The Thin Green Line


All across this great nation, disabled veterans of all ages and eras are being abandoned and persecuted by our government for choosing to use the only medicine that truly alleviates their suffering from chronic pain and post-traumatic stress disorder — marijuana.

America is a country at war — not just with terrorists, but with ourselves. In the midst of all our government’s partisan posturing, there’s one issue that supposedly unites Republicans and Democrats alike: supporting our troops. But medals and parades, however noble the sentiment, aren’t what our wounded men and women in uniform really need; what they need is compassion and proper treatment for the agonies and injuries they brought back with them. Unfortunately, the sad truth is that a great many vets come home and realize they’ve survived one war, only to find themselves casualties of another — the War on Drugs.

There are approximately 33,000 Iraq and Afghanistan war vets who have returned home with serious injuries and conditions that cause them chronic pain. In addition, the National Center for Mental Health reports that nearly 30% of US troops who have spent time in war zones suffer from some degree of post-traumatic stress disorder (PTSD) — including about 115,000 Iraq and Afghanistan vets, and nearly a million Vietnam vets. The symptoms of PTSD include insomnia, night terrors, depression, flashbacks, migraines, rapid heart rate, irritability, outbursts of anger, apathy and thoughts of suicide. These symptoms are so severe that according to the Department of Veterans Affairs’ mental-health director, Dr. Ira Katz, close to 1,000 veterans a month attempt suicide. Tragically, statistics show that about half of them succeed. Unbelievable as it may seem, more vets have actually committed suicide since 2001 than have died in battle.

The medications typically prescribed to treat PTSD are antidepressants such as Prozac, Zoloft, Selexa and Paxil — selective serotonin reuptake inhibitors (SSRIs) that increase serotonin levels in the brain. For chronic pain, most patients are given highly potent anticonvulsants like Klonopin, as well as powerful opioids like OxyContin and MS-Contin (a form of morphine) — narcotics so powerful that they practically turn the patient into a zombie. These medications are also extremely habit-forming (with nearly a 60% dependency rate) and can be very dangerous; according to a 2006 Fox News report, 5% of patients using SSRIs exhibited psychotic and/or suicidal tendencies. And in June of 2008, the Charleston Gazette reported that four PTSD victims died from medications (Paxil, Klonopin and Seroquel) prescribed to them by VA clinics.

“Treatment by the VA is far more dangerous than combat in Baghdad,” writes Dr. Phillip Leveque, a columnist for Salem-News.com, an online-only news agency that has devoted a great deal of coverage to veterans’ issues. Dr. Leveque is uniquely overqualified to speak on this subject: Not only was he a professor of pharmacology and a forensic toxicologist, he was also a concentration-camp liberator in World War II who suffered from PTSD himself and specialized in treating vets with the illness during his time as a practicing physician. This 86-year-old doctor (nicknamed “the most dangerous man in Oregon”) has become a passionate champion of veterans’ rights and was one of the principle petitioners for Oregon’s medical-marijuana law back in 1988.

“Having covered combat operations in both Iraq and Afghanistan, I have many concerns for our returning veterans,” says Salem-News.com executive editor Tim King. “I’ve received hundreds of emails and comments from combat veterans over the years telling me that marijuana is the only thing that brings them relief from the nightmares and related problems stemming from PTSD. This is the biggest reason we’ve gone out on a limb in recent years to cover medical marijuana.”

Of course, pot’s effectiveness in dealing with PTSD is no secret to those who served in Vietnam — like the former machine gunner who now goes by the handle Hemp Solo.

“We needed weed to survive there,” he says flatly. “When you smoked a joint, you were able to forget the atrocities of the day before. If you didn’t smoke, you couldn’t sleep.” Solo continued to use marijuana for his PTSD after coming home, but soon found himself at odds with the law for doing so. “We figured, if it helped us over there, it’ll help us over here. But here, it gets you in trouble.”

Tired of getting busted, this pot-smoking patriot decided to fight back and created Veterans for Weed (theveteransforweed.com) — a website dedicated to vets who’ve been prosecuted or persecuted because of weed. This “new VFW,” as he calls it, serves as a forum for stoner soldiers to vent and get advice. “We got feedback from this one vet who, after working at the same company for 20 years, was given a random urine test and lost his job,” says Solo. “That kind of stuff happens to vets every day.”

