Va Issues Official Medical Marijuana Directive

[welj31]

VA ISSUES OFFICIAL MEDICAL MARIJUANA DIRECTIVE

"The purpose of this VHA Directive is to provide guidance on access to and the use of medical marijuana by Veteran patients."

 

by Larry Scott, VA Watchdog dot Org

 

 

 

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On July 17 we brought you this story:

 

VA HEALTH CHIEF CLARIFIES AGENCY'S MEDICAL MARIJUANA POLICY -- Dr. Robert Petzel says veterans who legally use medical pot could continue to receive opioids for pain management at the VA.

http://www.vawatchdog.org/10/nf10/nfjul10/nf071710-2.htm

 

Now, the VA has made it official with VHA Directive 2010-035.

 

The Directive is posted below and is available here for viewing or download.

 

 

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Department of Veterans Affairs

Veterans Health Administration

Washington, DC 20420

 

VHA Directive 2010-035

July 22, 2010

 

 

 

 

 

 

MEDICAL MARIJUANA

 

1. PURPOSE: The purpose of this Veterans Health Administration (VHA) Directive is to provide guidance on access to and the use of medical marijuana by Veteran patients.

 

2. BACKGROUND

 

a. Fourteen states have enacted laws authorizing the use of medical marijuana. These authorizations generally require a physician to complete forms stipulating that a patient suffers from one or more of a variety of conditions and would benefit from the use of marijuana for medical purposes. Medical conditions associated with the use of medical marijuana include, but are not limited to: glaucoma, chemotherapy induced nausea, multiple sclerosis, epilepsy and chronic pain. Veterans who receive their care from the Department of Veterans Affairs (VA) and who have a desire to participate in state medical marijuana programs might ask their VA physicians to complete these authorization forms.

 

b. State laws authorizing the use of medical marijuana are contrary to Federal law. The Controlled Substances Act (Title 21 United States Code (U.S.C.) 801 et al.) designates marijuana as a Schedule I drug meaning that it has no currently accepted medical use and there are criminal penalties associated with its production, distribution, and possession. A VA physician’s completion of a form that would permit a patient to participate in a state medical marijuana program could result in the Drug Enforcement Administration’s actual or threatened revocation of the physician’s registration to prescribe controlled substances, as well as criminal charges.

 

c. VHA policy does not prohibit Veterans who use medical marijuana from participating in VHA substance abuse programs, pain control programs, or other clinical programs where the use of marijuana may be considered inconsistent with treatment goals. Although patients participating in state medical marijuana programs must not be denied VHA services, modifications may need to be made in their treatment plans. Decisions to modify treatment plans in those situations are best made by individual providers in partnership with their patients. VHA endorses a step-care model for the treatment of patients with chronic pain: any prescription(s) for chronic pain should be managed under the auspices of such programs described in VHA policy regarding Pain Management.

 

3. POLICY: VA providers must comply with all Federal laws, including the Controlled Substances Act. Due to marijuana’s classification as a Schedule I drug under the Controlled Substances Act, it is VHA policy to prohibit VA providers from completing forms seeking recommendations or opinions regarding a Veteran’s participation in a state medical marijuana program. If a Veteran presents a prescription or authorization for medical marijuana to a VA provider or pharmacist, VA will not provide marijuana nor will it pay for the prescription to be filled by a non-VA entity. NOTE: Possession of medical marijuana by Veterans while on VA property is in violation of VA regulation 1.218(a)(7) and places them at risk for prosecution under the Controlled Substances Act.

 

4. ACTION

 

a. Deputy Under Secretary for Health for Operations and Management (10N). The Deputy Under Secretary for Health for Operations and Management is responsible for ensuring that medical facility Directors are aware of the prohibition of completing forms for participation in state medical marijuana programs.

 

b. Chief Officer Patient Care Services. The Chief Officer Patient Care Services is responsible for providing clinical guidance to VA providers regarding factors to be considered when determining how substance abuse, pain control, or other treatment plans could be impacted by Veterans’ participation in state medical marijuana programs.

 

c. Medical Facility Directors. Medical facility Directors are responsible for ensuring VA clinical staff are aware:

 

(1) Of the prohibition of completing forms for participation in medical marijuana programs.

 

(2) That if a patient reports participation in a state medical marijuana program to the clinical staff, that information is entered into the "non-VA medication section" of the patient's electronic medical record following established medical facility procedures for recording non-VA medication use.

 

5. REFERENCES

 

a. Office of General Counsel (OCG) Opinion on State Medical Marijuana Registration Forms - VAOPGCADV 9-2008.

 

b. Title 21 U.S.C. 801 et al, the Controlled Substances Act.

 

c. VHA policy regarding Pain Management.

 

6. FOLLOW-UP RESPONSIBILITY: Pharmacy Benefits Management Services (119) is responsible for the content of this Directive. Questions may be addressed to (202) 461-7326.

 

7. RESCISSIONS: None. This VHA Directive expires July 31, 2015.

 

Robert E. Petzel, M.D.

