VA considers softer stance on medical marijuana for military veterans

“Don’t ask, don’t tell” is how many veterans have approached health-care conversations about marijuana use with the doctors they see from the Department of Veterans Affairs.

Worried that owning up to using the drug could jeopardize their VA benefits — even if they’re participating in a medical marijuana program approved by their state — veterans have often kept mum. That may be changing under a new directive from the Veterans Health Administration urging vets and their physicians to open up on the subject.

The new guidance directs VA clinical staff and pharmacists to discuss with veterans how medical marijuana could interact with other medications or aspects of their care, including treatment for pain management or post-traumatic stress disorder.

The directive leaves in place a key prohibition: VA providers are still not permitted to suggest veterans try state-approved medical marijuana programs, because the drug is illegal under federal law.

That disconnect makes veterans wary, said Michael Krawitz, a disabled Air Force veteran in Ironto, Virginia, who takes oxycodone and marijuana to treat extensive injuries he suffered in a motorcycle accident while stationed in Guam in 1984.

“Vets are happy that there’s a policy, but they’re unnerved by that prohibition,” he said.

Krawitz, 55, is the executive director of Veterans for Medical Cannabis Access, an advocacy group. He has always been open with his VA doctors about his medical marijuana use and hasn’t suffered any negative consequences. But Krawitz said he has worked with veterans who have been kicked out of their VA pain management program after a positive drug test and told they couldn’t continue until they stopped using cannabis.

Such actions are usually misunderstandings that can be corrected, he said, but he suggests that the Veterans Health Administration should provide clear guidance to its staff about the new directive so veterans aren’t harmed if they admit to using marijuana.

Although the new guidance encourages communication about veterans’ use of marijuana, the agency’s position on the drug hasn’t changed, said Curtis Cashour, a VA spokesman.

Cashour referred to a quote from Veterans Affairs Secretary David Shulkin, who said at a White House briefing in May that he thought that among “some of the states that have put in appropriate controls [on the use of medical marijuana], 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 federal law changes, the secretary said, the VA is not “able to prescribe medical marijuana.”

Cashour declined to provide further information about the new directive.


Related: Veterans and access to cannabis — 2017 in review


Under federal law, marijuana is classified as a Schedule I drug, meaning it has no accepted medical use and a high potential for abuse. Heroin and LSD are other Schedule I drugs. Doctors aren’t free to prescribe marijuana. But in states that have legalized medical marijuana, doctors may refer patients to state-approved programs that allow marijuana use in certain circumstances. (Doctors can, however, prescribe three drugs approved by the Food and Drug Administration that are made of or are similar to a synthetic form of THC, a chemical in marijuana.)

Twenty-nine states and the District of Columbia have laws that allow people to use marijuana for medical purposes. Patients who have a disease or condition that’s approved for treatment with marijuana under these laws are generally registered with the state and receive marijuana through state-regulated dispensaries or other facilities.

Moves by states to legalize marijuana for medical or recreational use have created a confusing landscape for patients to navigate. Attorney General Jeff Sessions this month rescinded an Obama-era policy that discouraged federal prosecution for marijuana use in states where it is legal. That action has further clouded the issue.

Some consider caution a good thing. The accelerating trend of states approving marijuana for medical and recreational purposes may be getting ahead of the science to support it, they say.

A report released last January by the National Academies of Sciences, Engineering and Medicine examined more than 10,000 scientific abstracts about the health effects of marijuana and its chemical compounds on conditions ranging from epilepsy to glaucoma. The experts found conclusive evidence for a relatively limited number of conditions, including relief of chronic pain, nausea and vomiting associated with chemotherapy, and of muscle spasms associated with multiple sclerosis.

“I believe that there are chemicals in marijuana that have medicinal properties,” said Otis Brawley, chief medical officer at the American Cancer Society. “I would love to know what those are, what their medicinal properties are and what the dose should be.” But, he said, studies are extremely challenging to do because of restrictions in the United States on conducting research on Schedule I drugs.


Related: Veterans overwhelmingly support medical cannabis research, legalization


No matter where the research stands, getting a complete medication or drug history should be standard procedure at any medical appointment, say medical providers.

In that respect, the guidance from the VA is a positive development.

“It’s absolutely critical that you know what your patients are taking, if only to be better able to assess what is going on,” said J. Michael Bostwick, a psychiatrist at the Mayo Clinic in Rochester, Minn., who has written on medical marijuana use.

Andrews writes for Kaiser Health News, an editorially independent news service that is a program of the Kaiser Family Foundation.

Pennsylvania Attorney General Stands Up for State’s Medical Marijuana Law

DENVER – January 23, 2018 – NanoSphere Health Sciences Inc. has announced that it has signed an agreement to license its technology, as it pertains to cannabis products, in the State of California, according to a press release. According to ArcView’s 2016 Annual Industry Report, the legal cannabis market in California was $1.8 billion in 2016, is expected to reach $3.7 billion this year, and is further projected to exceed $5 billion in 2019.

