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ANALYSIS

Military veterans and medical marijuana — a combustible mix

Dr. Kelly King talks with a medical marijuana patient during a consultation for her fibromyalgia and sleeping problems at the ReleafMD, Center for Medical Marijuana in Brandon. The patient, who did not want to be identified, was a nurse for 30 years and is currently using CBD oil and CBD relief balm. Her husband, who is a veteran, is also treated by Dr. King, who provides prescriptions for legal medical marijuana to patients in need, several of whom are veterans.

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By ILEANA NAJARRO | Tampa Bay Times, St. Petersburg, Fla. | Published: July 26, 2019

TAMPA — When a newly retired U.S. Army veteran applied for a job in March, he told the local recruiter that he was using CBD oil through Florida’s medical marijuana program.

The revelation was soon confirmed by a failed drug test. The federal contract position would have paid $10,000 for a month’s work abroad — needed money for his family. But forced to choose between his health and his wallet, he kept taking the CBD oil.

“I don’t think it’s right that we have to make that choice,” said Vincent, 45, who asked that his full name not be used out of fear his legal cannabis use could jeopardize his veteran benefits.

Veterans like Vincent — who served two tours in Iraq — find themselves increasingly frustrated with the hurdles they face in trying to access marijuana for medical purposes even as support for legalizing the drug continues to grow.

Lucrative federal jobs become off limits even if they reside in one of the 34 states with a medical marijuana program. They need to pay out of pocket for the drug and required doctor visits, and it has to be in cash because banks can't work with the marijuana industry under federal law. And many worry they could lose hard-earned benefits if they publicly disclose legal use.

The U.S. Department of Veteran Affairs states on its website that “veterans will not be denied VA benefits because of marijuana use,” including disability payments.

Yet when Vincent asked his veteran service officer how his marijuana use would affect his disability and retirement checks, he said the officer could not give him a clear answer.

Individual reports, such as a case in Massachusetts this year where a veteran reportedly lost their VA home loan eligibility because they worked for a legal marijuana company, stoke fear and uncertainty.

But the perceived risks aren’t stopping a growing number of veterans from trying medical marijuana as an alternative treatment, though they are careful to remain in the shadows.

Dr. Kelly Ennix King, a physician in Brandon licensed to prescribe medical marijuana, said about 40 percent of her cannabis patients are veterans. That number keeps rising, King said, as more veterans grow tired of pharmaceuticals prescribed by the VA that are either inadequate, don’t work or have significant side effects.

Vincent sustained multiple injuries across his 27 years of military service, including permanent nerve damage from the neck down, total reconstructive shoulder surgery and a post-traumatic stress disorder diagnosis.

He was put on multiple narcotics, including Oxycontin. At one point he was taking up to 10 different medications for pain management alone. The medications combined later led to stage three kidney disease and a damaged liver, he said.

When he moved his family to Florida about a year ago, he began seeing advertisements for CBD oil. Derived from the hemp plant — a cousin of the marijuana plant — CBD oil doesn't produce a high. And while some doctors say considerable testing is needed before it can be declared medically effective, fans of the oil say it can relieve pain and reduce anxiety and depression, among other uses.

After months of researching CBD and reading testimonials from fellow veterans, Vincent went to see King.

She explained how the drug could help him, how veterans in particular can benefit from CBD given the nature of military injuries.

“It wasn’t about trying to get high and sit on your couch and wait for the munchies to kick in,” Vincent said. “ It was actually about feeling better and being able to function on a daily basis without feeling impaired.”

For the last seven months, the occasional use of CBD helped relieve some of Vincent’s pain due to his nerve damage. He has been able to lower his pharmaceutical intake down to two prescriptions.

“It’s like night and day,” he said of the CBD’s effectiveness.

In the latest Iraq and Afghanistan Veterans of America member survey, 20 percent reported using marijuana for medical purposes. Yet of those respondents, only 31 percent have spoken to their doctor about their use.

King said she often sees veteran patients who tell her their VA doctors don’t know about her CBD prescriptions.

It creates a problem where primary care doctors are unable to have a complete medical record for their patients, and are unable to track their patients’ responses to marijuana.

The VA created a directive in 2017 to better outline how patients legally using marijuana can speak to their VA provider. Yet many veterans remain wary of opening up.

In response, U.S. Rep. Greg Steube, R-Sarasota, introduced a bill earlier this year to essentially codify the directive, making sure no veteran benefits could be stripped due to legal marijuana use.

Other bills introduced this year go a step further, calling on the VA to conduct its own research into the medical properties of marijuana.

“Medicinal cannabis may have the potential to manage chronic pain better than opioids and treat PTSD, and clinicians need to understand the efficacy of this drug and any negative side effects,” said U.S. Rep. Mark Takano, chairman of the House Veterans Affairs Committee.

He said VA doctors in legal states like Florida should be allowed to provide recommendations for medical marijuana programs. That could save out-of-pocket costs veterans face in accessing the drug.

On top of the $75 fee to enter Florida’s marijuana registry, patients like Vincent must pay for doctor visits and pay in cash for CBD oil that costs $70 to $100 a month, depending on the needed dosage.

Trulieve, one of the largest dispensaries in Florida, said in a statement that the company offers a 10 percent discount to veteran patients, and affiliated nonprofits help pay some veterans’ doctor appointments.

The end game for these advocacy groups is federal legalization of marijuana, which would open the door to federally funded research, remove employment limitations, and potentially put a dent in the veteran suicide epidemic.

Even just expanding the VA’s right to research and recommend medical marijuana would make a difference, Vincent said.

“In the meantime, guys like me have to suffer,” he said. “We have to go in the shadows of trying to make these things work.”

Within the last two weeks Vincent secured employment to enhance the disability and retirement pay his family depends on. To do so, he reduced his CBD doses.

Whether he will be able to keep the job on the lower dosage is unclear. If the pain gets worse, he said, he would return to his regular CBD regimen.

The need to choose, he said, remains the issue.

“All we want from the government is what they promised us,” he said. “They promised to take care of us and our families after serving our country.”

“Part of that is being able to get the medications I require to function as close to normal as possible like every other American.”

inajarro@tampabay.com

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