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Medical cannabis as an alternative to opioids for veterans
Like many veterans, the rigors of military service took a toll on Air Force veteran and DAV life member Jarid Watson’s body. He’s not sure when exactly it happened—perhaps during physical training or while loading and unloading cargo planes as a member of the world-famous U.S. Air Force Thunderbirds—but at some point during his nearly 12 years in uniform, a bone growth on the ball joint of his hip tore his labrum and damaged much of the surrounding cartilage.
The injury brought on chronic pain for Watson and eventually led to his medical retirement from the military in 2016. It also severely affected his sleep, which in turn negatively influenced his motivation and mood. As a father, husband, entrepreneur and student, he knew something had to be done to combat the pain and restore his ability to get a good night’s rest, for the benefit of himself, his family, his career and his studies.
For Watson, there was only one choice.
The Cannabis cure
DAV calls for more research into medical cannabis as an alternative pain relief option for veterans with chronic pain, PTSD and TBIs.
Like many veterans, the rigors of military service took a toll on Air Force veteran Jarid Watson’s body. He’s not sure when exactly it happened-perhaps during physical training or while loading and unloading cargo planes as a member of the world-famous U.S. Air Force Thunderbirds… continue reading
Marijuana’s promising moment
Iraq veteran finds cannabis helpful as Washington debates how to move forward.
Like many veterans, service took a toll on Ryan Rasnick.
While he was driving in western Anbar Province in Iraq in 2009, an RKG-3—a Russian-made anti-tank hand grenade—was hurled directly in front of his vehicle. Rasnick quickly slammed on the brakes. And while the maneuver likely saved his and other lives, it violently jostled his neck causing longterm damage… continue reading
Is medical cannabis legal?
Over the past two decades, the legal status of medical marijuana in many states has evolved to reflect the shifting attitude towards cannabis as a viable medicine.
Currently, 33 states and the District of Columbia have state-approved medical marijuana programs, as do Guam, Puerto Rico and the U.S. Virgin Islands. Two additional states have passed medical cannabis legislation that is expected to be fully implemented at a later date, while seven states permit cannabinol (CBD) oil—the non-psychoactive component in cannabis—for medical purposes only.
Visit the National Conference of State Legislatures to find which states have medical marijuana programs.
However, physicians face ethical and legal barriers when deciding to recommend medical marijuana for veterans—while it may be permitted where they live, it remains a federally prohibited drug.
What types of conditions can medical marijuana treat?
The FDA notes increasing interest in the use of cannabis to treat a variety of medical conditions, including glaucoma, cancer, multiple sclerosis, chemotherapy-induced nausea, and certain seizure disorders. Of the states that allow medical marijuana, chronic pain, traumatic brain injury and post-traumatic stress disorder are often qualifying medical ailments.
What are other possible benefits?
Advocates and researchers believe that legal access to medical cannabis could potentially alleviate the opioid addiction crisis that has been reported among veterans.
According to the Department of Veterans Affairs, an estimated 65% of veterans suffer from chronic pain and are twice as likely to die from an accidental prescription opioid overdose as non-veterans. As such, many veterans are looking for alternatives to highly addictive and potentially dangerous opioid medications—like medical marijuana.
According to USA Today, almost every VA facility has experienced a steady drop in its opioid prescription rates since 2012, with an overall decline of 41 percent. The VA is also continuing its efforts to promote safe prescribing practices and to address the broader opioid epidemic in the United States, which includes alternative therapies for its patients.
Are there efforts underway to legalize medical cannabis for veterans within VA?
VA scientists are able to conduct research on marijuana benefits and risks, and potential for abuse, under regulatory approval. Any questions related to research can be addressed to [email protected] .
Several bills introduced in the 116 th Congress, including the VA Medicinal Cannabis Research Act of 2018 (H.R. 5520), the Veterans Medical Marijuana Safe Harbor Act (S. 3409), and the Veterans Equal Access Act (H.R. 1647) sought reforms concerning medical marijuana for veterans. While these bills did not ultimately make it into law, new legislation is likely to be introduced in the 117 th Congress.
