While Americans across the nation on Veterans Day honored those who have served in the Armed Forces, the Department of Veterans Affairs has continued to dishonor the welfare of veterans by upholding a policy which suppresses the speech of its physicians.
Since California passed the nation’s first medical marijuana laws in 1996, 22 other states and DC have followed suit in acknowledging the myriad health benefits of cannabis. Yet despite the overwhelming evidence and support from the medical community, the US government has continued to list cannabis as a Schedule I drug, thus maintaining that it has no medical value. Accordingly, the Department of Veterans Affairs has refused to openly discuss the potential medical benefits of cannabis.
The medical efficacy of marijuana is especially pertinent to veterans because marijuana has analgesic properties which have proven to be successful in treating chronic pain, an ailment which affects over 50 percent of males under care of the VA. Though the VA did adjust its policy in 2010 to allow patients who have been recommended medical marijuana from outside physicians to retain their benefits, given that they adhere to state medical marijuana laws, the department still effectively censors its physicians by barring them from discussing medical marijuana with any patient. As a result, VA physicians have handed out prescription opioids like candy in order to treat patients who experience chronic pain.
From 2001 to 2012, the number of opioid prescriptions issued by VA physicians rose 270 percent, according to data compiled by the Center for Investigative Reporting, and 646,234 veterans were receiving prescription painkillers by December 2013.
While opioids are successful in treating pain, they are alarmingly addictive. Over two million Americans now suffer from prescription opioid substance use disorders, and more than half of the veterans who receive prescription opioids continue to consume them beyond 90 days. Opioid addiction is highly problematic, as its consequences are fatal. In 2012 alone, 16,007 people overdosed from prescription painkillers. Among veterans, the opioid overdose mortality rate is 33 percent higher than that of civilians. Rather than taking stringent steps to ensure that these medications are not irresponsibly prescribed, the VA has in fact prescribed painkillers to veterans with PTSD — who are more susceptible to addiction — at higher rates than those without diagnosed mental health disorders.
However, the VA has attempted to curb drug abuse by maintaining an opioid prescription policy which prohibits patients from using illicit drugs and will revoke the prescriptions of those who test positive for such substances. This policy, though effective for ensuring the safety of hard drug users, is especially unfortunate considering that using cannabis in conjunction with prescription opioids may in fact decrease potential harm. While the VA told USA Today in May that it reviews cases involving marijuana and prescription painkillers on an individual basis, many veterans have been forced to choose between cannabis and pharmaceuticals after some VA physicians cited concern over potential adverse effects. And with just two VA pain management specialists per 100,000 veterans in 2013, simply one disagreeing doctor has the potential to affect 50,000 lives.
In a study published in Clinical Pharmacology & Therapeutics in 2011, a team of researchers found that cannabis “augments the analgesic effects of opioids” without producing any serious adverse effects on study participants. These results paralleled a 2004 study in Life Sciences which concluded that low doses of the two substances could “safely be administered” and “without increasing detrimental side-effects.”
More importantly, a Canadian study published in the Journal of Psychoactive Drugs in 2012 found that not only can cannabinoids “prevent the development of tolerance to and withdrawal from opiates,” but that they can “rekindle opiate analgesia after a prior dosage has become ineffective.” The study concluded that increasing the availability of cannabis could “lead to a reduction in the prescription use of opiates.” An August study in theJournal of the American Medical Association echoed this conclusion, noting that states with medical cannabis laws had an average opioid overdose mortality rate at nearly one quarter less than that of states without such laws.
The results of these studies are of critical importance to the welfare of veterans because they show that there are methods to significantly reduce opioid use and dependency, which in turn could curtail high rates of overdose. While it is certain that VA doctors will remain forbidden from recommending medical marijuana to patients until the federal government accepts its medical benefits, the department must ensure that America's troops are fully informed of medical treatment options and strive to offer them only the best and safest treatments. Until the VA desists from suppressing speech that could potentially benefit the health of veterans, it will perpetuate high drug abuse rates and fail to offer veterans the real solutions they deserve.