Katelyn Baker
Well-Known Member
Veterans dealing with trauma and stress have a variety of treatment options available to them, but despite its legality in some states–and some say, its superior effectiveness–marijuana is not one of those options.
Fred* deployed to Iraq with the U.S. Army's 25th Infantry Division in 2008, and returned with trauma-induced mental health issues. Though he never experienced any combat, the constant vigilance–and a handful of close calls–left him with a severe case of anxiety, he said.
He was based 17 miles north of Baghdad at Camp Taji with Macedonian army soldiers, and they also shared the base with the Iraqi army. Although he was part of an artillery unit, he stood watch at the front gate and conducted routine searches for improvised explosive devices (IEDs) along the main supply route that connected his base to the city.
One day as he stood watch, a fast-moving ambulance approached the gate. The knowledge that car bombers often used ambulances to carry out their missions put him on edge. Fred fired a smoke grenade and a tracer round from his rifle to stop it. It was the fourth instance he experienced of a vehicle trying to run the gate.
"It just catches you off guard," he said.
On a separate night, his unit was relieved after a five-hour IED patrol. They didn't find any that night, but the unit that relieved them got hit pretty bad. Fortunately, no one died.
"I'm pretty sure people were waiting for us to leave, then placed an IED, and waited for the next convoy to go by," Fred said. "It's just like–it could have been us."
The situations he faced during his deployment induced extreme trauma in Fred, who now lives with his parents in Nipomo. To ease his anxiety, he began smoking marijuana. He found it also helps with the pain he has from an unrelated knee injury he sustained earlier this year.
It's not easy for him to get his medical marijuana because it's too expensive, and it's neither offered through the Department of Veterans Affairs (VA) health care nor covered by any form of insurance. And though it's legal in certain states like California, doctors in the VA system can't prescribe–much less recommend–medical marijuana because of federal prohibition.
Personal cultivation offers a less expensive alternative; however, it poses legal questions.
Proposition 64 passed by voters on Nov. 8 and other recent statewide legislation hasn't made access any easier for veterans who want to grow it themselves. And a patchwork of local laws prohibiting new cultivation sites has left veterans on the Central Coast seeking answers.
Not covered by the VA
Randy Danks didn't come home with physical injuries. The Pismo Beach resident and Army veteran served from 2006 to 2010 and deployed once each to Kandahar, Afghanistan, and forward operating base Warhorse near Baqubah, Iraq, as infantry with the 2nd Cavalry Regiment, a unit that had armored Stryker vehicles.
He didn't go into detail about his time on deployment, although at one point he experienced an explosion that left him diagnosed with post traumatic stress disorder (PTSD), according to Danks' father-in-law Bill Bookout.
Danks is one of the 11 to 20 percent of veterans who received PTSD stemming from the conflicts spanning the time between the Vietnam War to operations Enduring Freedom and Iraqi Freedom, according to the VA.
More than a third of veterans enrolled in the VA health care system have a disability connected with their time in service, according to statistics. In 2013, 3.75 million of the nearly 10 million veterans enrolled had a service-connected disability. This status entitles them to receive a monetary benefit paid to them each month, but it makes no allowances for medical marijuana.
If they could get medical marijuana through the VA, workplace laws would add further complications for Danks and other veterans who need medical marijuana. Since California's Drug-Free Workplace Act of 1990, every employer awarded a contract or grant from the state government is required to make sure its employees don't use illegal drugs.
Even with recreational marijuana's newfound legality written into Proposition 64, it still isn't clear for Danks, who works for a company that contracts with Caltrans, whether using the drug would be allowed at his job.
Instead, Danks received a prescription for Celexa, or a pharmaceutical mood stabilizer approved by the Food and Drug Administration in 1998 to treat major depression.
Danks said he believes that medical marijuana could be beneficial for him, but he thinks the mood stabilizer is working for the most part. However, Celexa has at least one undesirable side effect: liver damage. According to the National Institutes of Health, liver toxicity is known to occur in rare instances with the drug.
"It kills my liver," Danks told the Sun.
While Danks and other veterans would prefer to use medical marijuana as an alternative to prescription medication, mental health professionals remain skeptical.
The right drug?
