Medicinal Cannabis and the Veterans Administration

Michigan passed a medicinal law in 2008. Last May Gabriel Perez, the Director of the Lutz Medical Center in Saginaw, wrote a letter to the Saginaw News editor. This letter was in response to a previous article about medicinal cannabis on federal property. That letter follows;

Editor, The News:

As a clarification to the article on medical marijuana in the VA, it is important for veteran patients and visitors of the VA medical center in Saginaw and community based outpatient clinics in Alpena, Clare, Gaylord, Oscoda and Traverse City to understand how the new law regarding the use of medical marijuana will be handled by VA medical center police and practitioners.

The legalization of medical marijuana in Michigan is acknowledged. However, pursuant to federal law, VA physicians, nurse practitioners and other licensed clinicians are not authorized or permitted to participate in the recommendation for treatment of or prescribing medical marijuana to a VA patient that would otherwise be legal in Michigan. Furthermore, the VA will not dispense, prescribe or store medical marijuana, and its possession on VA property remains illegal and a criminal offense.

However, it is acknowledged that testing positive for marijuana in a patient, based upon a random drug screening, will not serve as a breach of the current pain management agreement if the patient submits documentation in support of the marijuana being prescribed and dispensed in conformity with Michigan law.

The above withstanding, veteran patients and visitors who are registered users of medical marijuana must follow all laws and regulations for the possession and use of the medical marijuana and shall not bring medical marijuana on the grounds of the VA medical center. Possession on federal grounds remains illegal and may subject the possessor to appropriate criminal charges.

Our priority to provide quality health care to veterans remains steadfast. A veteran’s care and the right to pain management continue to be very important in enhancing the veteran’s health care outcomes.

Veterans with questions or concerns regarding their participation with medical marijuana may be directed to their primary care provider.

Gabriel Perez
Lutz Veterans Affairs Medical Center

Okay, now hold that thought. I’ll get back to the above in a moment. First I’ve another letter to show you. This one is from Robert Petzel, the under secretary for health for the veterans department, to a Michael Krawitz. Krawitz is the executive director for Veterans for Medical Marijuana Access. The letter is dated July, 6th. The New York Times published it just the other day. I don’t know why but, I find it ironic that Mr. Krawitz address is in Virginia. Virginia is not a medicinal cannabis state. Here’s the letter;

This is a follow-up response to your letter requesting clarification of the Veterans Health Administration’s (VHA) policy regarding the practice of prescribing opioid therapy for pain management for Veterans who provide documentation of the use of medical marijuana in accordance with state law.

If a Veteran obtains and uses medical marijuana in a manner consistent with state law, testing positive for marijuana would not preclude the Veteran from receiving opioids for pain management in a Department of Veterans Affairs (VA) facility. The Veteran would need to inform his provider of the use of medical marijuana, and of any other non-VA prescribed medications he or she is taking to ensure all medications, including opioids, are prescribed in a safe manner. Standard pain management agreements should draw a clear distinction between the use of illegal drugs, and legal medical marijuana. however, the discretion to prescribe, or not prescribe, opioids in conjunction with medical marijuana should be determined on clinical grounds, and thus will remain the decision of the individual health care provider. the provider will take the use of medical marijuana into account in all prescribing decisions, just as a provider would with any other medication. This is a case-by-case decision, based upon the providers judgement, and the needs of the patient.

Pssst, this is old news. I’ve had a narcotics contract with the VA for over eight years. When I entered the contract and the doc told me I would be subject to random drug UAs I told him that was a deal-breaker. I told him of my cannabis use. His response was that due to Washington’s medicinal cannabis laws he would overlook the cannabis positive result. I’ve been peeing hot for pot since day one.

When the Michigan letter was published I mistook it for a national policy. When I next saw my PCP I mentioned that I thought the new guidelines were a progressive step for the VA. He went off on a bit of a tirade saying that no policy, guideline, whatever could dictate how a primary care provider administers to a patient. He said those decisions were the provider’s only. That was over a year ago. He said about the same thing that has been published twice now. Once in respect to operations within a state and the second nationally.

Now, don’t get me wrong! I do think this is a very positive step. There might be doctors out there that have been kicking pain patients to the curb because they thought it was expected of them. This policy states that’s not the case.

Also, the very existence of the policy is an indication that the Veterans Administration recognizes the medicinal efficacy of cannabis. That, boys and girls, ladies and gentleman, is the real ground gained here. How many inches to the mile? Heh.


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