Ottawa has lost control of $150M program for reimbursing veterans' cannabis: audit

An internal audit by Veterans Affairs Canada suggests the federal government has all but lost control as it shells out hundreds of millions of dollars for veterans' medical marijuana each year without proper oversight, direction or evidence of health benefits.

Quietly published this week, the audit's results come amid an explosion in the number of veterans seeking reimbursement for their medical pot, from around 100 in 2014 to more than 18,000 last year — with no end to the surge in sight.

As a result, Veterans Affairs spent more than $150 million on medical marijuana last year — more than on all other prescription drugs combined. And that number is expected to grow to $200 million this year and $300 million by 2025-26.

Yet even as demand has grown exponentially, auditors found a continuing paucity of research about the medical benefits — and risks — of veterans using cannabis, especially those struggling with psychological trauma.

This has coincided with a lack of direction and control over who can get medical marijuana, what conditions the drug is being prescribed for and how veterans are getting authorization for their CMP (cannabis for medical purposes).

"VAC has taken steps to operationalize its policy to provide veterans with access to reimbursement for their CMP treatment," the audit reads. "However, there remain serious gaps in internal controls in the areas of veteran health and program management."

Veterans Affairs started reimbursing a small number of former military personnel for their medical cannabis in 2008, at which point the approvals were granted on an extremely limited basis and with the approval of a medical specialist.

The move followed a series of court decisions more than 20 years ago that first allowed a legal exemption from criminal prosecution for the consumption of medical marijuana.

Then, in 2014, Health Canada relaxed its rules on who could authorize the use of medical marijuana and for what conditions and circumstances. The new rules didn't put a limit on the amount of pot that could be authorized, or the cost.

That change resulted in an explosion of claims and costs — despite the Liberal government's decision in 2016 to limit claims to three grams per day at $8.50 per gram, with an allowance of up to 10 grams per day with medical authorization.

Auditors noted that the limited research information available suggests individuals should use less than three grams of cannabis per day and have regular followups with their health-care providers.

Health Canada and the College of Family Physicians of Canada have also warned about the potential negative impact of marijuana use by individuals suffering from mental health conditions, particularly post-traumatic stress disorder.

But the audit report says that Veterans Affairs has not provided any directions or restrictions on what kinds of health conditions are eligible for reimbursement of medical marijuana.

Virtually any medical condition is eligible. That includes PTSD, which the auditors found was a diagnosis for "the vast majority" of veterans who have been reimbursed for medical cannabis.