Pennsylvania officials recently issued a memo stating that the federal government is withholding grant money for certain health programs that allow medical marijuana use among participants—but there is an exception.
In the bulletin posted this month, the state Department of Drug and Alcohol Programs said the federal Substance Abuse and Mental Health Services Administration (SAMHSA) “has been including the following special conditions in federal funding awards.”
Those conditions stipulate that grant funds “may not be used, directly or indirectly, to purchase, prescribe, or provide marijuana or treatment using marijuana.”
This decision, which also impacts grant funding for education programs, prompted a notice last year from Maine’s Education Department, which warned grant recipients about SAMHSA’s updated cannabis policy.
That said, a 2020 follow-up from the federal agency that was included in the new Pennsylvania notice adds some nuance to the policy. SAMHSA clarifies that recipients would only be disqualified from the grants if the people participating in their program are using marijuana for mental health or substance misuse treatment.
Further, it said that organizations would be able to continue receiving funding if patients use cannabis for those purposes so long as the clinician involved in their treatment documents the usage and the patient “is willing to work with the practitioner to understand the risks of the marijuana use and be willing to work toward using evidence-based alternatives to treat their mental/substance use disorder.”
But as far as advocates are concerned, the overall policy is convoluted, potentially preventing access to funding that could benefit whole communities simply because a given patient might be using cannabis in compliance with state laws.
What’s more, the effect of the ban could be arbitrary. What if, for example, a patient claimed that they were using medical marijuana to treat a pain condition when they could simultaneously be using it for undisclosed, mental health-related reasons? Then, theoretically, the grant funds would still be made available, contingent upon a non-disclosure.
But SAMHSA is insistent about the requirement in its memo.
The agency’s Q&A offers: “What if the patient is very clear about their wish to remain on their medical marijuana for their mental or substance use disorder—in this instance can the organization serve them?”
“No. The organization cannot serve a patient who is on medical marijuana for a mental or substance use disorder and wishes to remain on such treatment,” it says. “SAMHSA promotes the use of evidence-based practices and there is no evidence for such a treatment; in fact, there is increasing evidence that marijuana can further exacerbate mental health symptoms.”
“Further, SAMHSA believes the use of marijuana for these conditions in a treatment program designed to treat these conditions can compromise the therapeutic environment for those patients receiving services who wish to remain abstinent, use evidence-based treatment approaches and achieve recovery,” it continues.
“The practitioner should be very clear with the patient regarding the risk of being dismissed from the program if the patient chooses to remain on medical marijuana for mental/substance use disorder. If a patient is adamant about their desire to remain on medical marijuana for mental or SUDs despite the clinician’s efforts, the program should work with the patient to find an alternative non-SAMHSA funded program.”
After SAMHSA announced in 2019 that its marijuana policy would impact organizations applying for its two main opioid treatment program and another that provides funding to combat alcoholism and substance misuse, the Illinois Department of Human Services and Oregon Health Authority said the rule meant it would not be eligible for certain grants.