The licensee, based in Oakland, California, is a private-label manufacturer of pharmaceutical goods for more than 35 leading brands in the legal cannabis space. The agreement provides the manufacturer with a non-exclusive license to NanoSphere’s patent pending NanoSphere Delivery System and its branded Evolve NanoSerum line. Evolve NanoSerum is the first clinically tested transdermal cannabis product to show pain relief within minutes.

The manufacturer, in joint venture with NanoSphere, will establish the Evolve product line as its flagship product across its network of brands, with distribution throughout California.

“Given its population and stature in the legal cannabis space, California represents an incredibly exciting market for us,” said Robert Sutton, Chairman and CEO at NanoSphere. “This new venture not only opens up a huge market, but is a fantastic opportunity to increase our visibility and reputation in the legal cannabis space, and represents a significant stepping stone to reaching even more new patients and consumers with our lauded transdermal delivery system.”

NanoSphere is commercializing its disruptive, next-generation nanoparticle cannabis delivery system platforms under the brand name Evolve Formulas. In July 2017, Evolve launched its NanoSerum product for the recreational and medical cannabis markets in Colorado. In fewer than six months of sale, the award-winning NanoSerum product has already established itself as a name in the market.

The award-winning Evolve is now available in more than 70 accounts throughout Colorado. NanoSphere plans to expand its network with manufacturers and operators in several states, licensing our technology and bringing the Evolve brand to new U.S. markets, and building on that success by further introducing new product applications. Each product application will be designed to deliver a unique pharmacokinetic and pharmacodynamic profile of cannabinoid activity and therapeutic applications.

“Since California was the first state to legalize medical use in 1996, the pharmaceutical industry has made great strides in researching the possible medical uses of cannabis,” Sutton concluded. “Accordingly, we are proud to bring the Evolve family of products to patients across the Golden State.” 

Images courtesy of NanoSphere Health

Pueblo County Joins Letter Urging Sessions to Leave Colorado Marijuana Laws Alone

DENVER – January 23, 2018 – NanoSphere Health Sciences Inc. has announced that it has signed an agreement to license its technology, as it pertains to cannabis products, in the State of California, according to a press release. According to ArcView’s 2016 Annual Industry Report, the legal cannabis market in California was $1.8 billion in 2016, is expected to reach $3.7 billion this year, and is further projected to exceed $5 billion in 2019.

The licensee, based in Oakland, California, is a private-label manufacturer of pharmaceutical goods for more than 35 leading brands in the legal cannabis space. The agreement provides the manufacturer with a non-exclusive license to NanoSphere’s patent pending NanoSphere Delivery System and its branded Evolve NanoSerum line. Evolve NanoSerum is the first clinically tested transdermal cannabis product to show pain relief within minutes.

The manufacturer, in joint venture with NanoSphere, will establish the Evolve product line as its flagship product across its network of brands, with distribution throughout California.

“Given its population and stature in the legal cannabis space, California represents an incredibly exciting market for us,” said Robert Sutton, Chairman and CEO at NanoSphere. “This new venture not only opens up a huge market, but is a fantastic opportunity to increase our visibility and reputation in the legal cannabis space, and represents a significant stepping stone to reaching even more new patients and consumers with our lauded transdermal delivery system.”

NanoSphere is commercializing its disruptive, next-generation nanoparticle cannabis delivery system platforms under the brand name Evolve Formulas. In July 2017, Evolve launched its NanoSerum product for the recreational and medical cannabis markets in Colorado. In fewer than six months of sale, the award-winning NanoSerum product has already established itself as a name in the market.

The award-winning Evolve is now available in more than 70 accounts throughout Colorado. NanoSphere plans to expand its network with manufacturers and operators in several states, licensing our technology and bringing the Evolve brand to new U.S. markets, and building on that success by further introducing new product applications. Each product application will be designed to deliver a unique pharmacokinetic and pharmacodynamic profile of cannabinoid activity and therapeutic applications.

“Since California was the first state to legalize medical use in 1996, the pharmaceutical industry has made great strides in researching the possible medical uses of cannabis,” Sutton concluded. “Accordingly, we are proud to bring the Evolve family of products to patients across the Golden State.” 

Images courtesy of NanoSphere Health

NanoSphere Health Sciences Inc. Signs License Agreement to Open California Market

DENVER – January 23, 2018 – NanoSphere Health Sciences Inc. has announced that it has signed an agreement to license its technology, as it pertains to cannabis products, in the State of California, according to a press release. According to ArcView’s 2016 Annual Industry Report, the legal cannabis market in California was $1.8 billion in 2016, is expected to reach $3.7 billion this year, and is further projected to exceed $5 billion in 2019.

