Posted on Jun 13, 2015
VA policy on marijuana and painkillers lacks consistency, veterans say. What do you say?
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AUSTIN, Texas (Tribune News Service) — Since early 2013, Vietnam veteran Bill Williams had received daily doses of hydrocodone to help him deal with chronic leg and back pain. For more than 30 years, he has taken anti-anxiety drugs like Valium to help with the post-traumatic stress disorder he developed after a lengthy tour on a Navy submarine.
Occasionally, the 62-year-old Brackettville resident would smoke marijuana, which he said provided relief for his pain and PTSD in ways the pharmaceuticals could not. His experience with that drug, which he said also helped him sleep, mirrors that of a growing number of veterans who have turned to medical marijuana as an alternative to traditional treatments.
At first, he said, his Department of Veterans Affairs doctors tolerated his marijuana use, telling him that if it helped his symptoms he should continue. But that changed with the introduction of stricter VA policies on narcotic painkillers, the result of new Drug Enforcement Administration rules on hydrocodone and a VA push to reduce the number of patients receiving the medications.
In April, after he tested positive for marijuana, the VA canceled his hydrocodone prescription.
The incident is emblematic of a brewing battle over marijuana use among veterans suffering with chronic pain and anxiety disorders and the VA's evolving, sometimes confusing, position as more states legalize the drug.
"There is no consistency, even in the states where it's legal," said Roger Martin, executive director of Grow4Vets, which advocates for marijuana treatment of pain and PTSD.
As a federal agency, the VA is in an unusual position. It recognizes marijuana possession as a federal offense, but its policy doesn't prohibit veterans who get state-sanctioned medical marijuana from participating in VA pain control programs.
And officials say a positive marijuana test doesn't automatically result in an opioid prescription cancellation, but should cause doctors to assess patients for "misuse, adverse effects and withdrawal." The decision to halt opioid drugs when a patient uses marijuana "need(s) to be made by individual providers in partnership with their patients," the agency's policy states.
But in states such as Texas, where marijuana isn't legal, the VA's policy is less clear. Asked specifically about marijuana use by Texas patients, VA officials couldn't provide clarification.
Williams' doctor at the San Antonio VA, for example, told him that the agency's policies provided no wiggle room. "Due to the presence of the marijuana, based on current VA practice guidelines, I am unable to prescribe further controlled substances (hydrocodone) at this time," he wrote in a letter to Williams.
Martin said his group has heard from a number of veterans like Williams who say their painkiller prescriptions have been abruptly canceled in recent months because of marijuana use.
"It's a flat-out violation of the Hippocratic oath," he said. "It puts veterans and the people around them in danger."
Pain specialist Dr. C.M. Schade, director emeritus of the Texas Pain Society, said that civilian doctors in Texas must halt narcotic prescriptions for patients who test positive for controlled substances; they can be resumed once the patient stops taking the illegal drug or enters treatment.
Williams said he stopped smoking marijuana months before his positive test, which he blamed on secondhand smoke from toking friends, but he acknowledged previous positive tests. But he said that shouldn't disqualify him from receiving the pain medication he needs to function on a daily basis, especially if it is allowed in states like Colorado and Washington.
He recently underwent a procedure to burn the nerve endings in his back, which should give him relief for several months, but he fears for the future.
"What's scaring me is that in (the coming) months, when I'm going to need pain medication, are they going to give it to me?" he said. "I'm not a person that's going to go beg the VA for pain meds. I have a high tolerance for pain. But once those nerves grow back I won't be able to live with it."
http://www.stripes.com/news/veterans/va-policy-on-marijuana-and-painkillers-lacks-consistency-veterans-say-1.352200
Occasionally, the 62-year-old Brackettville resident would smoke marijuana, which he said provided relief for his pain and PTSD in ways the pharmaceuticals could not. His experience with that drug, which he said also helped him sleep, mirrors that of a growing number of veterans who have turned to medical marijuana as an alternative to traditional treatments.
At first, he said, his Department of Veterans Affairs doctors tolerated his marijuana use, telling him that if it helped his symptoms he should continue. But that changed with the introduction of stricter VA policies on narcotic painkillers, the result of new Drug Enforcement Administration rules on hydrocodone and a VA push to reduce the number of patients receiving the medications.
In April, after he tested positive for marijuana, the VA canceled his hydrocodone prescription.
The incident is emblematic of a brewing battle over marijuana use among veterans suffering with chronic pain and anxiety disorders and the VA's evolving, sometimes confusing, position as more states legalize the drug.
"There is no consistency, even in the states where it's legal," said Roger Martin, executive director of Grow4Vets, which advocates for marijuana treatment of pain and PTSD.
As a federal agency, the VA is in an unusual position. It recognizes marijuana possession as a federal offense, but its policy doesn't prohibit veterans who get state-sanctioned medical marijuana from participating in VA pain control programs.
And officials say a positive marijuana test doesn't automatically result in an opioid prescription cancellation, but should cause doctors to assess patients for "misuse, adverse effects and withdrawal." The decision to halt opioid drugs when a patient uses marijuana "need(s) to be made by individual providers in partnership with their patients," the agency's policy states.
But in states such as Texas, where marijuana isn't legal, the VA's policy is less clear. Asked specifically about marijuana use by Texas patients, VA officials couldn't provide clarification.
Williams' doctor at the San Antonio VA, for example, told him that the agency's policies provided no wiggle room. "Due to the presence of the marijuana, based on current VA practice guidelines, I am unable to prescribe further controlled substances (hydrocodone) at this time," he wrote in a letter to Williams.
