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Ariz. Vets: Allow Medical Marijuana For Ptsd


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By Yvonne Wingett Sanchez - The (Phoenix) Arizona Republic

Posted : Tuesday Jun 5, 2012 12:27:58 EDT

PHOENIX — Emanuel Herrera returned from war addicted to painkillers and barely able to tolerate his children’s voices.

The former staff sergeant had enlisted in the Arizona National Guard after 9/11, wanting to help his country. In 2006, while providing security for a convoy near Camp Anaconda in Iraq, his truck hit an improvised bomb. The blast turned the night into day, nearly destroyed his neck, damaged the discs in his back and left him with brain injuries and post-traumatic stress.

Last year, despite warnings from medical staff at the local veterans hospital, he began to smoke pot legally under the state’s new medical-marijuana program to cope with the physical and mental pains of combat.

“My doctors shunned me and didn’t approve of me doing it,” said Herrera, a Purple Heart recipient. “One doctor said I could get some repercussions for doing it. But I did it legally. And I know for a fact — I’m a walking testimonial — that it works.”

No one collects data on the number of veterans participating in medical-marijuana programs in the 17 states where it is legal. But veterans and program advocates say those who have served are turning to cannabis more and more to deal with the disabling symptoms of post-traumatic stress disorder, traumatic brain injuries and chronic physical pain.

In Arizona, veterans are leading the push for health officials to add PTSD as a qualifying condition for the medical-marijuana program. Currently, only individuals with diagnoses such as chronic pain, cancer and other debilitating conditions qualify. Two other states include PTSD as a qualifying condition.

But the federal government has sent mixed messages about its stance on the issue, with law enforcement opposing states’ programs and VA medical staff allowing participation. Medical experts disagree on whether the drug helps or hurts veterans.

Veterans Affairs’ policy


The Department of Veterans Affairs in 2010 formally began to allow patients treated at its medical facilities to use medical marijuana in states where it is legal. But because the drug remains illegal under federal law, VA doctors themselves cannot recommend it.

The directive put to rest concerns among some veterans and their families that they could lose benefits if they tested positive for marijuana.

But distrust of the government still prevents some veterans from signing up with state medical-marijuana programs, instead opting to buy the drug — and ingest it — illegally.

The VA asks patients to tell physicians if they are using marijuana because it almost always affects their care. Typically, Deering said, physicians will alter patients’ care until it is clear how the marijuana interacts with narcotics. He said marijuana is shown to help with certain medical conditions, but there is not a lot of scientific research on how it interacts with prescription drugs.

Paula Pedene, a spokeswoman with the VA hospital, said medical staffers urge patients to first try intense therapy to treat PTSD instead of self-medicating with marijuana, herbal remedies and other methods.

“They live in a place that has passed this law, and it’s their choice to use it,” Pedene said. “The question is: How can we co-manage their care?”

She said the VA does not keep track of the number of patients who say they participate in the medical-marijuana program, nor do they report them to federal agencies, such as the U.S. Department of Justice or the Drug Enforcement Administration.

Both agencies oppose medicinal use of pot.

Caught in a bind


Iraq veteran Cory Woodstock believes the VA abandoned him after he began smoking marijuana illegally. He suffers from a traumatic brain injury, PTSD, depression and physical pain.

While serving in the military, the security convoys he rode in were involved in three bomb attacks within 38 hours.

By the time the Purple Heart recipient returned home to Apache Junction, Ariz., he was on 23 prescriptions, taking 57 pills a day. In 2009, he smoked marijuana for a short time after veteran friends told him it would help stop the voices in his head and the pain radiating through his body.

But once the pot showed up in his urine tests, he said, his VA doctor cut him off all prescriptions, which he still needed to manage his pain. He stopped ingesting marijuana, afraid federal officials would strip him of his benefits because they still consider pot to be illegal. He sought treatment outside the VA system but said it hasn’t helped as much as the marijuana did.

“It was an experiment, and it worked,” he said. “I was able to sleep. I wasn’t so conscious about not being able to speak (well). I told the doctors I tried it and it helped. They said it voided my contract with the VA.”

