columbiadailyherald.comhttp://columbiadailyherald.com/news/nation/more-veterans-press-va-recognize-medical-marijuanaMore veterans press VA to recognize medical marijuana
November 17, 2014 - 8:22pm
Every
morning, former Air Force senior airman Amy Rising makes breakfast for
her second-grader, drives him to school and returns home to prepare what
she calls her medicine.
She suffers from
severe anxiety after four years working in the frenetic global command
center at Scott Air Force Base in Illinois, coordinating bombings and
other missions in Iraq and Afghanistan.
Rising
says she has found a treatment that helps her cope. But her local
Veterans Affairs hospital does not provide it — because her medicine is a
joint.
At a time when the legalized use of
marijuana is gaining greater acceptance across the country, Rising is
among a growing number of veterans who are coming out of the “cannabis
closet” and pressing the government to recognize pot as a legitimate
treatment for the wounds of war. They say it is effective for addressing
various physical and psychological conditions related to military
service — from chronic back pain and neuropathic issues to panic attacks
and insomnia — and often preferable to widely prescribed opioid
painkillers and other drugs.
Researchers in
the United States and several other countries have found evidence that
cannabis can help treat post-traumatic stress disorder (PTSD) and pain,
although studies — for instance, looking into the best strains and
proper dosages — remain in the early stages.
Veterans
are lobbying for more states to legalize cannabis for medical use — 23
states and the District of Columbia allow this — but the primary target
is the federal government and, in particular, the Department of Veterans
Affairs.
The federal government classifies
marijuana as a “Schedule 1” drug, the same as heroin and LSD, deeming
that it has no accepted medical use and a high potential for abuse. That
means that VA, which runs the largest network of hospitals and health
clinics in the country, cannot prescribe pot as a treatment, even for
veterans who live in a state where medical marijuana is legal.
Veterans
Affairs says that its physicians and chronic pain specialists “are
prohibited from recommending and prescribing medical marijuana for PTSD
or other pain related issues.” Medical staff are also prohibited from
completing paperwork required to enroll in state marijuana programs
because they are “federal employees who must comply with federal law,”
said Gina Jackson, a VA spokeswoman.
The
swelling chorus of veterans who want to take advantage of marijuana but
can’t reflects the growing disconnect between more tolerant state
policies and the federal government’s unwillingness to budge.
Advocates
such as Rising say it is urgent that the federal government recognizes
marijuana as a treatment because there are so many veterans of recent
wars.
Although Rising did not serve in
Afghanistan or Iraq, she said the pressure of her work was intense.
“What was really hard about working in command was never being able to
see the damage you did on the ground,” she said. “You start to think
about all the orphans and widows you created, and that you do hit
civilians.”
Without marijuana to treat what
she says is PTSD, Rising said she feels “like the Incredible Hulk and
that danger is around every corner and that my nerves could explode.”
After
dropping off her son at school on a recent morning, she prepared a pair
of blunts. She took some pot out of a jar, dumped the guts of two Dutch
Master cigars and re-rolled them with the marijuana. Then she slipped
her blue Air Force jacket over her blue and white flower-print dress and
went into her suburban back yard to smoke, putting her long blond curls
behind her ears.
Medical marijuana is
legal for treating some conditions where Rising lives. She declined to
identify her home state except to say it is in the Mid-Atlantic.
“It’s
not about getting stoned. It’s about getting help,” she said. “The VA
doesn’t have any problem giving us addictive pharmaceutical drugs by the
bagful.”
Winning acceptance for medical
marijuana, she said, involves convincing the government that there’s
more to it than “Cheech and Chong, a stoned vet burning one down to Bob
Marley tunes.”
If veterans report their use
of marijuana to VA, they could face criminal charges if they live in a
state where it is illegal. And though few have indeed been charged, the
mere possibility has spawned a culture of “Don’t ask, don’t tell,” said
Michael Krawitz, a former Air Force staff sergeant and the director of
Veterans for Medical Cannabis Access.
VA
medical staff have warned that this culture is making for a dangerous
situation, especially as ever more states legalize medical marijuana,
because doctors do not know all the medications their patients are
using. Patients are not routinely given drug tests, but those who are
prescribed large amounts of opiates and risk overdosing can be asked to
take these tests, which can turn up marijuana use.