Dr. Tauheed Zaman is an assistant professor of psychiatry at UC San Francisco and has treated veterans who told him that medical marijuana helps with their psychiatric issues. But he remains skeptical because there are no current studies that prove the drug's effectiveness.
In fact, he's leery when vets tell him they use medical marijuana for this reason because it could trigger underlying mental health issues. The connection is not yet understood, Zaman said.
According to the VA, there has been no study of marijuana use in the overall veteran population. However, marijuana use is increasing among veterans. Use has jumped from 13 to 22.7 percent from fiscal years 2002 to 2014 according to the VA. The wars in Afghanistan and Iraq began in 2001 and 2003, respectively.
The two main chemicals in marijuana that people are most interested in, according to Zaman, are the psychoactive tetrahydrocannabinol (THC) and the non-psychoactive cannabidiol (CBD). Yet there are still more than 80 additional compounds that aren't well understood, he added.
While the high from marijuana may provide a feel-good aspect, Zaman believes that the euphoric effect that results from consuming THC could be related to its addictive effects, whereas the CBD is better for well-being and relieving anxiety.
Dr. Pedro Guimaraes, a psychiatrist and owner of Central Coast Behavioral Health in San Luis Obispo (SLO), believes that the THC can actually be harmful by promoting psychosis, or a severe mental disorder characterized by the disconnection with external reality.
Both doctors also said that chronic marijuana use can lead to dependence. The Diagnostic and Statistical Manual–the handbook psychiatric professionals use to diagnose mental health disorders–even classifies chronic cannabis consumption as a mental illness.
Guimaraes is cautious when treating a patient who uses marijuana because of the possibility that prescription drugs can react negatively in conjunction with marijuana. Often, he takes the approach of easing them off marijuana before writing any prescriptions.
"We follow them really close to stimulate them to decrease their amount of cannabis use," Guimaraes told the Sun.
Guimaraes and Zaman believe that more research ought to be done, however a variety of obstacles stand in the way.
For one, Zaman said it's hard to do controlled research because of the problem with consistency. There are too many variations in chemicals between marijuana plants, he said.
"When people are taking it, depending on how deeply they inhale, they are getting different concentrations," Zaman told the Sun.
Getting approved for research is another obstacle because the Drug Enforcement Administration (DEA) classifies marijuana as a Schedule 1 drug (in the same category as heroin), Zaman said.
A catch-22
Conducting research on marijuana is difficult, Zaman said. In order for it to happen, researchers need to go through a tedious process.
According to Zaman, researchers would need to submit special applications to the DEA and then have in-person interviews with federal agents. Then they'd have to purchase a special vault and attempt to crack it open to ensure no one will steal their research. On top of that, they must receive marijuana from DEA-approved growers, of which there is only one–the Marijuana Research Project at the University of Mississippi in Oxford.
Reclassifying marijuana would certainly open it up to more research, Zaman said. However, last August, the DEA refused to reclassify the plant. Yet, in the decision DEA Acting Administrator Chuck Rosenberg promoted more research.
The DEA has, in fact, loosened some restrictions to researching marijuana. In the last two years, the total number of approved individuals and institutions registered to research marijuana has doubled from 161 in April 2014 to 354 currently, according to the DEA. Some research includes effects of smoked marijuana on humans and more than 90 studies on CBD.
"Folks might be surprised to learn that we support this type of research, but we do," Rosenberg wrote in the decision on Aug. 11.
The DEA recently issued a final rule that put all marijuana extracts–including the non-psychoactive CBD–under the same regulatory control as marijuana, according to a Dec. 14 announcement published in the Federal Register. With this rule, extracts are treated as a Schedule 1 drug, or one that's considered to have no accepted medical use.
Further research of these chemicals could take years, if not decades, but veterans simply don't want to wait.
Legal, but not legal
When Proposition 64 passed, some expected it would make marijuana a lot more accessible.
The new law isn't exactly laissez-faire, according to Sean Kiernan, spokesman with Weed For Warriors, a nonprofit founded in 2014 that helps provide veterans with safe access to medical marijuana. He pointed to a provision in Proposition 64 that lets local governments regulate and tax recreational marijuana in their jurisdictions.
