Marijuana is not just the best drug, it's the only drug that
consistently helps people suffering from post-traumatic stress disorder,
a parade of doctors, researchers and veterans told a panel of lawmakers
At issue is Senate Bill 281, which would add PTSD, as it's commonly
called, to the list of qualifying conditions for medical marijuana use
"We have failed to find any medications at this point that provide
consistent benefits" for the thousands of war veterans and others who
suffer from the disorder, said Bryon Krumm, a psychiatric nurse
practitioner at the Sage Neuroscience Center in Albuquerque, New Mexico.
"It's all pretty much been a crap shoot up to this point."
US National Library of Medicine - National Institutes of Health
advances in understanding of the mode of action of tetrahydrocannabinol
and related cannabinoid in-gredients of marijuana, plus the
accumulating anecdotal reports on potential medical benefits have
spurred increasing re-search into possible medicinal uses of cannabis.
Recent clinical trials with smoked and vaporized marijuana, as well as
other botanical extracts indicate the likelihood that the cannabinoids
can be useful in the management of neuropathic pain, spasticity due to
multiple sclerosis, and possibly other indications. As with all
medications, benefits and risks need to be weighed in recommending
cannabis to patients. We present an algorithm that may be useful to
physicians in determining whether cannabis might be recommended as a
treatment in jurisdictions where such use is permitted.
The Department of Veterans Affairs doesn't care much
about you smoking marijuana.
You won't lose a benefit if you're smoking marijuana. The only people
who are concerned are in the health care arena of the VA...your doctors.
Most enlightened physicians recognize that marijuana has some medicinal
benefit and that there is no evidence of harmful side effects other than
the obvious...inhaling hot smoke. Most agree that the single most
devastating side effect of recreational marijuana use is that it remains
illegal and you may be arrested for it.
Having said that, your doctor may feel differently. If your doctor makes
a decision that you shouldn't be smoking, he or she has the right to
ask you to stop. Few people will try to help you with that sort of
problem as the doctor is the clinical authority and makes those
Most mental health providers will ask that you refrain from all
recreational substance use. If you are diagnosed with any mental health
problems, your doctor will want your head to be as clear as possible
during treatment. You should comply.
Doctors who treat your chronic pain with narcotics may also tell you to
lay off the recreational marijuana. They want to be able to judge the
effects of the treatments they offer you without any other substances
Orthopedic doctors today are often refusing such surgery as hip and knee
replacement unless the patient gives up tobacco and marijuana. They
believe that smoking anything will displace vital oxygen and interfere
with the critical healing process.
Doctors who do transplants like kidneys or other organs also frequently
tell the patient to quit smoking marijuana. This is as much a matter of
discipline as anything else. They know that if you refuse to follow
their orders, you may not do as well with your transplant and they can
offer the organ to another patient who will be more compliant.
Although society is undergoing some positive changes in how we view
recreational substance use, marijuana remains an illegal drug. Federal
laws are strict and in some states, even a small amount can earn you
You do not have any "rights" to smoke pot. If you're smart, and you want
to keep your health care provider happy, you'll pay close attention to
what the provider tells you.
Read on for the rest of the story about why you may or may not want to use marijuana.
How does this affect veterans? We get a
lot of mail each week from vets who worry about VA drug tests ordered by
their VA doctors.
As a general policy, VA isn't concerned about vets using marijuana. VA
is a federal organization so must obey the federal laws...VA doctors
won't be writing prescriptions for medical marijuana any time soon.
Your VA doctor may still tell you that you must abstain from smoking
pot. Every doctor has the authority to inform you that he/she believes
that marijuana use will interfere with your treatment. This is true even
if you live in a state where marijuana is now quasi-legal.
Mental health professionals and pain clinic docs may insist that you
give up your recreational weed while you're in their care. That's
legitimate and if you don't pay attention, they have every right to
discontinue your treatments.
In the big picture, marijuana use is not a medical concern, the debate
is just politics as usual. Most health care professionals recognize that
like another popular recreational substance...alcohol comes to
mind...moderation is the answer. If you are an occasional drinker or an
occasional marijuana smoker, your doctor will probably tell you to keep
it within reasonable limits and it won't have any effects on your
However, even though some states are lifting restrictions, federal law
is strict and prohibits the possession or use of marijuana.
