American Legion applauds first step to improve education and transparency for psychotropic medications, but says more needs to be done.
Veterans will receive additional education before being prescribed with psychotropic medications such as antidepressants and opioids, starting in 2027. This follows a Sept. 28 announcement by the U.S, Department of Veterans Affairs (VA) that it will expand signature consent beyond long-term opioid therapy for the first time.
VA said it will implement new educational measures on the benefits and risks of certain medications that will enable veterans to make a more comprehensive assessment of treatment decisions in consultation with their providers and families. The list of medications includes antipsychotics, stimulants, antidepressants, anxiolytics and opioids. Signed consent will be required in two cases: when opioids and benzodiazepines are prescribed together, and when antidepressants are prescribed to veterans under 30.
“This step by VA Secretary Doug Collins signifies real progress,” American Legion Executive Director of Government Affairs Mario Marquez said. “Signature consent will now reach beyond long-term opioids, and every veteran prescribed a psychotropic medication will receive standardized education. This treats every veteran as a partner. Informed consent does not discourage treatment. Instead, it makes sure each veteran understands their choices and alternatives, and allows them to help determine the treatment best suited to their needs.”
VA will add the following informed consent requirements starting in 2027:
· Patient education and signature consent prior to any concurrent prescription of opioids and benzodiazepines.
· Patient education and signature consent prior to prescribing an antidepressant to a veteran younger than 30.
· Standardized patient education for veterans who are prescribed psychotropic medications, including those that only require oral consent.
· Documented informed consent discussions about risks, side effects, benefits, alternatives, and how to safely discontinue the medication, including for psychotropic medications that only require oral consent.
The American Legion has advocated for more transparency, including joining dozens of other veterans service organizations in the spring to pass the Written Informed Consent Act, which would require VA to obtain “written, informed consent” from patients before prescribing certain psychiatric medications.
In May 2023, the Legion’s National Executive Committee approved Resolution No. 18, Written Informed Consent. Among other things, the resolution calls for a national black box monitoring standard across VA's regional healthcare networks routine prescription drug monitoring program queries, public tracking of adverse outcomes, and mandatory follow-up wellness checks.
“The resolution calls for signed consent before VA prescribes any medication carrying an FDA black box warning,” Marquez said. “It also calls for signed consent on every medication carrying an FDA black box warning. We will keep working with VA to get there. Consent represents the start of care, not the end. The American Legion stands ready to assist VA with training, follow-up, and tracking outcomes in 2027 and beyond.”
During the rest of 2026, VA will communicate these new requirements to VA staff, train its employees on the new procedures, and update all policies and procedures.
- Veterans Healthcare