The licensee, based in Oakland, California, is a private-label manufacturer of pharmaceutical goods for more than 35 leading brands in the legal cannabis space. The agreement provides the manufacturer with a non-exclusive license to NanoSphere’s patent pending NanoSphere Delivery System and its branded Evolve NanoSerum line. Evolve NanoSerum is the first clinically tested transdermal cannabis product to show pain relief within minutes.

The manufacturer, in joint venture with NanoSphere, will establish the Evolve product line as its flagship product across its network of brands, with distribution throughout California.

“Given its population and stature in the legal cannabis space, California represents an incredibly exciting market for us,” said Robert Sutton, Chairman and CEO at NanoSphere. “This new venture not only opens up a huge market, but is a fantastic opportunity to increase our visibility and reputation in the legal cannabis space, and represents a significant stepping stone to reaching even more new patients and consumers with our lauded transdermal delivery system.”

NanoSphere is commercializing its disruptive, next-generation nanoparticle cannabis delivery system platforms under the brand name Evolve Formulas. In July 2017, Evolve launched its NanoSerum product for the recreational and medical cannabis markets in Colorado. In fewer than six months of sale, the award-winning NanoSerum product has already established itself as a name in the market.

The award-winning Evolve is now available in more than 70 accounts throughout Colorado. NanoSphere plans to expand its network with manufacturers and operators in several states, licensing our technology and bringing the Evolve brand to new U.S. markets, and building on that success by further introducing new product applications. Each product application will be designed to deliver a unique pharmacokinetic and pharmacodynamic profile of cannabinoid activity and therapeutic applications.

“Since California was the first state to legalize medical use in 1996, the pharmaceutical industry has made great strides in researching the possible medical uses of cannabis,” Sutton concluded. “Accordingly, we are proud to bring the Evolve family of products to patients across the Golden State.” 

Images courtesy of NanoSphere Health

VA Blames Prohibition for Lack of MMJ Research

PTSD is one of the most common service-related ailments affecting active duty military personnel and veterans. Animal therapy has been shown to be effective in treating symptoms of PTSD. Cannabis can be a very effective supplement to pet therapy and has been shown to have strong healing benefits in its own right.


PHOTO NORTH CAROLINA NATIONAL GUARD

Despite overwhelming evidence that veterans can benefit massively from cannabis medicine, obstacles created by federal prohibition are keeping it out of their hands.


Cannabis medicine offers life changing relief from a kaleidoscope of conditions, but recently much of the public’s focus has been on its remarkable pain-relieving qualities and its utility in easing the symptoms of opiate withdrawal and supplementing or replacing opioid pain killers.

This is no coincidence; the fascination with alternatives to opioid pain killers comes at a time when they’re wreaking unprecedented damage on society, with overdose death rates spiking across the country. Cannabis not only offers an alternative to opioids, it allows many pain patients using opioids to reduce their effective dose, which also reduces the risk of potentially lethal complications or overdose.

Few groups are in more dire need of pain relief than veterans: A report from the Veterans Administration found 60 percent of returning combat veterans (and 50 percent of senior veterans) struggle with chronic pain, versus the national average of 30 percent, and many veterans suffer from both PTSD and chronic pain. The VA’s primary solution for these conditions? Opioids.

It has been documented how the VA heavily overprescribed opioid medication and fueled the current epidemic. Now veterans are seeking alternatives, with an American Legion phone survey finding nearly a quarter of veteran household respondents use medicinal cannabis.

But that medical marijuana use is often illegal (plus always illegal federally) and can jeopardize a veteran’s access to their other medications, although it does not affect their benefits. While the VA issued new guidance in 2017 urging VA care providers to discuss their patients’ cannabis use and any possible contraindications with other medication, they still cannot recommend or prescribe cannabis medication.

The reason, of course is federal prohibition. But now the VA is using prohibition as the explanation for its decision not to study the impact of cannabis medicine on veterans.

From the Washington Post:

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.”

It’s clearly true that the federal government’s prohibition on cannabis creates some obstacles for those looking to research its effects. That said, research is conducted on cannabis all the time.

John Hudak, deputy director of the Center for Effective Public Management at the Brookings Institution, told the Washington Post that the VA was trying to pass the buck by blaming prohibition for its decision not to research medical cannabis.

“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.”

Rep. Walz also said he found the the response “disappointing and unacceptable,” echoing Hudak’s sentiment that the VA’s response was disingenuous and false.

“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.

Support for cannabis medicine in the veteran community is growing. Even the conservative American Legion passed a resolution urging the federal government to allow safe access for vets and that organization’s survey data shows that over 80 percent of veterans support federal legalization of medical cannabis.

Ultimately Congress will need to do something, just as it will need to act on the broader issue of federal prohibition. But the most recent effort to address veterans access stalled: the Veterans Equal Access amendment passed the Senate Appropriations committee but was killed by House Republicans.

So for now, all veterans seeking cannabis medicine can really rely on is each other.

TELL US, are you a veteran who uses cannabis medicine? How does it help you?