight of research, including such regulations prescribed by the
Office of Research and Development of the Department of Veterans
Affairs, the Department of Health and Human Services (including through
the National Institute on Drug Abuse), the Food and Drug
Administration, the Drug Enforcement Administration, and the National
Institutes of Health.
(b) Data Preservation.--Research conducted pursuant to subsection (a)
shall include a mechanism to ensure the preservation of all data,
including all data sets, collected or used for purposes of the research
required by subsection (a) in a manner that will facilitate further
research.
(c) Forms of Cannabis To Be Researched.--The forms of cannabis
described in this subsection are--
(1) varying forms of cannabis, including--
(A) full plants and extracts;
(B) at least three different strains of cannabis with
significant variants in phenotypic traits and various
ratios of tetrahydrocannabinol and cannabidiol in
chemical composition; and
(C) other chemical analogs of tetrahydrocannabinol;
and
(2) varying methods of cannabis delivery, including topical
application, combustible and non-combustible inhalation, and
ingestion.
(d) Implementation.--If the Secretary conducts and supports research
under subsection (a), the Secretary shall--
(1) before conducting and supporting such research, develop a
plan to implement this section and submit such plan to the
Committees on Veterans' Affairs of the House of Representatives
and the Senate; and
(2) issue any requests for proposals the Secretary determines
appropriate for such implementation.
(e) Reports.--During the five-year period beginning on the date of
the enactment of this Act, the Secretary shall submit periodically, but
not less frequently than annually, to the Committees on Veterans'
Affairs of the House of Representatives and the Senate reports on--
(1) the implementation of this section; or
(2) the rationale of the Secretary with respect to
determining not to implement this section.
(f) Covered Veteran Defined.--In this section, the term ``covered
veteran'' means a veteran who is enrolled in the patient enrollment
system of the Department of Veterans Affairs under section 1705 of
title 38, United States Code.
AMENDMENT TO H.R. 5520 OFFERED BY MR. WENSTRUP OF OHIO
Page 2, line 4, strike the subparagraph heading and insert
``Research.--''.
Page 2, line 11, after the period insert the following new
sentence: ``The Secretary shall ensure that such research is
conducted in accordance with applicable regulations relating to
the oversight of research, including such regulations
prescribed by the Office of Research and Development of the
Department of Veterans Affairs, the Department of Health and
Human Services (including through the National Institute on
Drug Abuse), the Food and Drug Administration, the Drug
Enforcement Administration, and the National Institutes of
Health.''.
Page 3, strike lines 6 through 21 and insert the following
new subsections:
(d) Implementation.--If the Secretary conducts and supports
research under subsection (a), the Secretary shall--
(1) before conducting and supporting such research,
develop a plan to implement this section and submit
such plan to the Committees on Veterans' Affairs of the
House of Representatives and the Senate; and
(2) issue any requests for proposals the Secretary
determines appropriate for such implementation.
(e) Reports.--During the five-year period beginning on the
date of the enactment of this Act, the Secretary shall submit
periodically, but not less frequently than annually, to the
Committees on Veterans' Affairs of the House of Representatives
and the Senate reports on--
(1) the implementation of this section; or
(2) the rationale of the Secretary with respect to
determining not to implement this section.
PURPOSE AND SUMMARY
H.R. 5520, as amended, the ``VA Medicinal Cannabis Research
Act of 2018,'' would (1) make it clear that VA is authorized to
conduct and support research into medicinal cannabis, (2)
require VA to report to Congress on how it intends to exercise
such authority, and (3) require VA to preserve all data
collected or used for research in a manner that could
facilitate further research. H.R. 5520, was introduced by
Representative Timothy Walz of Minnesota on April 16, 2018.
BACKGROUND AND NEED FOR LEGISLATION
In 2017, The American Legion, the nation's largest Veteran
Service Organization, contracted with an independent public
opinion research company to conduct a nationwide survey
regarding veteran use and access to medical cannabis. The
survey, conducted over two days with over 1,300 respondents and
a +/- 3.5 percent margin of error, determined that 92 percent
of veteran households support research into the efficacy of
medical cannabis for mental and physical conditions and that 22
percent of veterans are currently using cannabis to treat a
mental condition.\1\
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\1\https://www.legion.org/veteranshealthcare/239814/survey-shows-
veteran-households-support-research-medical-cannabis
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These survey results highlight a large and growing need for
valid scientific data and research into the safety and efficacy
of cannabis as a medical treatment for veterans suffering
chronic mental and physical conditions, especially as an
alternative to treatment with opiate or other addictive or
otherwise dangerous medications.