Martin said his group has heard from a number of veterans like Williams who say their painkiller prescriptions have been abruptly canceled in recent months because of marijuana use.
"It's a flat-out violation of the Hippocratic oath," he said. "It puts veterans and the people around them in danger."
Pain specialist Dr. C.M. Schade, director emeritus of the Texas Pain Society, said that civilian doctors in Texas must halt narcotic prescriptions for patients who test positive for controlled substances; they can be resumed once the patient stops taking the illegal drug or enters treatment.
Williams said he stopped smoking marijuana months before his positive test, which he blamed on secondhand smoke from toking friends, but he acknowledged previous positive tests. But he said that shouldn't disqualify him from receiving the pain medication he needs to function on a daily basis, especially if it is allowed in states like Colorado and Washington.
He recently underwent a procedure to burn the nerve endings in his back, which should give him relief for several months, but he fears for the future.
"What's scaring me is that in (the coming) months, when I'm going to need pain medication, are they going to give it to me?" he said. "I'm not a person that's going to go beg the VA for pain meds. I have a high tolerance for pain. But once those nerves grow back I won't be able to live with it."
http://www.stripes.com/news/veterans/va-policy-on-marijuana-and-painkillers-lacks-consistency-veterans-say-1.352200
Health
Department of Veterans Affairs (VA)
Marijuana
Posted 9 y ago
Responses: 8
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People need to get over the stigma of marijuana. If it helps, let doctors prescribe it; let people use it. Besides, it's not something that's manufactured by man. God put it on the earth; who is man to declare something natural illegal?
Just my two cents.
Just my two cents.
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As long as marijuana is illegal under Federal law this will be a problem for the military - even if states decriminalize or legalize it.
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Capt Seid Waddell
SPC Jan Allbright, with several states now decriminalizing recreational use, the studies will come. The impact on society will become much more obvious, IMHO.
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Suspended Profile
The human body has receptors for Cannabis that make it an outstanding analgesic. The Brits have a pill for of CBD, the analgesic part of Marijuana (It does not have THC, the psychoactive part) making it a non-addictive, non-sedating, very effective pain killer. It's beyond time that we have this too...
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Another thought on this issue: if MMJ helps a Veteran function better then by law their service connected disability (i.e. PTSD) would decrease. So how are Veteran Service Organizations going to handle Veterans functioning better hence a decrease in rating for PTSD. It already happens for cancer related to Agent Orange. Initially a person can get 100% but then it's decreased when found to be in remission.
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SPC Jan Allbright, M.Sc., R.S.
Interesting observation. Change PTSD to Epilepsy.
If the medication stops your Epilepsy then they should stop paying for your medicine? The Epilepsy wasn't cured, it is controlled, so the disability didn't decrease, it's just under control.
If the medication stops your Epilepsy then they should stop paying for your medicine? The Epilepsy wasn't cured, it is controlled, so the disability didn't decrease, it's just under control.
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CPT Topher Murphy
Correct, if the functioning improves (the way laws for disability are written) then yes the rating would decrease. Again the Agent Orange example and prostate cancer. Cancer is never considered cured but only in remission. And if a person has SC'd epilepsy then it is rated on the person's functioning.
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CPT Topher Murphy
Let me clarify, NO to stopping the medication assistance. Yes to decreased disability rating if functioning improves. That is the way the law is written.
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Given the fact that VA is funded by the US Government until marijuana use is legal for medical use by the US Government VA will not be permitted to prescribe it to veterans. Pain killers are legal to prescribe and therefore the only course of action available to the VA.
Do I agree, no. I think it should be legalized for medical use.
Do I agree, no. I think it should be legalized for medical use.
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What I've been saying right along, let the FDA control it as a legal pharmaceutical and problem solved. it is so beyond me how this is such an issue. The FDA controls opiates and other narcotics so why is marijuana so different?
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1LT David Moeglein
I agree with you MAJ Robert (Bob) Petrarca. However, pharmaceutical companies can't make the kind of profit on a natural substance, that they can on a patented synthetic product. Pharmaceutical companies fund medical schools and the FDA. Herein lies the rub.
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Suspended Profile
http://www.military.com/military-report/va-docs-may-recommend-rx-marijuana.html?ESRC=mr1116.nl
According to this report, if this legislation passes the House and is signed by the President, VA docs will be authorized to write marijuana letters for medical marijuana in states where it's legal...
According to this report, if this legislation passes the House and is signed by the President, VA docs will be authorized to write marijuana letters for medical marijuana in states where it's legal...
VA Docs May Recommend Rx Marijuana
Legislation passed November 10 by the U.S. Senate includes a provision that would allow VA doctors to recommend medical marijuana to patients in states where it is legal.
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marijuana should never have been listed as a narcotic
the whole drug scare, reefer madness and hate campaigns of the plant is what cleared the way for prohibition and ridicules over dramatization and classification of the plant
an end to prohibition would really be above the ignorance
In the land of the free and home of the brave I believe we should the right to our own decision to live our life as we choose
if this choice does not afflict or harm anyone I see no wrong with it, are we not free to our own pursuit of happiness I guess not if you don't live in the right state or if your still serving
the whole drug scare, reefer madness and hate campaigns of the plant is what cleared the way for prohibition and ridicules over dramatization and classification of the plant
an end to prohibition would really be above the ignorance
In the land of the free and home of the brave I believe we should the right to our own decision to live our life as we choose
if this choice does not afflict or harm anyone I see no wrong with it, are we not free to our own pursuit of happiness I guess not if you don't live in the right state or if your still serving
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