Under Secretary for Health

 

DISTRIBUTION:

E-mailed to the VHA Publications Distribution List 07/22/2010

[MLM]

Thanks for posting this info again. I really think this needs a caveat though. I recently posted about a VA psychologist that threatened to use my MMJ against me to determine my mental state for my comp. & pen. exam.

[bobandtorey]

Thanks i go to the V.A all the time they wont sign your Rec: but thats OK for now as long as they help and not hurt then am OK with it for now

[lkline300]

Thanks for posting this info again. I really think this needs a caveat though. I recently posted about a VA psychologist that threatened to use my MMJ against me to determine my mental state for my comp. & pen. exam.

 

If I remember your case, Doc didn't know your history, didn't read other doc's reports ( even in house ones), and did not know VA policy.

 

Very bizarre case.You would think all these things would be great arguments to use to appeal any un-favorable recommendations this man may make.

 

 

 

I have been treated well at the VA regarding my patient status. My only reservation is if they change their policy back to what it was, all of us with mmj non- va meds listed in our records may have some problems. I'm not worried, It's just a reservation.

 

It is a good thing though. Even though they won't come out & say it the fact that they are accepting it adds to mmj's acceptance as a legit Tx. IMO

 

Send a copy of this letter to the Quack in case he doesn't have time to read his hospital memo's.

[solabeirtan]

No Smoking in the Hospital ! duuuhhh......

 

Glad its Official Policy anyways ,

got its own Classification "non-VA medication section" on our file.

 

I think this is cool 'cause we will be providing some much needed data for research etc., for what its worth.

[greenbuddha]

Thanks for posting this info again. I really think this needs a caveat though. I recently posted about a VA psychologist that threatened to use my MMJ against me to determine my mental state for my comp. & pen. exam.

 

MLM, If I were you I would print this article out and take it with you next time you visit this particular psychologist.

 

As long as the VA does NOT countermand your use of MMJ this psychologist has no legal or professional right to demand that you NOT use MMJ.

 

However, the psychologist DOES have aright to 'refuse' treatment to anyone if they feel that what the patient is doing could be hampering their treatment.

 

I know for a fact that many mental health professionals are pro-MMJ. But of course any mental health professional should be concerned as to how ANY pain med might be affecting a patient's condition.

 

So the worst that might happen would be that you may have to find another mental health professional to go to, assuming that the psychologist you see is not assigned to you by the VA..

 

Anyone, unless their insurance or the VA requires that they see a 'specifically named' professional, has the right to see 'any' medical or mental health professional that they might choose to see.

[Guest 1TokeOverLine]

File this in the "For what it's worth" section:

 

The VA is my primary care team, and the doctor assigned to me has noted in my electronic file that my medical cannabis use indicates that "I refuse to follow recommended treatment", therefor I am now a "renegade" patient not entitled to treatment until I conform to her recommendations.

 

My medical cannabis use has allowed me to cut my pain meds in half, and for that she considers that I refuse to take her prescribed medications and further treatment should not be considered until I adhere to her instructions.

 

I have requested reassignment of primary doctor citing her adamant refusal to consider alternative medicines as a viable pain treatment option.

 

40 years of dealing with the insanity of the VA I can tell you from personal experience - never trust a word they say, even if it is in writing. They will find a way to stab you in the back, it will come back to haunt you.

 

1T

[greenbuddha]

File this in the "For what it's worth" section:

 

The VA is my primary care team, and the doctor assigned to me has noted in my electronic file that my medical cannabis use indicates that "I refuse to follow recommended treatment", therefor I am now a "renegade" patient not entitled to treatment until I conform to her recommendations.

 

My medical cannabis use has allowed me to cut my pain meds in half, and for that she considers that I refuse to take her prescribed medications and further treatment should not be considered until I adhere to her instructions.

 

I have requested reassignment of primary doctor citing her adamant refusal to consider alternative medicines as a viable pain treatment option.

 

40 years of dealing with the insanity of the VA I can tell you from personal experience - never trust a word they say, even if it is in writing. They will find a way to stab you in the back, it will come back to haunt you.

 

1T

 

 

1T... Totally agree.

 

Anyone that has ever been in the military knows that if you want to get screwed over... sign up!

[+Silverblue]

The way this country treats its veterans is disgraceful. If anyone's ever been to a Native American event, see how they Honor vets. It's wonderful! I've been to a few pow-wows and every time, they have a special ceremony for the vets and I think active duty persons, too. It's beautiful! Usually they'll have more than one ceremony, one to open the event and one to close it, if I recall- it's been a few years since I went to one. I don't remember if the honorees were all Native Americans or not, all I remember is a colorful display, no cameras allowed for that part, a sincere show of respect, and the great Pride I felt from them. Thank you to those who serve. I don't believe in war, but I am thankful to those who lay their lives on the line. It's not just a job, it's a sacrifice. How a nation treats it's warriors may be an indication of how it treats its citizens.

 

Sincerely, Sb