What the VA Won’t Prescribe: A Joint

Broken healthcare, cannabis prosecutions, and billion-dollar privatization schemes are pushing veterans toward alternatives the federal government still punishes them for using.

Rico walked into the VA pharmacy in Tucson with a joint and a lighter and no camera, because he wasn’t there to perform.

“I went to catch a case,” he told me. Flat. Like he was reading off a grocery list. “A federal case.”

Ricardo “Rico” Pereyda. U.S. Army. Over 300 combat missions in Baghdad. Medically retired at 23, 100% permanently disabled, combat-related. He spent years doing everything the machine asked before the machine decided he was the problem.

They burned him down faster than a Seattle pinner.

Fellowship programs, community leadership roles, civic engagements, all gone. His prospects evaporated. And the institution legally obligated to keep him alive watched every bit of it happen with an impressive sense of antipathy.

His dogs kept wandering over as we talked, pushing their heads into his hands. He’d scratch behind an ear without breaking the thought.

“This kept a bullet out of my mouth.”

Ricardo “Rico” Pereyda, U.S. Army veteran, 300+ combat missions, medically retired at 23

“I’m telling them,” he said. “This kept a bullet out of my mouth. You were excited to put me in front of cameras, have me on panels, run your dog and pony show. But the second I start sharing my experience and the experiences of others, you shut us down. Stigmatized us. After telling us nothing was off the table and that you were so goddamn concerned about the suicide rate.”

So he walked into the pharmacy and lit it.

Nobody in that building could reconcile the rulebook with the man standing in front of them. All they could do was stand there while the smoke curled toward the fluorescent lights. Pereyda engineered that moment with the precision of a man who’d run 300 combat missions and understood that sometimes, the most devastating thing you can do to an enemy is force them to see themselves for what they are.

“Please Hold”

Here is what the VA is:

The largest integrated healthcare system in the United States, with nine million veterans served annually, 360,000 employees, and a 2024 budget of $328 billion, up 583% since 2001. What essentially equates to Five Mayo Clinics stacked on top of each other, with a big flag out front and a suicide hotline that’s currently understaffed.

“Please hold.”

Here is what the VA cannot do:

Acknowledge that a plant legal in 40 states might be worth discussing with the human beings in its waiting rooms, or treat those humans like they’re capable of making an informed decision about their own body. Their own survival.

Here is what the VA can do, and does, every single day, without a single congressional review:

Hand opioids to a population twice as likely to die from an accidental overdose as the rest of the country. Sign the prescription. Wish them luck.

In a survey of 510 veterans using medical cannabis, 91% said it improved their quality of life, 80% reported fewer psychological symptoms, and 21% used fewer opioids. The VA’s official 2023 clinical guidelines recommend against cannabis for PTSD treatment, while remaining legally barred from conducting the trials that would generate evidence to revisit that recommendation. They cite insufficient evidence. And they are prohibited from gathering sufficient evidence. The snake is eating its tail in a tightly controlled environment. 

It’s what you call a managed outcome.

So why is the VA failing the people it exists to serve on a budget bigger than most countries’ entire economies? 

The VA serves patients carrying nine to twelve simultaneous medical conditions when the average American walks in with three to five. Congress keeps expanding who qualifies—burn pits, Gulf War syndrome, Agent Orange—without funding the infrastructure to absorb them. The financial management software was built in 1992 and has never been meaningfully updated. 137 of 139 VA health centers report severe staffing shortages. 

137 out of 139.

Then there’s the money bleeding out of VA facilities and handed to private providers, jumping from $15 billion in 2018 to $28.5 billion in 2023. When the money leaves, the VA loses staff. When the VA loses staff, it fails more veterans, and those failures get harvested as evidence that veterans should be routed to private providers. Rinse and repeat until the VA is a shell, and the money is somewhere else entirely. Concerned Veterans for America, funded by the Koch network, has had a seat at the table in both Trump administrations, engineering exactly this outcome, and the current VA Secretary Doug Collins arrived in office having already carried three of their bills in Congress.

Then the political mythology rolls in, covering everything in a fine mist of manufactured gratitude. 

Politicians love veterans the way they love the flag. Loudly, right on cue, in front of the cameras, and always at a safe distance. But the VA budget, the unglamorous, politically inconvenient line item, gets picked apart by the same politicians who just gave a standing ovation at the Veterans Day ceremony.

Every year, Congress passes the Veterans Equal Access Act by voice vote, a practically ceremonial event, then quietly guts it from the final bill. 

Which keeps almost passing. 

And then doesn’t. 

And then doesn’t. 

And then doesn’t.

Robb Harmon has helped over a thousand veterans navigate the actual mechanics of getting and keeping a medical card. He knows exactly what a voice vote means and exactly what it doesn’t:

A recommendation without infrastructure creates delay. A recommendation without support creates abandonment. And a recommendation without real access is not progress, it’s policy theater.

Meanwhile, 17.6 veterans die by suicide every day,  a number that has barely twitched in a decade of speeches, appropriations, and ceremonial voice votes from people who will never spend a night in a VA waiting room, wondering if the thing that actually helps them is going to put them in prison.

The Glove Capital of the World

Upstate New York is the kind of cold that feels inconsiderate, almost personal, and Gloversville hunkers there like a town that got left behind mid-sentence and never stopped waiting for the rest of the story to be told.