What is DAV’s stance on medical cannabis for veterans?
DAV Resolution 023, passed by DAV members in 2018, calls for research into the medical efficacy of medical cannabis for treating conditions of service-disabled veterans. Additionally, as mentioned above, DAV has supported legislation which seeks to do this. This is an important issue for many disabled veterans and DAV members—and leadership believes it is critical to enhance the base of knowledge surrounding the potential benefits and risks.
Can veterans get medical marijuana through the VA?
Currently, VA doctors cannot provide or recommend medical marijuana for veterans as the federal status for cannabis remains a Schedule 1 substance, making the drug illegal in the federal government’s eyes. Because of this, veterans should never bring any type of marijuana into a VA facility, even when provided through a state-sanctioned medical marijuana program.
However, veterans participating in a state-sanctioned medical marijuana program will not be denied VA benefits, according to the Department of Veterans Affairs. VA providers are able to discuss cannabis use with veteran patients and adjust care and treatment plans as needed. Veterans are encouraged to discuss medical marijuana use with their VA providers as part of their confidential medical record.
The VA will not pay for medical marijuana prescriptions from any source, nor will VA providers complete paperwork or forms required for a veteran to participate in a state-approved medical marijuana program.
However, anecdotal feedback from veterans shows that VA’s directives and actual patient experiences sometimes differ in cases where a prescribed medical marijuana user walks into a federal (VA) facility.
View VA’s full directive on medical marijuana here. If you have questions regarding this policy please contact [email protected] .
Is it true that I could lose the right to buy or own firearms if I use medical cannabis?
Marijuana, despite medical and recreational legalization in some states, is still illegal under federal law.
According to the Bureau of Alcohol, Tobacco and Firearms, “Any person who uses or is addicted to marijuana, regardless of whether his or her state has passed legislation authorizing marijuana for medicinal purposes is an unlawful user of or addicted to a controlled substance and is prohibited by Federal law from possessing firearms or ammunition.”
Some states have remedial steps to restore 2 nd Amendment rights for registered medical marijuana users. But it is important to remember that even in states where it is legal, the federal law still applies.
Will I Lose My VA Disability Benefits If I Use Marijuana?
Many veterans wonder if marijuana use will affect their VA disability compensation. Even though some states have legalized medical and/or recreational marijuana use, it is still considered a Schedule One Controlled Substance under federal law. This means the federal government views it as illegal. However, veterans will not be denied VA benefits for their marijuana use.
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In this article about pot and VA disability
States that have legalized marijuana
The following states have fully legalized marijuana, meaning that it is decriminalized and can be legally used for medicinal purposes or otherwise.
Because marijuana laws can change at a rapid pace, they can be confusing to follow. The Defense Information Systems Agency has an interactive map of all 50 states’ marijuana legalization status that updates monthly for easy access.
If I use marijuana, what does that mean for my VA benefits?
Because marijuana is considered a Schedule One Controlled Substance at the federal level, the VA is required to follow all federal laws and regulations, including those about marijuana. This means that VA health care providers are not allowed to recommend or assist veterans in obtaining it.
However, if a veteran participates in a state marijuana program, that does not affect eligibility for VA services and care. VA providers are encouraged to discuss marijuana use with veterans to aid in comprehensive care planning and to adjust treatment plans as needed.
Here are some other important facts that veterans need to know about marijuana use:
- VA health care providers will document marijuana use in a veteran’s medical record for use in treatment planning. This information will always be confidential and protected under patient privacy and confidentiality laws and regulations.
- VA health care providers may not recommend medical marijuana.
- VA pharmacies may not fill prescriptions for medical marijuana.
- The use or possession of marijuana is prohibited at all VA medical centers, grounds, and locations.
- VA health care providers may not complete paperwork or forms required for veteran patients to participate in state-approved marijuana programs.