As an Army veteran, Kiernan said that Proposition 64 was like "legalizing weed for rich kids" and will only serve as a barrier to affordable marijuana.
Danks and his father-in-law Bookout discovered one such barrier right away. The day after Proposition 64 passed they applied for a business license to open a recreational marijuana dispensary in Pismo Beach. The city instead passed a 45-day moratorium (which can be extended for more than 10 months) prohibiting such businesses until the city figures out how to regulate marijuana.
According to cannabis research firm New Frontier Data, California's marijuana market is expected to reach $7.6 billion by 2020. With the local regulation provision, Kiernan is afraid the new law will prompt governments to cash in and regulate the industry to the point it'll squeeze out those who don't have the money to invest in a grow.
"Vets are mainly poor kids from poor neighborhoods," Kiernan told the Sun. "Proposition 64 does not give us a lot of rights. It was basically regulatory capture."
Even before Proposition 64, governments on the Central Coast began placing their own restrictions on marijuana. In September 2015, Gov. Jerry Brown signed the Medical Marijuana Regulation and Safety Act in to law, which also had a provision that allowed local control of the plant.
Both SLO and Santa Barbara counties have banned any new grows in unincorporated areas while allowing existing ones to operate. A number of cities have enacted similar bans, including Santa Maria, Buellton, Solvang, and Guadalupe in Santa Barbara County. All cities in SLO County also banned marijuana cultivation.
The city of Santa Barbara is somewhat of an exception. It allows personal cultivation in 100-square-foot plots (10 feet by 10 feet, or about the size of a large closet) and three storefront dispensaries. Mobile dispensaries are still allowed in all parts of Santa Barbara County.
There is one reprieve for cultivation: Proposition 64 forbids prohibition on indoor grows.
But indoor grows can become problematic. If not done properly, they can lead to fires. The wrong type of fuse caused one indoor grow to erupt in flames at a rental home on Jasmine Street in Lompoc in February 2015, according to Lompoc Fire Department Chief Kurt Latipow.
The laws have effectively concentrated marijuana grows to the select few, according to Seymour Weisburg, an attorney for the Santa Barbara chapter of the National Organization for the Reform of Marijuana Laws.
"Production is limited and monopolistic," Weisberg told the Sun. "It makes no sense to me to prohibit the right to grow for your own personal needs.
"You're still going to be able to get delivery, but at a higher price," he added.
With the suicide and opioid epidemic hitting the veteran population hard, Kiernan said it's more important than ever for the VA to stop blocking marijuana access to veterans.
The Sun reached out to the Santa Maria VA clinic for some answers. In response a representative from the Los Angeles branch of the Veterans Health Administration (VHA) declined to talk about medical marijuana but explained that even though the VA can't prescribe marijuana or recommend it, veterans who use it aren't penalized by the agency.
"Patients who participate in a non-VA marijuana program will not be denied access to care for VA clinical programs," Nikki Baker, associate chief for VHA Public and Congressional Relations, said in an emailed statement to the Sun.
In her statement, Baker added that veterans who use marijuana ought to be "assessed for misuse, adverse affects, and withdrawal."
Earlier this year, there were a few legislative attempts to at least remove some VA barriers.
Last May, Congress voted on legislation attached to a 2016-2017 VA funding bill that would give veterans the right to discuss medical marijuana with their doctors in any state where it's legal.
According to the Military Times, the House of Representatives passed the legislation sponsored by Rep. Earl Blumenauer (D-Ore.) by a vote of 295-129, and the U.S. Senate overwhelmingly approved its own version with a vote of 89-8.
The legislation was poised to become law when it was removed one month later upon passage of the budget bill, according to Stars and Stripes.
The legislative wrangling doesn't seem to help Fred much, who has a medical marijuana card but only uses it when he can afford it. He'd like to be able to get his medicine through the VA at little to no cost. Instead, he got 800-milligram ibuprofen pills and some prescription pain pills, which he said are addictive.
"Weed is better because it helps me keep my mind off pain," he said.