As a substance listed as Schedule 1 by the Drug Enforcement
Agency, cannabis is determined to have ``no current accepted
medical use and a high potential for abuse.''\2\ However, there
is no clear guidance on VA's legal authority to conduct
research and study the possibility of an ``accepted medical
use'' for medical cannabis.
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\2\United States Drug Enforcement Agency. (n.d.). Drug Fact Sheet:
Marijuana. [PDF File].
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Section 2 of the bill would clarify that the Secretary of
the Department of Veterans Affairs may conduct research on the
medical efficacy of cannabis on veterans, requires the
Secretary to submit annual reports to Congress on the findings
of any research conducted using this authority, and to preserve
all data collected using this authority for use in future
research opportunities.
HEARINGS
On April 17, 2018, the Subcommittee on Health conducted a
legislative hearing on a number of bills including H.R. 5520.
The following witnesses testified:
The Honorable Beto O'Rourke, U.S. House of
Representatives, 16th District, Texas; The Honorable
Tim Walberg, U.S. House of Representatives,7th
District, Michigan; The Honorable Neal Dunn, U.S. House
of Representatives, 2nd District; Florida; The
Honorable Luis Correa, U.S. House of Representatives,
46th District, California; The Honorable Mike Coffman,
U.S. House of Representatives, 6th District, Colorado;
Louis J. Celli, Director, National Veterans Affairs and
Rehabilitation Division, The American Legion; Adrian M.
Atizado, Deputy National Legislative Director, Disabled
American Veterans; Sarah S. Dean, Associate Legislative
Director, Paralyzed Veterans of America; and Kayda
Keleher, Associate Director, National Legislative
Service, Veterans of Foreign Wars of the United States.
Statements for the record were submitted by:
The Elizabeth Dole Foundation; The Independence Fund;
Veteran Cannabis Project; Wounded Warrior Project; and
Iraq and Afghanistan Veterans of America.
SUBCOMMITTEE CONSIDERATION
There was no subcommittee consideration of H.R. 5520.
COMMITTEE CONSIDERATION
On May 8, 2018, the full Committee met in open markup
session, a quorum being present, and ordered H.R. 5520, as
amended, favorably reported to the House of Representatives by
voice vote. During consideration of the bill, the following
amendment was considered and agreed to by voice vote:
An Amendment to H.R. 5520 offered by Representative
Brad Wenstrup of Ohio, the Chairman of the Subcommittee
on Health.
COMMITTEE VOTES
In compliance with clause 3(b) of rule XIII of the Rules of
the House of Representatives, there were no recorded votes
taken on amendments or in connection with ordering H.R. 5520,
as amended, reported to the House.
COMMITTEE OVERSIGHT FINDINGS
In compliance with clause 3(c)(1) of rule XIII and clause
(2)(b)(1) of rule X of the Rules of the House of
Representatives, the Committee's oversight findings and
recommendations are reflected in the descriptive portions of
this report.
STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES
In accordance with clause 3(c)(4) of rule XIII of the Rules
of the House of Representatives, the Committee's performance
goals and objectives are to permit the federally-regulated
study into the safety and efficacy of medical cannabis for
treatment in veterans with mental and physical conditions,
while ensuring VA is required to follow established federal,
clinical and scientific guidelines.
NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX EXPENDITURES
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee adopts as its
own the estimate of new budget authority, entitlement
authority, or tax expenditures or revenues contained in the
cost estimate prepared by the Director of the Congressional
Budget Office pursuant to section 402 of the Congressional
Budget Act of 1974.
EARMARKS AND TAX AND TARIFF BENEFITS
H.R. 5520, as amended, does not contain any Congressional
earmarks, limited tax benefits, or limited tariff benefits as
defined in clause 9 of rule XXI of the Rules of the House of
Representatives.
COMMITTEE COST ESTIMATE
The Committee adopts as its own the cost estimate on H.R.
5520, as amended, prepared by the Congressional Budget Office
pursuant to section 402 of the Congressional Budget Act of
1974.
CONGRESSIONAL BUDGET OFFICE COST ESTIMATE
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
for H.R. 5520, as amended, provided by the Congressional Budget
Office pursuant to section 402 of the Congressional Budget Act
of 1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, May 9, 2018.