- The VA will not pay for medical marijuana prescriptions from any source.
Does the VA drug test?
When you have routine lab work done such as blood tests or urinalyses at any VA hospital or clinic, they may check for drugs. It is important to note that blood tests and urinalyses are performed to check for conditions and abnormalities, not to specifically check for the presence of drugs.
The VA uses a standardized four-panel drug detection kit. This test shows the presence of narcotics (Vicodin, morphine, Oxycontin, and others), marijuana, cocaine (or crack), and amphetamines. Some tests might detect benzodiazepines such as Valium and similar drugs.
Another purpose of routine blood tests and urinalyses is to ensure that you are taking your prescribed medications properly. The VA’s policy states that it is up to each treating doctor to decide how to handle a veteran’s marijuana use. VA doctors cannot prescribe medicinal marijuana, but they can choose to ignore marijuana use if they do not see a problem.
If they do see a problem, they most likely would be concerned about the potential interference of using prescribed medications and marijuana. You would most likely be instructed to make the choice of using marijuana or prescribed medications. This is strictly a therapeutic decision by the provider. As mentioned above, it should be clear that the VA does not routinely test for illegal drugs.
VA-certified disability benefits attorney Zack evans describes the VA Rating Formula for Mental Disorders and Disabilities.
Are marijuana use and willful misconduct related?
Unfortunately, there is not a simple answer to this question. Willful misconduct is an intentional act or omission which is in disregard of a known risk. If you receive a willful misconduct finding, you may not be eligible for VA disability benefits. The Code of Federal Regulations states that a mere technical violation of police ordinances or regulations will not necessarily constitute willful misconduct.
You will not receive a willful misconduct finding for using marijuana if it did not cause injury, death, or disease. The VA may find that marijuana use is related to trying to cope with PTSD or other conditions. This would be a condition eligible for a VA rating and compensation. On the flip side, the VA can punish you if the willful misconduct was found to be a result of abusing drugs for fun and you were not using the drugs as a coping mechanism for something you were diagnosed with.
To summarize, it is possible to receive a willful misconduct finding from marijuana use if it causes an injury, disease, or death. As stated above, there are exceptions to this rule.
Marijuana for PTSD symptoms
Veterans who suffer from PTSD have been reporting for years that cannabis helps manage their PTSD. There have been multiple studies examining the relationship between cannabis and PTSD symptoms. One study found that cannabis reduced the severity of intrusions, which are described as returning thoughts of a traumatic event, by about 62%, irritability by 67%, flashbacks by 51%, and anxiety by 57%. The study suggested that cannabis does reduce PTSD symptoms acutely, but it might not have longer-term beneficial effects.
A study published in December 2020 had promising news for the long-term benefits of cannabis for PTSD. The findings concluded that people with PTSD saw a greater reduction in their symptoms, but they were 2.57 times more likely to recover from PTSD during the study than those who were not using cannabis.
Limited research makes it difficult to assess the potential for cannabis as a method of treatment for PTSD. Other studies show somewhat inconclusive results on the effectiveness of cannabis in treating PTSD symptoms.
Advocating for veterans who use medical marijuana
Advocates who support using medical marijuana to treat veterans have stepped up their efforts in recent years. The initiatives range from Congressional law proposals to grass-roots projects.
The VA Medical Cannabis Research Act of 2021
The VA Medical Cannabis Research Act of 2021 was introduced into the Senate on April 29, 2021. This is not the first time legislation like this has been considered by Congress.
The purpose of the bill is to require the VA to perform clinical research on the safety and efficacy of medical cannabis in treating veterans for PTSD and chronic pain. A growing number of veterans use medical cannabis to treat their symptoms. The bill would require the VA to acknowledge that. At the time of this article’s publication, the bill was still being considered in the Senate. The Committee on Veterans’ Affairs held a hearing in June 2021.
