The American Legion wants the federal government to change course on marijuana
The Washington Post - Christopher Ingraham -9/8/2016
The American Legion, a group representing 2.4 million U.S. military veterans, has called on Congress to remove marijuana from Schedule 1 of the federal Controlled Substances Act and "reclassify it in a category that, at a minimum will recognize cannabis as a drug with potential medical value."
In a resolution passed at the Legion's annual convention last week, the organization said it hopes that better research into marijuana and an official acknowledgment of its potential medical benefits will hasten the development of new treatments for post-traumatic stress disorder and traumatic brain injuries, ailments that have plagued veterans returning from the wars in Iraq and Afghanistan.
The Legion's resolution, published online by Marijuana.com, noted that the federal Drug Enforcement Administration recently approved the country's first randomized, controlled trial using whole-plant, smoked marijuana to treat PTSD symptoms. That study will be conducted by Sue Sisley, an Arizona researcher who tried for nearly a decade to get a green light for the research but struggled to find an academic institution to sponsor it. The University of Colorado ultimately agreed to fund the research.
During an address at the Legion's convention in Cincinnati, Sisley told members that "veterans are exhausted and feel like guinea pigs; they’re getting desperate” and that traditional medications didn't seem to be providing adequate relief to many vets suffering from PTSD.
The DEA recently reaffirmed its decades-old policy of classifying marijuana among the most dangerous drugs, citing its "high potential for abuse" and "no currently accepted medical use." That position has faced increasing criticism from federal and state lawmakers, physicians,researchers and even some law enforcement groups.
Medical marijuana is extremely popular with voters: A June Quinnipiac University poll found that 89 percent supported the use of marijuana with a doctor's recommendation. Aseparate survey by the Iraq and Afghanistan Veterans of America found that 68 percent of responding members supported legalizing medical marijuana in their state, and 75 percent said that the Department of Veterans Affairs should allow medical marijuana as a treatment option.
A DEA position paper from 2013 states that "smoked marijuana has not withstood the rigors of science — it is not medicine, and it is not safe."
The legislation would approve medical marijuana to treat PTSD, only if conventional therapy isn't successful
By The Associated Press
TRENTON, N.J. — The Assembly on Thursday passed legislation to allow qualified New Jersey residents with post-traumatic stress disorder to get medical marijuana for treatment.
The Democrat-led Assembly voted 55-14, with seven abstentions, sending the bill to the Senate for consideration.
Republican Gov. Chris Christie, who has been critical of marijuana legalization in other states, ignored advocates of the bill who asked him to sign the measure as he walked into the statehouse Thursday.
Jim Miller, the co-founder of the Coalition for Medical Marijuana New Jersey and an organizer of a weekly pro-marijuana podcast on the statehouse steps, said he has asked the governor at least four times previously to support the measure, but Christie has never answered him.
Miller says he supports the bill to help veterans who are increasingly using cannabis even though it remains illegal in most states and isn’t approved by the Department of Veterans Affairs because major studies have yet to show it is effective against PTSD.
“They shouldn’t have to fight their government for the inherent right to health,” Miller said.
The legislation approves the disorder for treatment with marijuana only if it’s not treatable with conventional therapy.
Marijuana is currently approved in New Jersey to treat multiple sclerosis, terminal cancer and muscular dystrophy, among other medical diseases. It’s also approved for seizures and glaucoma if those conditions are resistant to conventional treatment.
The U.S. Senate passed an amendment in November that would allow Veterans Affairs doctors to recommend medical marijuana to veterans in states where it’s legal. The proposal failed to pass the House.
A military veteran and student at the Art Institute of Philadelphia is using his skills as a photographer to protest the overmedication of our nation’s heroes.
Mike Whiter, 39, launched the photo project “Operation Overmed,” which features pictures of veterans, including Whiter, rejecting pharmaceutical options and using alternative treatments such as medical marijuana for their health issues.
Whiter told NBC10 he joined the Marines at the age of 19 and eventually became a Staff Sergeant. After the Iraq War, Whiter was diagnosed with post-traumatic stress disorder and was medically discharged. He went to a VA Hospital which placed him on medication.
“Over a period of five years I was on 40 different medications,” he said. “Everything from anti-depressants to anti-anxiety medication. At one point they had me on Methadone for chronic pain. I was 35 at the time.”
Wanting to find an alternative to the medication, Whiter started using medical marijuana after watching a documentary about it in 2012. Since then he hasn’t turned back.
“I felt more relaxed after one joint than I had after tons of combinations of pharmaceuticals,” he said. “I threw away my pills and my quality of life is better than it has been in years. I think it is very important to note that cannabis is not a cure for PTSD, but in combination with therapy, it can open a whole new world for you.”