As if losing a job for smoking pot wasn’t devastating enough, vets are also losing their medical benefits. That’s because many hospitals in the VA system require patients to sign a “pain contract” before they can receive any prescription medications. While the specifics of these contracts vary from hospital to hospital, the one universal provision is that patients must consent to random drug screening—and if they test positive for marijuana, their pain meds will almost certainly be discontinued.

In 2005, disabled Air Force veteran Michael Krawitz refused to sign a pain contract at a VA hospital in Virginia and was immediately cut off from his meds. He challenged the contract’s legality on the grounds that it violated his civil rights — namely, his Fourth Amendment right against unreasonable search and seizure, his Fifth Amendment right against self-incrimination, and his 14th Amendment right to equal protection under the law.

“Basically, what I said was this: You, the VA, can’t leverage my pain treatment against me to make me pee in a bottle for a non-medical test,” Krawitz explains. “You don’t have the authority.”

Sergeant Krawitz is now the executive director of Veterans for Medical Marijuana Access (VMMA), an advocacy group founded in 2007 by Michigan marijuana activist Martin Chilcutt. The VMMA started out just trying to “rally the troops” — getting all the different veterans’ organizations together to pass resolutions in favor of medical-marijuana access. But in the past year or so, it’s taken on more of a leadership role, shifting its focus to lobbying lawmakers on behalf of sick and injured veterans.

“We’re developing a direct relationship with the VA authorities and every single member of the Veterans Affairs committees of both the Senate and the House,” says Krawitz. “Every single one of them is going to know our names and our faces by the time we’re done, and we will affect a medical-marijuana policy in the VA.”

Contrary to common belief, the imposition of pain contracts isn’t universal in the VA system — nor is it mandatory. A 2003 Veterans Health Administration directive on the treatment of pain noted that “adherence with [an] opioid agreement, if used,” could be part of a patient’s overall evaluation, but the decision to use one was supposed to be left to the doctor’s discretion. However, the doctors aren’t making these decisions; hospital administrators are. The VA claims that these contracts are meant to protect the patient — but protect them from what? Does the VA really believe that marijuana is more dangerous than the toxic cocktails they’re currently prescribing?

“The funny thing is that every veteran hears again and again that the reason marijuana is illegal is that it might lead to using hard drugs like morphine,” says Krawitz. “So think about the irony of coming into the VA hospital and being offered any amount of morphine you want as long as you stay away from marijuana!”

In reality, Krawitz believes, these contracts only serve to protect the VA and its doctors from any possible liability or legal repercussions. In a memorandum issued to the New Mexico VA Health Care System in March 2008, physicians are forbidden from recommending or authorizing the use of medical marijuana under penalty of civil and/or criminal penalties and revocation of their license. According to a top official at said organization, this policy is based solely on the “advice” of the Drug Enforcement Agency.

“The dea has done a great job of scaring doctors,” Krawitz says. “If a doctor is prescribing opiates, they’re extremely hesitant to recommend marijuana, and vice versa.”
Jeff Flesher, who runs Vetshelpcenter.com out of Oregon, takes narcotic medications to treat his Gulf War syndrome as well as a broken back. But he has yet to try marijuana as a medicine because, like many of his fellow vets, he’s afraid even to broach the subject with the VA.

“Even though I have a [medical marijuana] license card — what might happen to me if the VA doctors, after testing my blood, find marijuana? How might that impact my medical benefits? It’s questions like these that keep most vets from thinking about using medical marijuana.”

The tragic irony in all this is that, in the vast majority of cases, patients report that smoking marijuana actually helps them reduce the amount of narcotic pharmaceuticals they need to take. Roger Dowty, a medical-marijuana patient and licensed clinical counselor in Missoula, MT, has been taking narcotic pain medications for over two decades for the injuries he sustained during his 12 years as a firefighter in the Air Force. While he acknowledges his need for prescription painkillers, Dowty says that using marijuana has helped him cut the amount of pharmaceuticals in half.

“I survive in a much happier world now because of cannabis,” he says. “I’m able to sleep better, play longer, have dropped 55 pounds, and my blood work is the best it’s been in 20 years.”