News Moderator: Katelyn Baker 420 MAGAZINE ®
Full Article: Central Coast Veterans Want The Option To Use Medical Marijuana For Mental Illnesses
Author: David Minsky
Contact: 805-347-1968
Photo Credit: Jayson Mellom
Website: Santa Maria Sun
Fred* deployed to Iraq with the U.S. Army's 25th Infantry Division in 2008, and returned with trauma-induced mental health issues. Though he never experienced any combat, the constant vigilance–and a handful of close calls–left him with a severe case of anxiety, he said.
He was based 17 miles north of Baghdad at Camp Taji with Macedonian army soldiers, and they also shared the base with the Iraqi army. Although he was part of an artillery unit, he stood watch at the front gate and conducted routine searches for improvised explosive devices (IEDs) along the main supply route that connected his base to the city.
One day as he stood watch, a fast-moving ambulance approached the gate. The knowledge that car bombers often used ambulances to carry out their missions put him on edge. Fred fired a smoke grenade and a tracer round from his rifle to stop it. It was the fourth instance he experienced of a vehicle trying to run the gate.
"It just catches you off guard," he said.
On a separate night, his unit was relieved after a five-hour IED patrol. They didn't find any that night, but the unit that relieved them got hit pretty bad. Fortunately, no one died.
"I'm pretty sure people were waiting for us to leave, then placed an IED, and waited for the next convoy to go by," Fred said. "It's just like–it could have been us."
The situations he faced during his deployment induced extreme trauma in Fred, who now lives with his parents in Nipomo. To ease his anxiety, he began smoking marijuana. He found it also helps with the pain he has from an unrelated knee injury he sustained earlier this year.
It's not easy for him to get his medical marijuana because it's too expensive, and it's neither offered through the Department of Veterans Affairs (VA) health care nor covered by any form of insurance. And though it's legal in certain states like California, doctors in the VA system can't prescribe–much less recommend–medical marijuana because of federal prohibition.
Personal cultivation offers a less expensive alternative; however, it poses legal questions.
Proposition 64 passed by voters on Nov. 8 and other recent statewide legislation hasn't made access any easier for veterans who want to grow it themselves. And a patchwork of local laws prohibiting new cultivation sites has left veterans on the Central Coast seeking answers.
Not covered by the VA
Randy Danks didn't come home with physical injuries. The Pismo Beach resident and Army veteran served from 2006 to 2010 and deployed once each to Kandahar, Afghanistan, and forward operating base Warhorse near Baqubah, Iraq, as infantry with the 2nd Cavalry Regiment, a unit that had armored Stryker vehicles.
He didn't go into detail about his time on deployment, although at one point he experienced an explosion that left him diagnosed with post traumatic stress disorder (PTSD), according to Danks' father-in-law Bill Bookout.
Danks is one of the 11 to 20 percent of veterans who received PTSD stemming from the conflicts spanning the time between the Vietnam War to operations Enduring Freedom and Iraqi Freedom, according to the VA.
More than a third of veterans enrolled in the VA health care system have a disability connected with their time in service, according to statistics. In 2013, 3.75 million of the nearly 10 million veterans enrolled had a service-connected disability. This status entitles them to receive a monetary benefit paid to them each month, but it makes no allowances for medical marijuana.
If they could get medical marijuana through the VA, workplace laws would add further complications for Danks and other veterans who need medical marijuana. Since California's Drug-Free Workplace Act of 1990, every employer awarded a contract or grant from the state government is required to make sure its employees don't use illegal drugs.
Even with recreational marijuana's newfound legality written into Proposition 64, it still isn't clear for Danks, who works for a company that contracts with Caltrans, whether using the drug would be allowed at his job.
Instead, Danks received a prescription for Celexa, or a pharmaceutical mood stabilizer approved by the Food and Drug Administration in 1998 to treat major depression.
Danks said he believes that medical marijuana could be beneficial for him, but he thinks the mood stabilizer is working for the most part. However, Celexa has at least one undesirable side effect: liver damage. According to the National Institutes of Health, liver toxicity is known to occur in rare instances with the drug.
"It kills my liver," Danks told the Sun.
While Danks and other veterans would prefer to use medical marijuana as an alternative to prescription medication, mental health professionals remain skeptical.
The right drug?
