Veterans work to legalize medical marijuana amidst wave of suicides, overdoses

By CATHY MCKITRICK | Standard-Examiner, Ogden, Utah (Tribune News Service) | Published: January 13, 2016

Following last year's legislative session where hopes of legal medical marijuana went up in smoke, a group of Utah military veterans banded together in hopes of achieving a different outcome in 2016.

Sandy resident Drew Reese, part of Utah Veterans for Medical Cannabis, said they'd grown tired of burying fellow soldiers who had died from suicide or drug overdose.

However, many veterans clam up when it comes to openly discussing marijuana to treat their post-traumatic stress disorder symptoms. Many believe talking openly and honestly about such things could put their Veterans Administration medical benefits and care at risk.

Reese, 35, served seven years in the U.S. Army and four years in the Air Force. He is rated at a 100 percent disability.

"The VA had me on a pill cocktail for over eight years," Reese said of the benzodiazepine/opiate combination he said he took to manage frequent migraines and severe arthritis. At the peak of his dosages, Reese said he took 28 pills a day.

And he stopped counting friends lost to overdoses when the tally hit 18. While a reported 22 U.S. veterans die daily from suicide or overdose, Reese said that some speculate the figure is actually double that number, somewhere between 45 to 50 per day, because the report only analyzed data from 21 states.

He easily could have been next statistic.

"After my fourth accidental overdose, I decided to stop using those heavy medications," Reese said. "I should not have to live with the fear of whether I'll wake up the next morning."

Cannabis, opioids, pain management

Reese said his understanding — and the perception of veterans like him — is that the VA could strip benefits altogether if a patient is found to be using medical cannabis.

"Anybody that admits to using cannabis, the VA will place them on a 'pain contract' and cut off their other medications, regardless of whether cannabis is legal in their state," Reese said. A pain contract sets conditions for patients to meet in order to continue treatment. Sometimes the contracts limit a person to a single doctor or single pharmacy, so while they can help prevent opioid abuse, it can also make it harder to seek out alternative treatments.

"There is so much fear because for a lot of these vets, their only medical care comes from the VA. They have no other insurance," Reese said.

Jill Atwood, public affairs officer for the VA's Salt Lake City Health Care System, cited a January 2011 directive governing veteran access to clinical programs should they choose to use medical cannabis in a state where it is legal.

That directive points out that marijuana is still classified at the federal level as a Schedule 1 controlled substance. While it does not strip cannabis-using veterans of any VA benefits or care, it does bar VA providers from completing forms regarding a veteran's participation in a state cannabis program.

"Of course every veteran is treated individually," Atwood said via email.

A June 2015 article in the American Medical Association Journal of Ethics attempted to clarify the VA's policy on using cannabis in conjunction with opioids to treat long-term pain. Michael Krawitz, a disabled veteran who heads up Veterans for Medical Cannabis Access, related his struggle with chronic pain and said he found cannabis helpful in reducing the amount of opiate medication he needed to get adequate relief.

Krawitz referred to new VHA Directive 1005 dated May 6, 2014 which established a policy of informed consent and patient education before embarking on long-term opioid therapy. He also referenced a 2010 letter he'd received from VA doctor Robert Petzel saying that if a veteran tests positive for legal marijuana use, it should not preclude that individual from receiving opioids and other treatment through the VA.

Reached Tuesday by phone, Krawitz said the VA eliminated its use of so-called "pain contracts" in favor of pain management directives based on informed consent but he believes a strong disconnect persists between those directives and actual implementation.

Pending legislation

There are two bills being drafted for Utah's 2016 legislative session — Sen. Mark Madsen, R-Saratoga Springs, is sponsoring a whole-plant medical cannabis measure, while Rep. Brad Daw, R-Orem, and Sen. Evan Vickers, R-Cedar City, have teamed together to draft a more narrow resolution allowing the use of cannabidiol oil only.

While the Utah veterans group opposes the Daw-Vickers bill, some fear the Madsen measure will also leave many out in the cold.

"There's a very important part that we're troubled by, that only certain combat-related injuries will be allowed access to medical marijuana," Reese said. "That goes against everything we stand for. One of our ethos is that we never leave a fallen comrade behind, and Sen. Madsen's bill is asking us to leave many behind."

Reese pointed out that veterans injured in Syria would not qualify because it hasn't been declared a combat zone. And servicemembers suffering from PTSD due to sexual assault or trauma from stateside military base shootings would be similarly excluded.

"Cannabis will not cure everything, but we do have mountains of scientific evidence that shows it is stemming the tide of the suicide epidemic," Reese said.

According to governing.com, 23 states and the District of Columbia have enacted laws legalizing marijuana in some form.

Not enough data?

A common argument against medical cannabis is that very little research has been done in the U.S. to validate its use.

Sue Sisley, a physician specializing in internal medicine and psychiatry, is currently spearheading FDA-approved trials of whole plant marijuana on combat veterans who suffer from PTSD but the work hasn't come without consequence.

According to the online Phoenix New Times, the University of Arizona College of Medicine fired her this past summer in what many viewed as political blowback for her "intense focus on medical cannabis" and creating a scientifically significant study to examine its effects in treating PTSD.

Colorado's Medical Marijuana Scientific Advisory Council since stepped in and gave her a $2 million grant. That, coupled with a formal partnership with Johns Hopkins University helped propel Sisley's study forward.

In a recent phone message, Sisley said that she plans to be in Utah next week to meet with various state lawmakers and work with military veterans on pending legislation.
Several Utah Republican legislators made it to Phoenix last month for the American Legislative Exchange Council conference, and Sisley said she helped provide tours of various marijuana dispensaries and grow facilities.

"I think we may have won over a few who were skeptical, thinking it's a bunch of stoners trying to get high," Sisley said. "We're trying hard to bring some data ... to share the clinical trials that already exist about cannabis and to also show them there's nothing to be afraid of, and there's no reason they can't provide compassionate access to their sick and debilitated patients in Utah, especially the ones who desperately need lab-tested cannabis."

Contact reporter Cathy McKitrick at 801-625-4214 or cmckitrick@standard.net. Follow her on Twitter at @catmck.
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