Dowty found the caregivers in his area too expensive, so with some help from HIGH TIMES, he designed his own hydroponic system and began growing his own medicine. Partnering with an investor, he formed the caregiver company Medical Cannabis of Montana. But when he approached the county attorney to file the necessary paperwork and ensure that his new operation was in strict compliance with the law, he was immediately denied approval and threatened with prosecution.

Nikolai Jackson served as a combat medic during Operation Iraqi Freedom before being honorably discharged for PTSD and multi-level degenerative disc disease. As part of his treatment, the VA prescribed a staggeringly dangerous mix of medications, including Seroquel (an antipsychotic), Ambien (a sedative), Citalopram (an antidepressant), Prazosin (for hypertension), Ativan (an anticonvulsant/muscle relaxant used for anxiety disorders) and Clonazepam (ditto) — none of which helps him as much as cannabis does.

“Marijuana has cut my pill intake down to almost one-quarter of what it once was,” Jackson tells HT. “I smoke it daily, and it’s helped with my flashbacks, intrusive memories, anxiety, sleeping and social disorders. My quality of life has been greatly improved — as well as my memory and concentration. No manufactured pill has given me the pain relief and mobility that medical marijuana has for my problems and pain.”
Yet when Jackson tried to explain this to his therapist, the latter refused to see him again until he “got clean.”

“All I got was reefer-madness propaganda thrown in my face,” Jackson complains. “I don’t understand how the government could withhold medicine from any sick patient — especially those who have served their country honorably and developed symptoms from that service that marijuana alleviates.”

Even if PTSD sufferers live in a state that allows medical marijuana, it’s unlikely that they’ll be able to obtain a doctor’s recommendation for their condition, as PTSD is not on most states’ list of “acceptable” ailments. Most state laws allow medical-marijuana use only for severe physiological conditions (AIDS, cancer, glaucoma, multiple sclerosis, etc.), not psychological ones — in fact, Washington, Maine and Vermont have explicitly excluded mental illnesses such as anxiety and depression from their lists. Aside from California, New Mexico is the only other medical-marijuana state whose guidelines are broad enough to include PTSD (23% of the patients enrolled there are diagnosed withPTSD — the largest group). The reason for this is that PTSD is classified as a form of depression and lumped in with a number of other psychiatric conditions (such as anxiety and schizophrenia), making it extremely problematic for doctors and elected officials to include it in medical-marijuana legislation.

However, in a recent interview with Salem-News.com publisher Bonnie King, Dr. Leveque insisted that PTSD shouldn’t be classified as “depression” at all. “My dictionary defines depression as ‘dejected, dispirited, lowered in vitality or function or activity, and sad’ — and that’s just not it. On the other hand, anguish is defined as ‘distress, difficulty, extreme pain, agony, torture and torment.’ Being in an infantry battle is all of those things — and when you survive an infantry battle, you have all of those things. But you’re not ‘depressed.’”

Leveque believes that categorizing PTSD in such a way also allows the VA to delay and deny disability claims, which saves the agency money. PTSD needs to be separated from depression and other more ambiguous disorders before groups like VMMA can launch a successful nationwide push to include it under state medical-marijuana laws.

 “When you get a vet in there talking about smoking a little pot so they don’t have to stay up all night revisiting the horrors of war,” he says, “it becomes a little less controversial and a little easier to get that legislation through.”

Of course, testimonials—no matter how numerous or passionate — are no substitute for scientific research. Fortunately, the evidence that cannabis has legitimate medical value in treating these conditions continues to grow—and Israeli researchers have been at the forefront.

At the 2004 Clinical Conference on Cannabis Therapeutics (hosted by Patients Out of Time), Professor Raphael Mechoulam of Hebrew University in Jerusalem — the man who first isolated and named the THC molecule back in 1964 — postulated that cannabinoids aid the brain’s natural function of discarding unneeded information, making them a possible treatment for PTSD (see “Pot & PTSD”).

Taking this theory a step further, a recent study conducted by the Department of Psychology at the University of Haifa (published in the Journal of Neuroscience) found that a synthetic compound resembling THC can prevent the stress-induced enhancement of fear memories in rats — in effect minimizing or reducing traumatic memories.

“The endocannabinoid system has recently emerged as important in the regulation of extinction learning and in the regulation of the hypothalamic-pituitary-adrenal axis,” the study states. “Our findings may support a wide therapeutic application for cannabinoids in the treatment of conditions associated with the inappropriate retention of aversive memories and stress-related disorders.”