In
2011, VA issued a directive that said patients who were participating
in state marijuana programs for pain cannot lose their VA benefits,
adding that it is up to individual patients to craft their “treatment
plans” in consultation with their doctors.
Some
patients say their VA doctors are making them choose between their
prescription drugs and marijuana. “Doctors and administrators wrongly
assume that the use of marijuana along with opiates is unsafe,” Krawitz
said.
A study published last month in the
JAMA Internal Medicine Releases reported that “people already taking
opioids for pain may supplement with medical marijuana and be able to
lower their painkiller dose, thus lowering their risk of overdose.” The
study, written by Marcus Bachhuber, a researcher at the Philadelphia
Veterans Affairs Medical Center, and several colleagues, found that
“medical cannabis laws are associated with significantly lower
state-level opioid overdose mortality rates.”
Scott
Murphy, a retired Army specialist who is the head of Veterans for Safe
Access and Compassionate Care, has been compiling a petition asking that
marijuana no longer be classified as a “Schedule 1” drug. “Veterans in
states without medical marijuana laws feel they need to lie to their
physicians for the justifiable fear of losing their earned benefits,”
Murphy writes in the petition.
To counter
widespread perceptions about pot users, Murphy makes sure to wear a suit
when he lobbies on Capitol Hill and in his home state of Massachusetts,
where medical marijuana is legal for some uses. “I won’t wear a
tie-dyed shirt with a marijuana leaf,” he said.
Murphy
served in Iraq for more than a year, working in field artillery and
training Iraqi police officers. He said the physical stress of lugging
heavy military equipment contributed to degenerative arthritis and bone
pain in his leg, hip and wrist, and he began taking morphine, muscle
relaxers and Oxycontin.
“It never took away the pain,” he said. “I was at the point where I just wanted my leg to be taken off.”
Then,
two years ago, he started using a liquid form of cannabis that he puts
under his tongue. “I was able to go eight hours without taking my
medication,” he said.
Several VA doctors
who specialize in pain management and PTSD said in interviews that they
are eager for more research on the medical benefits of marijuana. These
doctors, who spoke on the condition of anonymity because they do not
have permission from VA to discuss marijuana with the news media, said
they feel frustrated because prescription drugs are not helping patients
who are suffering.
“Anecdotally we know it
works, and more and more studies are saying this,” said one VA doctor, a
PTSD expert who leads a large East Coast VA pain center. “But we aren’t
allowed to study it.”
Researchers at New
York University’s Langone Medical Center are developing the first
generation of cannabis-related medications targeted for PTSD, according
to Alexander Neumeister, a professor of psychology and radiology who is
supervising three drug trials. He said research has found that people
with PTSD have lower levels of cannabinoid receptors in the brain. These
receptors, called CB1, are activated when a person uses marijuana.
“We
are throwing the wrong pills at the problem and keep doing it,”
Neumeister said. “It’s upsetting. It’s heart-breaking and it’s just
wrong.”
He warned that marijuana for PTSD
and pain is “not ready for prime time yet,” because there must be more
research into the proper doses and the most effective strains.
Some veterans are not waiting for the studies to be finished.
Mark
DiPasquale, a 39-year-old retired Marine staff sergeant who served in
Iraq from 2005 to 2007, said marijuana was his “exit drug.”
To
treat back and bone injuries as well as PTSD, he said he had gone on 22
medications, including opioids and anti-anxiety medication. “I realized
none of these were working and I was about to be a father. I was so
jacked up on every pharmaceutical,” he said.
DiPasquale
looked for alternatives. He decided to use marijuana, inhaling it with a
vaporizer, to stop drinking alcohol and to adopt a largely vegan diet
(he occasionally eats fish). The regimen has worked, he said. But he
added that he has to spend a lot of money and time buying marijuana
“from people I trust or seeing if a random cousin has some.” DiPasquale,
who lives in New York — where voters have approved medical marijuana —
wishes VA would consider dispensing pot.
“It’s not like, ‘Let’s smoke a joint and feel better,’ ” he said. “We want to do it the right way.”
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