Woodstock wants to use pot again, but he will not sign up for the state’s program unless federal law enforcement changes its stance.

“I’m leery of the federal government. I’m not going to take the chance,” he said.

Doctors weigh in


Doctors disagree on how effective medical marijuana is to treat symptoms such as PTSD.

Dr. Sue Sisley, an internist in private practice and assistant professor of psychiatry and internal medicine at the University of Arizona, said marijuana is extremely effective for veterans. She said she sees many veterans who turn to marijuana only after conventional medicine doesn’t help.

“It’s really uncharted territory for veterans and the VA,” she said. “The VA has taken a position where they’re not going to terminate patients if they have a card, but the truth is that a lot of doctors have a strong bias against it — they believe they are just drug addicts.”

Dr. Edward Gogek, an addiction psychiatrist in private practice, believes people are pretending to use marijuana for treatment — including veterans. He said most veterans are substance abusers and should not be allowed to ingest marijuana.

“You’re talking about giving an addictive drug to people with substance- abuse disorders,” Gogek said. He said there are nonaddictive approaches to treating sleep disorders, PTSD and other conditions.

Across the nation, some veterans are urging the White House and Congress to legalize marijuana for veterans at the federal level. Michael Krawitz, executive director of Veterans for Medical Cannabis Access in Virginia, said veterans are “mercilessly being denied treatment” because they cannot access medical marijuana in all 50 states.

“Veterans found cannabis long before states started passing these laws,” he said “By a long shot, it’s better than the drugs they get at the VA.”

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"First, President Obama's administration ejected medical marijuana patients from the workplace then he threw them out of public housing then took away their ability to buy a gun then closed down their dispensaries and now he has apparently set his sights on veterans," said Michael Krawitz, executive director of Veterans for Medical Cannabis Access (VMCA).


Thousands of veterans asked the Obama Administration to at look into the science showing how cannabis works to alleviate suffering and save lives of veterans with brain injuries such as post-traumatic stress disorder (PTSD), and to then make appropriate changes in policy. "Allow United States Disabled Military veterans access to medical marijuana to treat their PTSD," the petition simply requested.


But the White House response to the veterans' petition was very disappointing. "We asked for a change in policy," Krawitz said. "To have our petition answered by the drug czar, an ex policeman, is most inappropriate given the drug czar is bound by law to ONLY discuss current law and has no power to discuss policy change with the public.



"Even the lowest ranking staffer at the White House or anyone from the Veterans Health Authority would have been more appropriate," Krawitz said.


With suicides outnumbering combat fatalities by a ratio of 25 to 1, according to Dr. Julie Holland, editor of The Pot Book, "This, given how effectively cannabis works to save lives, is an unacceptable loss," Krawitz said.


Recent research has revealed two things of great importance. One is that suicide rates drop around the implementation of medical marijuana laws, and the other is that new research indicates similar brain changes from athletic head injuries, military head trauma and brain changes from Alzheimer's disease and multiple sclerosis.



The latest research shows how a human body-wide set of control functions called the Endogenous Cannabinoid Receptor System may be activated or augmented by the ingestion of cannabis, which has both neural protective and neural regenerative properties to help relieve these difficult-to-treat medical conditions.


Al Byrne, retired Naval officer and cofounder of VMCA, was blunt in his assessment of the White House's disregard for injured veterans.



"Vets have used cannabis for PTS since the Revolutionary War," Byrne said. "We know what we need and to be told by our President, the Commander in Chief, that he does not care about those he has sent to war by denying medicine to the wounded is unconscionable."


"Our community can no longer afford to be ignorant about this," said cannabis consultant Mickey Martin, author of the book Medical Marijuana 101 and the marijuana blog Cannabis Warrior. "It is time we begin to have real conversation about the dangers of denying soldiers a safer alternative that can possibly help them to limit the issues that come with PTSD.


"If we really care about humanity, and if we really support our soldiers, it is obvious that our government MUST stop inhibiting research into cannabis and its therapeutic possibilities where PTSD and other serious illness are involved," Martin said. "And the war on the drugs themselves often give PTSD to a great number of officers and victims, as well.


The Department of Veterans Affairs is now in direct conflict with the White House, according to the VMCA.

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