Category Archives: VETERANS

VA says it won’t study medical marijuana’s effect on veterans

The Department of Veterans Affairs says it will not conduct research into whether medical marijuana could help veterans suffering from post-traumatic stress disorder and chronic pain, as veterans groups are pushing for the use of the drug as an alternative to opioids and anti-depressants.

In a letter to U.S. Rep. Tim Walz (D-Minn.), Department of Veterans Affairs Secretary David Shulkin said VA’s ability to research medical marijuana is hampered by the fact that the drug is illegal federally. Shulkin’s letter came in response to an inquiry by 10 Democrats on the House Veterans’ Affairs Committee. The letter asks Shulkin to commit the VA to investigating whether medical marijuana can help veterans suffering from PTSD and chronic pain and identify barriers to doing so.

“VA is committed to researching and developing effective ways to help Veterans cope with post-traumatic stress disorder and chronic pain conditions,” Shulkin wrote in a response to the members of Congress. “However, federal law restricts VA’s ability to conduct research involving medical marijuana, or to refer veterans to such projects.”

The response comes as at least 29 states, plus the District of Columbia, Guam and Puerto Rico, have legalized the use of medical marijuana in some form. Veterans groups, including the American Legion, have been pushing for the drug to be studied and used to help ease the effects of PTSD, chronic pain and other disorders.

“What America’s veterans need prioritized right now is for cannabis to be treated as a health policy issue,” said Nick Etten, founder and executive director of the Veterans Cannabis Project. “We’re desperate for solutions for the conditions we’re dealing with.”

According to a 2017 VA review, about 15 percent of veterans treated at outpatient PTSD clinics reported using marijuana in the previous six months. According to an American Legion phone survey released in November, 22 percent of veteran household respondents said they used cannabis to treat a medical condition. Ninety-two percent of veteran households surveyed for the Legion said they support researching whether marijuana can effectively treat mental and physical conditions and 82 percent said they want to have medical cannabis as a legal treatment option.

Last month the Veterans Health Administration urged patients to discuss medical marijuana use with their doctors. The shift will allow doctors and patients to determine what, if any, effect marijuana use might have on treatment plans. Veterans were earlier concerned that admitting to marijuana use could jeopardize their benefits. But VA physicians still cannot refer patients to state medical marijuana programs because of the federal prohibition.

[ VA Clears The Air On Talking To Patients About Marijuana Use ]

John Hudak, deputy director of the Center for Effective Public Management at the Brookings Institution, said even though marijuana is illegal federally, research on the drug is not prohibited.

“Obviously it is federally illegal, but there are no restrictions on doing scientific research on it. Universities do this all the time and there’s a process to go through,” he said, noting that the National Institute on Drug Abuse funds cannabis research. “It’s really a cop out for the VA to say, ‘oh, we’re not doing work on this because of federal law’ when actually federal law allows them to do that.”

Shulkin’s response was “disappointing and unacceptable,” Walz, the House committee’s ranking member, said in a statement.

“VA’s response not only failed to answer our simple question, but they made a disheartening attempt to mislead me, my colleagues and the veteran community in the process” by stating that the VA is restricted from conducting marijuana research. Walz, a veteran, said he plans to send another letter to Shulkin asking for further clarification.

A spokesman for Shulkin pointed to the secretary’s past comments on medical marijuana. Shulkin said in May, “My opinion is, is that some of the states that have put in appropriate controls, there may be some evidence that this is beginning to be helpful. And we’re interested in looking at that and learning from that. But until the time that federal law changes, we are not able … to prescribe medical marijuana for conditions that may be helpful.”

Shulkin said VA is offering a suite of alternative treatments for patients with PTSD, including yoga, meditation, acupuncture and hypnosis. The letter also said VA has a program to reduce the amount of opioids prescribed to patients with chronic pain; since 2013, Shulkin wrote, 33 percent fewer patients were receiving opioids.

There has not been much research into marijuana for medical purposes, in large part because of regulatory hurdles and the fact that marijuana is classified as a Schedule 1 drug along with substances including heroin. Until 2016, only researchers at the University of Mississippi were allowed to grow marijuana for scientific use; the DEA relaxed the rules and let other institutions apply to do so, though none have yet been approved.