Don't possess it on any VA property or you may learn that the VA police
force are the real deal...they aren't security guards, they're police
officers who have all the authority necessary to arrest you.
Much of the testing in both civilian and VA and military settings is
done with a standardized 4 drug detection kit. The test of your urine
would show the presence of narcotics (Vicodin, Oxycontin, morphine,
etc.). marijuana, cocaine (or crack) and amphetamines. In some tests
benzodiazepines (Valium and similar) may be detected.
Therefore, if you are tested to ensure that you are taking your
prescribed medication and you have been smoking marijuana, you'll likely
get a call from your doctor.
VA and many civilian providers today will insist that you sign a "Pain
Contract" if you are on any sort of pain medicines for more than a very
The reasoning behind this is controversial.
There is a common misconception that veterans who receive any sort of
pain medicine are likely to resell it at a very high profit. Like most
of the rumors that are published about the American "War On Drugs" there
is little truth to this.
The majority of veterans who receive pain medicines from VA are just
like you and they have no reason to want to sell their medicines. The
bulletins would have you believe that every pill is worth an enormously
inflated price and that vets can get rich by selling their medicines.
The result of all this is that you are likely to be tested to ensure
that you're taking your medicines. Once you sign the pain contract you
give VA the authority to test you at any time. They are not required to
tell you that you're being tested for drugs.
If you aren't taking your drugs at the time of the test, your provider may not extend any more refills.
If other drugs (such as marijuana) are seen during the test, you may or
may not be counseled. That depends on the individual provider.
When disabled veterans have their yearly lab tests done (blood & urine) for diabetes does the VA...
A. Check to see if you have your prescribed meds in your system?
B. Check for illegal drugs in your system?
You may be
referencing routine lab work (blood tests and urinalysis) during
physicals that may note high blood sugars as well as high cholesterol
and many other abnormalities.
You may at that time be checked for illegal drugs. That is almost
accidental because sometimes VA does check you for legal drugs. Here is
how it works...
If you have a condition
that causes chronic pain, you may be on long term therapy with oral
narcotic medications. In both the civilian world as well as the veterans
world, most treating caregivers today require that you will sign a
That agreement tells your doctor that you will only
take the narcotic strictly as prescribed and that you won't share it
with anyone else. It will also say that you agree to take a drug test to
see if there is a therapeutic level of the drug in your system. These
tests may be random or scheduled.
There has been an infrequent problem that patients will use their
narcotics to turn a profit...they may sell the pills to others. If you
are tested for your particular drug and you do not have any of it in
your system, you'll have some explaining to do.
For example, if your
prescription says you are to take 3 pills each day for your pain and you
have none of the medicine in your blood or urine, that would indicate
that you haven't taken the medicine for days and that you probably don't
When you are tested, the most frequent test is by urinalysis. Each test
kit has a cost associated with it. There are different types of test
kits that detect different types of drugs. The lower cost testing
supplies usually test for 4 drugs at the same time. Other kits will test
for 6 or 8 or more. As you would guess, the more drugs detected, the
higher the cost of the kit.
Beyond all that, to my
knowledge veterans are not routinely tested for illegal drugs. The
expense alone would be huge and in a more or less routine circumstance,
testing of all patients at a given facility may show that hundreds or
even thousands were using marijuana. The question of "What then?"
arises. Once VA identified all these veterans what should they do?
There are instances where mental health patients who are taking
psychotropic drugs will be tested to ensure that they are not taking
illegal drugs. That's a very serious situation as the mental health
patient can negatively affect the treatment plan by mixing their
prescribed medicines with recreational drugs. Patients who are
candidates for organ transplants may also be counseled (and tested)
about using recreational drugs because of the amount of anti-rejection
medicines they are likely to be required to take.
recently issued a policy about the use of marijuana by patients. State
laws regarding medicinal marijuana are changing across America but
federal laws aren't. VA is a federal institution and must walk a fine
line between condemning the use of marijuana or endorsing it.
What they did in the policy statement was to leave it up the the
individual treating doctor as to how to handle such a thing. VA will not
allow doctors to prescribe medicinal marijuana but your doctor can
pretty much ignore your use of it if he or she doesn't see a problem.
If your doctor believes that you have a conflict with the use of
prescribed medications and smoking marijuana, you may be instructed that
you must make a choice of marijuana or prescribed medications. That is
strictly a therapeutic decision by the provider and little appeal is
available should it happen to you.