Dr. Tauheed Zaman is an assistant professor of psychiatry at UC San Francisco and has treated veterans who told him that medical marijuana helps with their psychiatric issues. But he remains skeptical because there are no current studies that prove the drug's effectiveness.
In fact, he's leery when vets tell him they use medical marijuana for this reason because it could trigger underlying mental health issues. The connection is not yet understood, Zaman said.
According to the VA, there has been no study of marijuana use in the overall veteran population. However, marijuana use is increasing among veterans. Use has jumped from 13 to 22.7 percent from fiscal years 2002 to 2014 according to the VA. The wars in Afghanistan and Iraq began in 2001 and 2003, respectively.
The two main chemicals in marijuana that people are most interested in, according to Zaman, are the psychoactive tetrahydrocannabinol (THC) and the non-psychoactive cannabidiol (CBD). Yet there are still more than 80 additional compounds that aren't well understood, he added.
While the high from marijuana may provide a feel-good aspect, Zaman believes that the euphoric effect that results from consuming THC could be related to its addictive effects, whereas the CBD is better for well-being and relieving anxiety.
Dr. Pedro Guimaraes, a psychiatrist and owner of Central Coast Behavioral Health in San Luis Obispo (SLO), believes that the THC can actually be harmful by promoting psychosis, or a severe mental disorder characterized by the disconnection with external reality.
Both doctors also said that chronic marijuana use can lead to dependence. The Diagnostic and Statistical Manual–the handbook psychiatric professionals use to diagnose mental health disorders–even classifies chronic cannabis consumption as a mental illness.
Guimaraes is cautious when treating a patient who uses marijuana because of the possibility that prescription drugs can react negatively in conjunction with marijuana. Often, he takes the approach of easing them off marijuana before writing any prescriptions.
"We follow them really close to stimulate them to decrease their amount of cannabis use," Guimaraes told the Sun.
Guimaraes and Zaman believe that more research ought to be done, however a variety of obstacles stand in the way.
For one, Zaman said it's hard to do controlled research because of the problem with consistency. There are too many variations in chemicals between marijuana plants, he said.
"When people are taking it, depending on how deeply they inhale, they are getting different concentrations," Zaman told the Sun.
Getting approved for research is another obstacle because the Drug Enforcement Administration (DEA) classifies marijuana as a Schedule 1 drug (in the same category as heroin), Zaman said.
A catch-22
Conducting research on marijuana is difficult, Zaman said. In order for it to happen, researchers need to go through a tedious process.
According to Zaman, researchers would need to submit special applications to the DEA and then have in-person interviews with federal agents. Then they'd have to purchase a special vault and attempt to crack it open to ensure no one will steal their research. On top of that, they must receive marijuana from DEA-approved growers, of which there is only one–the Marijuana Research Project at the University of Mississippi in Oxford.
Reclassifying marijuana would certainly open it up to more research, Zaman said. However, last August, the DEA refused to reclassify the plant. Yet, in the decision DEA Acting Administrator Chuck Rosenberg promoted more research.
The DEA has, in fact, loosened some restrictions to researching marijuana. In the last two years, the total number of approved individuals and institutions registered to research marijuana has doubled from 161 in April 2014 to 354 currently, according to the DEA. Some research includes effects of smoked marijuana on humans and more than 90 studies on CBD.
"Folks might be surprised to learn that we support this type of research, but we do," Rosenberg wrote in the decision on Aug. 11.
The DEA recently issued a final rule that put all marijuana extracts–including the non-psychoactive CBD–under the same regulatory control as marijuana, according to a Dec. 14 announcement published in the Federal Register. With this rule, extracts are treated as a Schedule 1 drug, or one that's considered to have no accepted medical use.
Further research of these chemicals could take years, if not decades, but veterans simply don't want to wait.
Legal, but not legal
When Proposition 64 passed, some expected it would make marijuana a lot more accessible.
The new law isn't exactly laissez-faire, according to Sean Kiernan, spokesman with Weed For Warriors, a nonprofit founded in 2014 that helps provide veterans with safe access to medical marijuana. He pointed to a provision in Proposition 64 that lets local governments regulate and tax recreational marijuana in their jurisdictions.
As an Army veteran, Kiernan said that Proposition 64 was like "legalizing weed for rich kids" and will only serve as a barrier to affordable marijuana.