President Trump said during the campaign that he supports making medical marijuana available to the very sick. His attorney general, Jeff Sessions, is a staunch opponent of marijuana. Sessions this month made it easier for prosecutors to enforce federal law in states that legalized marijuana. Eight states and the District allow the recreational use of marijuana.

Shulkin cited a VA analysis of existing research, which found “insufficient evidence” that medical marijuana helps patients with chronic pain or PTSD and could increase harm in some areas, including car crashes. A study by the National Academies of Sciences, Engineering and Medicine that reviewed studies on the health effects of marijuana and associated products found they can provide a “significant reduction in pain symptoms” for chronic-pain patients. But many say there has been a paucity of research.

“There has been no meaningful clinical research conducted on PTSD and brain injuries,” Etten said.

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"It’s the height of hypocrisy,"…

FDA Is Open To Medical Marijuana For Vets, But Other Agencies Stand In The Way

Mona Zhang , Contributor

Dr. Sue Sisley, a medical marijuana researcher, speaks at the Arizona Secretary of State’s Office Wednesday, April 14, 2010 at the Capitol in Phoenix. (AP Photo/Matt York)

When the U.S. Food and Drug Administration (FDA) warned cannabidiol producers against making medical claims about cannabis products, it seemed par for the course for any federal agency. Cannabis is simply not considered medicine in the eyes of the government.

But the FDA actually appears pretty open to considering the potential of marijuana as medicine. “We’ve had good experiences working with the FDA,” said Brad Burge, communications director at the Multidisciplinary Association for Psychedelic Studies (MAPS). The non-profit is currently conducting the first FDA- and DEA-approved clinical trial on whole-plant marijuana and enrolled its 30th participant on October 26.

“We have a long relationship with the FDA — a lot through our MDMA research. They’ve been open to approving research protocols into Schedule I drugs,” said Burge. “It’s other regulatory agencies that have been standing in the way.”

It’s certainly unhelpful that the National Institutes of Drug Abuse have a monopoly on growing research cannabis. The Drug Enforcement Administration and the Justice Department aren’t helpful on this front either. But the lack of support for the study from Veterans Affairs (VA) is even more egregious.

Dr. Sue Sisley, the trial’s lead researcher, says she’s determined to focus on veterans for this study. She plans to examine the effects of cannabis on 76 subjects with treatment-resistant PTSD. Her main motivation in focusing on veterans is the epidemic of veteran suicides in the U.S. The VA estimates that about 22 veterans commit suicide every day – Sisley thinks that number is probably higher.

“As a scientist, I’m skeptical of subjective claims,” said Sisley. “[But] we have a mountain of anecdotal reports from veterans claiming that cannabis is lifesaving.”

The implications go beyond saving their lives – Sisley has heard plenty of military spouses and children sing the praises of the drug. “The kids will say, ‘I got my dad back’ after years of [him] being disengaged, irritable and mean,” she said.

Now, her main challenge is recruiting enough veterans who fit the study criteria and are able to participate on-site in Phoenix, Arizona. Sisley estimates that the Phoenix VA hospital has 20,000 veterans in their system who meet the study’s eligibility requirements. But the hospital is refusing to provide information about the study to its patients.

“[In] some of the states that have put in appropriate controls [for medical marijuana], there may be some evidence that this is beginning to be helpful,” said VA Secretary David Shulkin at a White House press briefing in May. “We’re interested in looking at that and learning from that.”

But Sisley says that Shulkin has so far refused to express support for her study: “It’s the height of hypocrisy,” she said.

“The VA Secretary could make a call to the Phoenix VA, and we could start sharing information with these patients,” said Sisley. “Why does it take political courage to defend a federally legal study? Not even defend it, just fast-track it. We’ve been stonewalled at every turn.”

The researchers have paid for various types of advertising and hired a veteran to oversee recruitment efforts. Still, “the issue for us is [getting] cooperation from the Phoenix VA hospital,” said Sisley. Recruitment has dwindled to a “pretty slow trickle.”