The Veterans Medical Marijuana Safe Harbor Act of 2021
The Veterans Medical Marijuana Safe Harbor Act was first introduced in the Senate in February 2019 and was reintroduced into the current Congress in April of 2021. The bill would allow doctors at the VA to prescribe medical marijuana to veterans in states that have established medical marijuana programs. The bill would also create a temporary five-year safe harbor protection for veterans who use medical marijuana and would encourage the VA to research how medical marijuana could help veterans better manage chronic pain and reduce opioid abuse.
The bill was referred to the Committee on Energy and Commerce and the Committees on the Judiciary, and Veterans’ Affairs. Most recently, the bill was referred to the Subcommittee on Health, but at the time of this article’s publication, the Senate had taken no further action.
Veterans Cannabis Project
The Veterans Cannabis Project, founded by former Navy SEAL Nick Etten, supports giving veterans access to medical cannabis for treatment. Thirty-four U.S. states allow the use of medical cannabis and 83% of U.S. veterans support medical cannabis programs.
You can apply to become an advocate of the Veterans Cannabis Project here. As an advocate, you can get the chance to tell your story to policymakers and the public about why you advocate for cannabis treatment for veterans.
Veterans Cannabis Coalition
Eric Goepel, who served in the U.S. Army for 7 years, founded the Veterans Cannabis Coalition, which is dedicated to ending cannabis prohibition–especially for veterans. The purpose of the organization is to work with veteran leaders around the nation to advocate, organize, and educate on behalf of veterans and all patients of cannabis treatment.
What About CBD for Veterans?
Cannabidiol (CBD) is the naturally occurring compound found in the flower of cannabis. CBD is currently thought to be a safe and non-addictive substance. The difference between CBD and THC (tetrahydrocannabinol) is that CBD is non-intoxicating, unlike THC. THC is the compound in cannabis that makes a person feel “high” or “stoned” while using marijuana.
VA clinicians are not allowed to prescribe any products containing THC, CBD, or any other cannabinoids. However, research has suggested CBD can help with PTSD symptoms.
The FDA and National Center for Health Research have both concluded that there is not enough evidence to say with certainty that CBD is 100% safe. The World Health Organization has also published a report on CBD.
High THC use may be connected to long-term negative psychiatric effects. This is especially true for adolescents who consume large amounts of THC. However, there is no conclusive evidence that cannabis causes schizophrenia or other psychiatric disorders.
Marijuana vs. opioids
Veterans who suffer from PTSD have a greater risk of turning to alcohol and/or opioids to manage symptoms. Opioids are highly addictive and can cause a fatal overdose. Cannabis is a safer alternative because it greatly reduces the chance of dependence and eliminates the risk of fatal overdose compared to opioid-based medications. Also, a study found that medical cannabis patients reported that cannabis was just as effective, if not more, than opioid-based medications for pain.
Is marijuana more effective than other PTSD medications?
There is not a definite answer to this question because medications and cannabis can affect everyone differently. If standard PTSD medications work for you and do not cause any problems, keep following the medical advice from your doctor. If marijuana helps your PTSD symptoms more than standard medications, talk to your doctor. We aren’t medical experts. We’re here to help veterans get their VA disability benefits, not to give medical advice.
How a VA benefits attorney can help
Woods and Woods has helped thousands of veterans with their VA disability applications and appeals. Call us today to discuss your VA disability appeal or your first application. The call is free and we won’t charge you a single fee until we win your case.
All of our attorneys are VA-certified. Call us and join the thousands of veterans we have helped to receive the VA disability benefits they deserve.
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FREQUENTLY ASKED QUESTIONS
Veterans will not be denied VA benefits for their marijuana use. Talk to your doctor and follow their medical advice.
It is possible to receive a willful finding if a veteran’s marijuana use causes an injury, disease, or death. A veteran using drugs recreationally might be considered willful misconduct if the veteran is recreationally using drugs. However, the VA may find that marijuana use is related to trying to cope with PTSD or other conditions.