Danks and his father-in-law Bookout discovered one such barrier right away. The day after Proposition 64 passed they applied for a business license to open a recreational marijuana dispensary in Pismo Beach. The city instead passed a 45-day moratorium (which can be extended for more than 10 months) prohibiting such businesses until the city figures out how to regulate marijuana.
According to cannabis research firm New Frontier Data, California's marijuana market is expected to reach $7.6 billion by 2020. With the local regulation provision, Kiernan is afraid the new law will prompt governments to cash in and regulate the industry to the point it'll squeeze out those who don't have the money to invest in a grow.
"Vets are mainly poor kids from poor neighborhoods," Kiernan told the Sun. "Proposition 64 does not give us a lot of rights. It was basically regulatory capture."
Even before Proposition 64, governments on the Central Coast began placing their own restrictions on marijuana. In September 2015, Gov. Jerry Brown signed the Medical Marijuana Regulation and Safety Act in to law, which also had a provision that allowed local control of the plant.
Both SLO and Santa Barbara counties have banned any new grows in unincorporated areas while allowing existing ones to operate. A number of cities have enacted similar bans, including Santa Maria, Buellton, Solvang, and Guadalupe in Santa Barbara County. All cities in SLO County also banned marijuana cultivation.
The city of Santa Barbara is somewhat of an exception. It allows personal cultivation in 100-square-foot plots (10 feet by 10 feet, or about the size of a large closet) and three storefront dispensaries. Mobile dispensaries are still allowed in all parts of Santa Barbara County.
There is one reprieve for cultivation: Proposition 64 forbids prohibition on indoor grows.
But indoor grows can become problematic. If not done properly, they can lead to fires. The wrong type of fuse caused one indoor grow to erupt in flames at a rental home on Jasmine Street in Lompoc in February 2015, according to Lompoc Fire Department Chief Kurt Latipow.
The laws have effectively concentrated marijuana grows to the select few, according to Seymour Weisburg, an attorney for the Santa Barbara chapter of the National Organization for the Reform of Marijuana Laws.
"Production is limited and monopolistic," Weisberg told the Sun. "It makes no sense to me to prohibit the right to grow for your own personal needs.
"You're still going to be able to get delivery, but at a higher price," he added.
With the suicide and opioid epidemic hitting the veteran population hard, Kiernan said it's more important than ever for the VA to stop blocking marijuana access to veterans.
The Sun reached out to the Santa Maria VA clinic for some answers. In response a representative from the Los Angeles branch of the Veterans Health Administration (VHA) declined to talk about medical marijuana but explained that even though the VA can't prescribe marijuana or recommend it, veterans who use it aren't penalized by the agency.
"Patients who participate in a non-VA marijuana program will not be denied access to care for VA clinical programs," Nikki Baker, associate chief for VHA Public and Congressional Relations, said in an emailed statement to the Sun.
In her statement, Baker added that veterans who use marijuana ought to be "assessed for misuse, adverse affects, and withdrawal."
Earlier this year, there were a few legislative attempts to at least remove some VA barriers.
Last May, Congress voted on legislation attached to a 2016-2017 VA funding bill that would give veterans the right to discuss medical marijuana with their doctors in any state where it's legal.
According to the Military Times, the House of Representatives passed the legislation sponsored by Rep. Earl Blumenauer (D-Ore.) by a vote of 295-129, and the U.S. Senate overwhelmingly approved its own version with a vote of 89-8.
The legislation was poised to become law when it was removed one month later upon passage of the budget bill, according to Stars and Stripes.
The legislative wrangling doesn't seem to help Fred much, who has a medical marijuana card but only uses it when he can afford it. He'd like to be able to get his medicine through the VA at little to no cost. Instead, he got 800-milligram ibuprofen pills and some prescription pain pills, which he said are addictive.
"Weed is better because it helps me keep my mind off pain," he said.
News Moderator: Katelyn Baker 420 MAGAZINE ®
Full Article: Central Coast Veterans Want The Option To Use Medical Marijuana For Mental Illnesses
Author: David Minsky
Contact: 805-347-1968
Photo Credit: Jayson Mellom
Website: Santa Maria Sun