Hon. Phil Roe, M.D.,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 5520, the VA
Medicinal Cannabis Research Act of 2018.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Ann E.
Futrell.
Sincerely,
Keith Hall,
Director.
Enclosure.
H.R. 5520--VA Medicinal Cannabis Research Act of 2018
H.R. 5520 would allow the Department of Veterans Affairs
(VA) to conduct and support research related to the use of
medical cannabis in the treatment of veterans with chronic
pain, post-traumatic stress disorder, and other health
conditions. The bill would codify VA's existing authority to
conduct such research. On that basis, CBO estimates that
implementing H.R. 5520 would cost less than $500,000 over the
2019-2023 period, primarily to prepare and submit the necessary
reports to the Congress. That spending would be subject to the
availability of appropriated funds.
Enacting H.R. 5520 would not affect direct spending or
revenues; therefore, pay-as-you-go procedures do not apply.
CBO estimates that enacting H.R. 5520 would not increase
net direct spending or on-budget deficits in any of the four
consecutive 10-year periods beginning in 2029.
H.R. 5520 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act.
The CBO staff contact for this estimate is Ann E. Futrell.
The estimate was reviewed by Leo Lex, Deputy Assistant Director
for Budget Analysis.
FEDERAL MANDATES STATEMENT
The Committee adopts as its own the estimate of Federal
mandates regarding H.R. 5520, as amended, prepared by the
Congressional Budget Office pursuant to section 423 of the
Unfunded Mandates Reform Act.
ADVISORY COMMITTEE STATEMENT
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act would be created by H.R.
5520, as amended.
STATEMENT OF CONSTITUTIONAL AUTHORITY
Pursuant to Article I, section 8 of the United States
Constitution, H.R. 5520, as amended, is authorized by Congress'
power to ``provide for the common Defense and general Welfare
of the United States.''
APPLICABILITY TO LEGISLATIVE BRANCH
The Committee finds that H.R. 5520, as amended, does not
relate to the terms and conditions of employment or access to
public services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act of 1995.
STATEMENT ON DUPLICATION OF FEDERAL PROGRAMS
Pursuant to clause 3(c)(5) of rule XIII of the Rules of the
House of Representatives, the Committee finds that no provision
of H.R. 5520, as amended, establishes or reauthorizes a program
of the Federal Government known to be duplicative of another
Federal program, a program that was included in any report from
the Government Accountability Office to Congress pursuant to
section 21 of Public Law 111-139, or a program related to a
program identified in the most recent Catalog of Federal
Domestic Assistance.
DISCLOSURE OF DIRECTED RULEMAKING
Pursuant to section 3(i) of H. Res. 5, 115th Cong. (2017),
the Committee estimates that H.R. 5520, as amended, contains no
directed rulemaking that would require the Secretary to
prescribe regulations.
SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION
Section 1. Short title
Section 1 of the bill would provide the short title for
H.R. 5520, as amended, as the ``VA Medicinal Cannabis Research
Act of 2018.''
Section 2. Conduct of research into effects of cannabis on health
outcomes of certain veterans
Section 2(a) of the bill would provide the authority for
the Secretary of Veterans Affairs to conduct and support
research into the efficacy and safety of cannabis on the health
outcomes of covered veterans diagnosed with chronic pain, PTSD,
and other conditions the Secretary may deem appropriate. This
section also requires authorized research to comply with all
established federal guidelines and regulations.
Section 2(b) of the bill would require all research data
authorized and conducted under section 2(a) to be preserved in
a manner that will facilitate further research.
Section 2(c) of the bill outlines which forms of cannabis
are eligible for research, including (1) full plants and
extracts; (2) at least three different strains of cannabis with
significant variations of phenotypic traits and various rations
of THC and CBD (the active ingredients in cannabis); and, (3)
other chemical analogs of THC. This section also outlines the
methods of delivery for research, including topical
application, combustible and non-combustible inhalation, and
ingestion.
Section 2(d) of the bill requires the VA, prior to
conducting any research authorized by this section, to inform
Congress of its plan to conduct such research and issue any
requests for proposals the Secretary deems appropriate.
Section 2(e) of the bill requires VA to submit periodic
reports to Congress on (1) the implementation of this section
and (2) the rationale of the Secretary with respect to
determining not to implement this section.
Section 2(f) defines the term ``covered veteran.''
CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED
If enacted, this bill would make no changes in existing
law.
[all]