AMID NEW RESEARCH on how veterans are using cannabis to treat pain and post-traumatic stress disorder, a Republican representative from Bellingham is pushing legislation that would make it easier for vets to access medical marijuana.
The bill, H.4274, sponsored by Republican Rep. Michael Soter, would let someone buy medical marijuana based on paperwork from the US Veterans Affairs Administration indicating a disability, without requiring a separate recommendation from a health care provider. It would also add post-traumatic stress disorder and opioid use disorder to a list of illnesses that qualify a patient to buy medical marijuana in Massachusetts.
Dr. Marion McNabb, CEO of Cannabis Community Care and Research Network, or a pro- marijuana research organization nicknamed C3RN, said veterans typically find little support for marijuana usage at the VA because the drug remains illegal under federal law.
“Their VA providers are not allowed to prescribe or recommend it, and the VA providers are generally unaware of the medical benefits of cannabis and how it interacts with medications they’re currently taking,” McNabb said.
But opponents of the bill say it would let veterans bypass health care professionals in obtaining their medical marijuana and could lead to unsafe use of the drug.
“The idea you would bypass medical care while trying to get treatment is absolute insanity,” said Dr. Jordan Tishler, CEO of inhaleMD, a medical practice focused on prescribing medical marijuana. Tishler is president of the Association of Cannabis Specialists.
Lawmakers on the Joint Committee on Cannabis Policy held a hearing on the bill Tuesday, a day before C3RN plans to roll out the findings of its 10-month study of veterans who use cannabis.
The group surveyed 201 Massachusetts veterans who are already using marijuana, primarily for medical reasons. The survey found that 63 percent of respondents found marijuana helpful to treat chronic pain, and a similar percentage used it to treat anxiety. Fifty-four percent of respondents reported that marijuana helped treat depression, and 46 percent used it for post-traumatic stress disorder.
The survey found that 76 percent of veterans reported using marijuana to decrease their use of other medications, either over the counter or prescription drugs. Almost all respondents reported a better quality of life while using cannabis, with at least 40 percent reporting reduced alcohol and medication use, and at least 20 percent reporting less opioid and tobacco use.
At the same time, veterans reported barriers to accessing marijuana, most notably cost. No insurance covers medical marijuana. The veterans who responded to the survey spent an average of $317 a month on marijuana compared to $77 a month on prescription drugs.
Supporters of Soter’s bill say it will begin to reduce the challenges veterans face in obtaining medical marijuana by making it easier for them to register as patients, without the barrier of an extra doctor’s visit.
Of 33 states where medical marijuana is legal, 26 include PTSD as a qualifying condition. Four states include opioid use disorder. Both of these conditions are common among veterans. (Massachusetts’ law already allows a doctor to recommend marijuana to someone with any debilitating medical condition identified by a health care provider, not only those specifically mentioned in the law.)
Three states – Illinois, North Dakota, and Florida – let veterans use VA paperwork to access medical marijuana. Because marijuana is still federally illegal, VA doctors cannot recommend marijuana, and patients can potentially lose access to their other medications if they use marijuana.
Raymond Sabol served for nine years in the US Marine Corps with two combat deployments. He left in September 2015 with PTSD and chronic pain, and a 100 percent disability rating from the VA.
Because of his enormous anxiety, seeing a new doctor in an unfamiliar setting was “almost too much for me,” he said. It took him four years to visit a doctor who specialized in marijuana recommendations, bringing with him a stack of medical papers from the VA. Since he started using medical marijuana, Sabol said he stopped using around 20 other medications.
Allowing a veteran to use their VA paperwork to access medical marijuana, Sabol said, “would take gigantic steps forward to allow veterans like myself and those who are worse than me to access cannabis.”
Soter sponsored the bill on behalf of his constituent, Stephen Mandile, an Iraq war veteran who was seriously injured during military service and had PTSD. Mandile used marijuana to taper off dozens of other medications he was given by his VA doctors. Marijuana, he said, helped him “mind, body and soul.”
Mandile said the bill stems from his “desire to help as many people who are suffering as possible.”
While the Cannabis Control Commission, which regulates marijuana, voted not to support the bill, Commissioner Shaleen Title said she personally supports it. Title said she has heard from veterans who say it is “redundant, burdensome and prohibitively expensive” to take their diagnosis from the VA and get a second doctor’s diagnosis from a physician allowed to recommend marijuana.
Tishler said a disability certification from the Veterans Administration is an administrative certification, not a specific diagnosis, and does not have any information about the patient’s medical condition, medications or allergies – all of which are important to determine whether a patient should be using medical marijuana.
Tishler, who used to work for the VA, worries that veterans will take health care advice from their friends and use an unhealthy amount of marijuana, without the advice of a doctor trained in medical marijuana use.
“To get the benefit they need and not to end up in an overuse situation, they need proper professional guidance, which they can’t get from the VA at the moment and they certainly can’t get from their buddies,” Tishler said.
Amy Turncliff, a neuroscientist and public health advocate who volunteers with the Massachusetts Prevention Alliance, which has raised public health concerns about marijuana use, said the bill “is inconsistent with current science regarding marijuana as medicine.”
Turncliff cited recent research showing that marijuana use can actually increase the risk of depression, PTSD, opioid use and suicide attempts in military personnel.
She said allowing veterans access to medical marijuana for any disability recognized by the VA, without a separate medical opinion, sends the incorrect message that medical marijuana can treat almost any ailment, and that there is no harm to using it.
“We absolutely understand the underlying intentions are good but they’re not based in science and there really is risk that is not being promoted to the public,” Turncliff said.