Whiter also decided to pursue his passion in photography and enrolled in the Art Institute of Philadelphia. That’s where the foundation for his photo project took shape.
“I was having a hard time in the studio photographing subjects,” he said. “I have a hard time interacting with people sometimes. One of my professors said, ‘why don’t you shoot veterans? Then I decided to take it a few steps further and involve my activism.”
Whiter launched Operation Overmed in June 2. While the series so far has gotten attention from the medical marijuana community, Whiter hopes the project will reach a wider audience.
“I’m photographing people that use medical marijuana now because I’m a marijuana activist and I run in those circles so I know these people,” he said. “But I’m meeting other people who say, ‘Hey, I don’t use medical marijuana but screw the pill.’ The point is, all of these veterans have chosen alternative treatments whether its medical marijuana or acupuncture, yoga, I don’t care what it is. As long as they’re saying screw these pills, I want to do what’s right for my body. I’m taking my health into my own hands. And that’s what I want to show with these photographs.”
Whiter says his ultimate goal is to draw attention to the countless veterans who shared an experience similar to his own.
“Twenty-seven states report 22 veteran suicides a day,” Whiter said. “A lot of that can be attributed to the medications because guys with PTSD who are already suicidal are taking medications that have increased risks of suicidal thoughts or actions listed as a side effect. I was one of those guys. I was a slave. I was in my house stuck in my head for like five years man, just on all these pills.”
Whiter, who says the response to the project has been “overwhelmingly positive,” hopes his message will reach the average citizen.
“Veterans are overmedicated,” he said. “That’s the message that I really want to send out. The VA is killing the people who fought for this country and it’s not right.”
If you would like to participate in the Operation Overmed project, email Whiter at firstname.lastname@example.org. You can also visit his Facebook page and website for more information.
A former Navy SEAL makes the case for why the federal ban on medical marijuana needs to be lifted.
Medical marijuana is a political issue. It is a legal issue. But most important, it is a health issue that is playing an increasingly significant role in the quality of life for Americans, especially veterans.
Let’s start with the facts. There are approximately 2.7 million American veterans of the wars in Iraq and Afghanistan, and according to the Department of Veterans Affairs, upward of 20% of these veterans experience post-traumatic stress or depression. Between 2000 and 2014, over 300,000 service members were diagnosed with a traumatic brain injury. According to a 2014 survey, 40% of the Iraq and Afghanistan Veterans of America’s members “have known at least one Iraq or Afghanistan veteran who has died by suicide, and 31 percent have thought about taking their own life since joining the military.”
Unfortunately, the Veterans Health Administration is neither prepared nor equipped to fully address, prevent, or combat the complexity of veterans’ pain, leaving veterans to cope with the limited and inadequate treatment options provided by the system. Veterans are treated with “cocktails” of prescription drugs, including powerful and addictive opiates that are far more dangerous, and far less effective, than cannabis. The current arrangement is not meeting veterans’ health care needs. Veterans are taking matters into their own hands, and one of the most effective treatment tools they are choosing is medical marijuana.
Today, medical marijuana — also known as cannabis, its scientific name — is legal in 23 states and the District of Columbia. A Harris Poll survey conducted in May found that over 80% of Americans favor general legalization of medical marijuana. Further, medical marijuana is becoming increasingly recognized and touted by both medical experts and policymakers alike as a common sense, safer alternative to existing legal and common treatments. Why then, do our veterans continue to face such significant hurdles to access? Veterans deserve to be openly educated about cannabis and have the ability to legally obtain medical marijuana as a component of care for their enduring physical and psychological health challenges.
Over the past several months, I have talked to countless veterans in personal meetings and in focus groups; they attest to medical marijuana’s efficacy as a treatment. They rail against the drug cocktails and laugh at the notion that those complicated combinations of medicines are considered safer or more effective than medical marijuana.
The case for medical marijuana is not built solely on personal anecdotes. Expert support for medical marijuana is broad and diverse, and includes the American College of Physicians, the American Public Health Association, and the American Nurses Association. Contrary to what many people believe, medical marijuana research already exists and demonstrates that marijuana provides relief for post-traumatic stress, chronic pain, and other debilitating conditions. Just last year, New Mexico-based psychiatrist George Greer published the results of a chart review of 80 veterans who used cannabis to treat post-traumatic stress. He found that patients reported a 75% reduction in several main symptoms of post-traumatic stress, including hyperarousal and re-experiencing traumatic episodes.