On the heels of these findings, the Israeli Health Ministry began approvals for full clinical trials on over 50 Israeli soldiers with PTSD. The ministry already supplies cannabis to approximately 800 licensed patients suffering from severe pain due to cancer, multiple sclerosis and certain other conditions — as does Canada, whose Department of Veterans Affairs implemented a policy in May 2009 whereby the use of medical marijuana is not only accepted as part of treatment, but actually paid for by the government. Yet despite this mounting evidence and the overwhelming testimony from PTSD sufferers, our VA has still refused to acknowledge marijuana’s benefits or even discuss it as a treatment option.

There are glimmers of hope, however.

On Saturday, June 6, 2009, the Saginaw News posted a letter from Gabriel Perez, the director of the Aleda E. Lutz VA Medical Center in Michigan, which said that the VA would now accept medical-marijuana use in states where it was legal and would no longer remove veterans from its pain-management programs if they test positive for pot — provided they have a doctor’s recommendation, and as long as they don’t bring their medicine to a VA facility. The letter stated:

“It is acknowledged that testing positive for marijuana in a patient, based upon a random drug screening, will not serve as a breach of the current pain management agreement if the patient submits documentation in support of the marijuana being prescribed and dispensed in conformity with Michigan law. The legalization of medical marijuana in Michigan is acknowledged. However, pursuant to federal law, VA physicians, nurse practitioners and other licensed clinicians are not authorized or permitted to participate in the recommendation for treatment of or prescribing medical marijuana to a VA patient that would otherwise be legal in Michigan. Furthermore, the VA will not dispense, prescribe or store medical marijuana, and its possession on VA property remains illegal and a criminal offense.”

According to the veterans’ advocacy website VAWatchdog.org, this policy appears to be the same in all states where medical marijuana is allowed by law. However, the VA has yet to release an official statement on the matter. HIGH TIMES made several attempts to contact the VA by phone and email regarding its policy on medical marijuana — none of which were successful.

“It’s important to understand that in the VA system at this point, there is no policy,” says VMMA’s Krawitz. “As best as we can tell, that was a regional decision that was made in that part of the country.”

But according to Krawitz, that’s about to change. “I’ve been told by inside sources at the VA that they’re about to clearly spell out their policy regarding marijuana in their new guidelines on pain management, which are expected out any time now. Because of our work, it’s very possible that the VA may become the first federal agency/entity that recognizes medical marijuana.”

In the meantime, if you’re a vet out there who’s encountering problems related to marijuana use, VMMA offers this advice: “First, try to communicate with the doctor politely and see if you can correct the situation,” Krawitz suggests. “If not, go to the patient advocate’s office at the hospital. If all that fails, contact us. We’re here, and we’ll try to help them in any way we can. Most of all, if things seem shitty right now, just try to ride it out. Things are changing very fast, so just hold on.”

 This year, our government passed the largest-ever increase in the VA’s budget ($15 billion) and an historic health-care reform bill. Unfortunately, neither contained any provision for (or even discussion of) medical marijuana. With the American Medical Association’s vote last year to reclassify cannabis as a Schedule II drug under the Controlled Substances Act, isn’t it high time that we took the advice of former Surgeon General Dr. Jocelyn Elders and “put science ahead of politics”?

We owe our men and women in uniform an immeasurable debt of gratitude for defending us and our way of life. If our government and our political leaders truly want to honor this service, they need to retire their outdated reefer-madness rhetoric and put the well-being of our wounded heroes first. Otherwise, all those parades and promises will ring as hollow as the rifle blast at a military funeral.

Thanks to Salem-News.com, Veterans for Medical Marijuana Access, Veterans for Weed, Dr. Melamede, Dr. Leveque, Michael Krawitz, and especially to all the brave souls who fight for our freedoms both at home and abroad. For a full list of resources and information on this topic, go to hightimes.com/tags/veterans.

Editor’s Note –  Since the publication of this article — and thanks to the efforts of the VMMA and others — the VA has altered its policy toward medical marijuana: not only did they stop depriving US veterans who use medical marijuana their pain medications, but in many cases now even allow vets to use their cannabis on VA hospital premises

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