Two hundred glove manufacturers once employed half the county, with money flowing through the streets, until NAFTA made the math ugly, the factories left, and the people who stayed learned that decisions made in rooms you’re not invited to can hollow out everything you’ve ever known. And there’s not a goddamn thing you can do about it.

Jason Ambrosino runs Veterans Holdings out of Gloversville with a lock on moon rocks in New York, and when the state pulled a bait-and-switch on compliance systems and torched a year of his preparation overnight, he sued them. Because when you’re building something real in a place that’s already been abandoned once, you don’t lie down.

He came home from the Army, pharmaceutically managed into a fog of gabapentin and whatever else the VA had decided constituted appropriate care. He found Acid Test in that chemical haze and followed the thread to psychedelics and cannabis, treatments the VA would never sanction and certainly wasn’t going to prescribe. 

Cannabis and psychedelics did not just help me personally. They exposed how broken the existing approach was. At that point it stopped being a private health decision and became a responsibility.

He clawed his way off the pills. Then he got to work. “We did not come here to be another boom and bust story. If we are going to rebuild something in a place like this, it has to be durable.”

Don’t Ask, Don’t Tell

Tanisha Robinson has operated at levels in this industry that most people only read about while eating Cup Noodles at their desk. BrewDog, The Parent Company, Monogram—JAY-Z’s cannabis brand.

She’s also a Black, queer woman from a Mormon town in Missouri who served as an Arabic linguist and military intelligence specialist, got out in 2003, still under Don’t Ask Don’t Tell, navigating an institution that would have preferred she didn’t exist in the form she existed in. When I asked what that was like, she didn’t wax poetic: “I grew up my whole life in systems that weren’t really built for me in mind.”

Black Americans make up 13% of the U.S. population and nearly 19% of the active-duty Army. Overrepresented in combat roles, underrepresented in officer ranks, more likely to face court-martial, more likely to screen positive for PTSD, less likely to receive adequate care, and nearly four times more likely to be arrested for marijuana possession despite identical usage rates. Sent to fight at higher rates. Treated at lower rates. Imprisoned at higher rates. 

Robinson lived inside that equation before she ever set foot in a boardroom.

As a tithe to the wreckage, she launched Wonder with the 420 rule: 4.2% of profits carved out for people harmed by the War on Drugs. It won’t fix it. It’s meant to name it, put money behind the naming, and refuse to pretend the industry she’s building within exists separately from the one that put those veterans behind bars in the first place. When I asked her about the racial math of the legal industry, she didn’t flinch:

“Prioritizing licenses for people who are not equipped to build businesses sets them up for predatory investment situations, which ultimately means those licenses and brands end up in the hands of white dudes.”

The legal cannabis industry is 81% white-owned. Two percent are black-owned.

The Ouroboros

The military recruits hard from communities where “GI Bill” and “pension” and “VA home loan” are the only visible escape hatch. They pull from need, hand them a rifle, ship them somewhere disastrous, and when what’s left comes home, we return them to a system running on 30-year-old software and a magnetic ribbon on the back of a pickup truck.

One, preferably, with a set of testicles hanging off the bumper.

The genius of the arrangement is that responsibility gets sliced so thin across so many layers of administration that nobody has to say “I chose this.” The bureaucracy is a get-out-of-jail-free card, and it has been working perfectly for decades, most brutally for the communities it was designed to work against.

The veterans rotting behind bars for cannabis are disproportionately from the communities the War on Drugs was built to destroy, and we know it was built to destroy them because the man who helped build it said so, Nixon’s domestic policy chief, John Ehrlichman:

“Did we know we were lying about the drugs? Of course we did.”

The VA enforces federal scheduling that was constructed on that lie.

The Bill

Some veterans found cannabis worked better than anything the VA had ever handed them across a prescription counter. Some of them are in prison for it.

The same government that sent them promised to catch them when they returned, and banned the one thing that worked, put them in cages for it.

The Work Outlasts the Worker

Two years after the pharmacy, Pereyda started organizing. He pulled together fellow veterans who understood what was at stake and built the Veterans Action Council. He describes himself as part of a relay that was already running when he arrived and will keep running when he’s gone.

“People like Alice O’Leary Randall carried this fight forward long before I showed up,” he said. “Many of them didn’t live to see the changes they helped create. That’s the reality of movements like this. It’s a relay. It doesn’t require a Pereyda. It requires people who, at some point, decide they can’t look away.”

After chatting with Ambrosino, I landed on a similar vibe from a completely different life: What’s good for the community, good for Gloversville, good for the people in need, that’s what’s good for Ambrosino.

Pereyda with his pension and his 15 years of accumulated rage. Robinson with her 4.2% and a decade finding her way into rooms that were never unlocked for her. Ambrosino with his lawsuit and his moon rocks and his absolute refusal to let Gloversville become another cautionary tale.

Three people. Three roads into the same burning building. None of them waiting to be invited in.

Meanwhile, Robert Deals, Deshawn Reilly, Kristofer Fetter, and Brent Crawford are still in their cells.

Nobody got stuck with the bill, except the veterans.

The Veterans Crisis Line can be reached at 988, then press 1. The Last Prisoner Project advocates for veterans and others incarcerated on cannabis charges at lastprisonerproject.org.