If the study fails to recruit 46 more veterans in the next couple of months, “we’ll have to reevaluate,” she said. “We fought for so many years and the veteran community has stood shoulder to shoulder with us, helping us kick down the doors… Many of them have adopted this trial as their own.”

The American Legion, a veterans organization that has more than 2 million members, called on the VA to support the clinical trial in September. “We ask for your direct involvement to ensure this critical research is fully enabled,” wrote the organization’s National Commander Denis Rohan in a letter to Shulkin. “[The study] could potentially produce scientific evidence that will enhance, improve, and save the lives of veterans suffering from post-traumatic stress disorder.”

But Shulkin has remained mum on the issue.

“I’m assuming that [Attorney General] Sessions has created an atmosphere of fear around the word ‘cannabis’ and so nobody’s willing to step out,” said Sisley. “The FDA deserves major commendation because they at least are responsive.”

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Why Are So Many Veterans on Death Row?

By Jeffrey Toobin

A new study shows that at least ten per cent of death-row inmates are military veterans.

The death penalty has always provided a window into the darkest corners of American life. Every pathology that infects the nation as a whole—racism, most notably—also affects our decisions about whom to execute. A new report from the Death Penalty Information Center adds a new twist to this venerable pattern.

The subject of the report, just in time for Veterans Day, is the impact of the death penalty on veterans. The author, Richard C. Dieter, the longtime executive director of the invaluable D.P.I.C., estimates that “at least 10% of the current death row—that is, over 300 inmates—are military veterans. Many others have already been executed.” In a nation where roughly seven per cent of the population have served in the military, this number alone indicates disproportionate representation. But in a nation where military service has traditionally been seen as a route into the middle class—and where being a vet has been seen as more of a benefit than a burden—the military numbers are especially disturbing.

Why are so many veterans on death row? Dieter asserts that many veterans “have experienced trauma that few others in society have ever encountered—trauma that may have played a role in their committing serious crimes.” Although this is hardly the case with every veteran, or even the overwhelming majority of them, Dieter goes on to relate several harrowing stories that follow this model. Because of such traumas, many veterans suffer from post-traumatic stress disorder, for which they have too often received poor treatment, or none at all.

Veterans who kill are not, by and large, hit men or members of organized crime or gangs. They very often lash out at those around them. Dieter notes that a third of the homicide victims killed by veterans returning from Iraq and Afghanistan were family members or girlfriends. Another quarter were fellow service members. This record suggests that, if these veterans had received adequate mental-health care, at least some of them and their victims might have had a different fate.

But it’s possible to see, in the D.P.I.C. study, an echo of another recent high-profile study. Anne Case and Angus Deaton, of Princeton, found that the death rates for middle-aged white men have increased significantly in the past decade or so. This was largely due, according to the authors, to “increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis.” The Princeton study fits into a larger pattern in American life, which is the declining health and fortunes of poorly educated American whites.

That cohort has gravitated to military service for generations. And while, again, most veterans never commit any crime, much less crimes that carry the death penalty, the sour legacies of our most recent wars certainly play into the despair of many veterans. Earlier generations of veterans came home from war to ticker-tape parades, a generous G.I. Bill, and a growing economy that offered them a chance at upward mobility. Younger veterans returned to P.T.S.D., a relatively stagnant economy, especially in rural and semi-rural areas, and an epidemic of drug abuse. And they came home to a society where widening income inequality suggested the futility of their engagement with the contemporary world.

In an interview with Vox, Deaton said that the death rate for members of this cohort had increased, in part, because they had “lost the narrative of their lives.” This elegant, almost poetic phrase can be read to include the lost promise of military service—the vanished understanding that veterans earned more than a paycheck, that they also gained a step up in status, both economic and social. The reality has been that many veterans returned to lives that were materially and spiritually worse than the ones they left, and far worse than the ones they expected.

According to the Princeton study, a shocking number of poorly educated whites turned their rage inward, in the form of drug abuse and suicide. But a small handful inflicted their rage on others, and an even smaller number wound up on death row. They are different groups of people, and their individual stories are even more variegated, but it’s possible to see across them the symptoms of a broader anguish.

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