Diagnoses associated with reimbursement of cannabis for medical purposes among Canadian Veterans, 2016-23

Introduction : Canadian Veterans who are authorized to access cannabis for medical purposes (CMP) by a health care practitioner may be reimbursed for the cost by Veterans Affairs Canada (VAC). To assess eligibility for reimbursement, VAC receives and reviews medical authorizations to determine whether documented condition(s) are service-related. Methods: As a quality improvement project, we reviewed 150,663 cannabis authorizations during 2007-23, submitted by 24,987 Veterans. Results: The most recorded conditions on medical authorizations were posttraumatic stress disorder (48%; n = 72,006 authorizations) and chronic pain (47%; n = 70,598 authorizations), and 17% of medical authorizations (n = 25,119 authorizations) included both diagnoses. Veterans were reimbursed for multiple types of cannabis products, with most claims being for dried flower (48%; n = 870,665 claims), oils, and extracts (40%; n = 718,603 claims). The median maximum was 3 grams per day (interquartile range [IQR]: 3 to 4), and 79% of Veterans (n = 19,720) had an authorization for 3 or more grams per day. The median number of medical authorizations per Veteran was 5 (IQR: 3 to 8), and the median duration of each authorization was 307 days (IQR: 108 to 360). Discussion: By describing the conditions treated with CMP among Canadian Veterans, this study offers findings useful for researchers, regulatory bodies, and policy makers seeking to identify gaps between current clinical practices and associated clinical guidelines, medical evidence, and regulatory frameworks, particularly about the treatment of the most common conditions, posttraumatic stress disorder and chronic pain.