Yet while there has been a significant shift in perception and laws affecting general access to medical marijuana in recent years, veterans are still waiting for legislative action. Congress can start by passing proposed meaningful legislation, such as the Compassionate Access, Research Expansion and Respect States Act, which would allow VA healthcare providers to openly discuss and recommend medical marijuana for their patients in states where it is legal.
We must also remove barriers to research immediately. The first FDA-approved, randomized, controlled trial on cannabis and post-traumatic stress was scheduled to start this summer, but remains in limbo due to bureaucratic roadblocks, according to the lead researcher. Policymakers are demanding more research, but the agencies they oversee are stalling, creating a seemingly endless loop of shifting of responsibility and blame.
Once those barriers are removed, we can begin to tackle the next round of hurdles that exist for veterans who choose medical marijuana as a component of their care, including cost, employment complications, and recriminations that can lead to the loss of VA and other federal benefits. Eventually, medical marijuana must be legalized under all relevant federal and state laws.
I founded the Veterans Cannabis Project because I believe that the topic deserves focused, comprehensive attention at the national level. Though I am not a medical marijuana patient, I am a veteran who believes that medical marijuana is an important tool for veterans in their medical treatments. I have spent the past year listening to the stories of veterans who convinced me that concerted action is needed now. By investing in education, advocacy and research, and pursuing partnerships with likeminded organizations, I hope to ensure that veterans today and in future generations can improve their quality of life through access to medical marijuana.
Veterans need better and more effective treatments for the visible and invisible wounds they sustained in the line of duty. As veterans seek to make smart and responsible choices about their own treatments, medical marijuana must be a legal option.
VIA Task and Purpose
FDA Accepts Protocol for Study on Marijuana and PTSD
Check out our articles on PTSD and veterans in our June issue........-UA
Research on hold until approved by PHS and NIDA
HerbalEGram: Volume 8, Number 6, June 2011 American Botanical Council
On April 28, 2011, the US Food and Drug Administration (FDA) accepted a protocol from the Multidisciplinary Association for Psychedelic Studies (MAPS) for studying marijuana and post-traumatic stress disorder (PTSD) in veterans.1 If it obtains the remaining federal government approvals, as well as funding, the study will be the “first controlled clinical trial testing the therapeutic potential of marijuana for treating PTSD.”
MAPS aims to develop psychedelics and marijuana (cannabis sativa) into prescription medicines that treat conditions for which conventional medicines have provided limited relief. It has wanted to study the effect that marijuana has in patients with PTSD since noticing that more and more veterans were reporting the use of marijuana to treat PTSD symptoms.
“The idea that marijuana could be helpful for PTSD has been around for some time,” said MAPS Founder and Executive Director Rick Doblin, PhD (e-mail, May 17-June 1, 2011). “The reports of the veterans were what drew our attention to our need to learn more about how and in what ways marijuana impacted PTSD patients.”
According to Dr. Doblin, the MAPS research crew spent 8 months designing their study protocol and going through a “friendly but rigorous” critique process for further refining. After submitting to FDA, the organization and government agency were in close communication for 6 months until the recent acceptance announcement.
“I wasn't surprised with FDA's favorable review since I have come over the last 2 decades to respect the FDA's willingness to put science over politics,” said Dr. Doblin. “Still, it's breathtaking every time FDA gives us permission for a new precedent, like conducting the marijuana/PTSD study as an outpatient study. It means we understand each other's concerns.”
But before the study can begin, MAPS must obtain additional approval from a protocol review process that exists for no other Schedule 1 drug but marijuana. It is conducted by the Public Health Service (PHS) and the National Institute on Drug Abuse (NIDA)—2 government agencies with reputations for obstructing research on marijuana’s potential medical uses.2
PHS and NIDA Review
All human clinical research using controlled substances must receive approval from the Drug Enforcement Administration (DEA) and permission from FDA to proceed with protocols assessing risks and benefits of an Investigational New Drug (IND). Approval is also required from an Institutional Review Board (IRB), which reviews the protocol and informed consent to protect the rights of the subjects. Only marijuana research proposals must additionally receive scientific merit approval from a PHS/NIDA protocol review committee, after NIDA has signified that it has sufficient cannabis to support the proposed study.2
As a result of the requirement for PHS/NIDA review, researchers encounter a tedious process that often ends in denial or delay.2 While a handful of marijuana research has been approved by PHS/NIDA, several researchers have been denied, often despite FDA and IRB approval of the studies’ designs.
For example, MAPS, California NORML, and a private, DEA-licensed pharmaceutical industry analytical lab, Chemic Labs (Canton, MA), joined in 2003 to study vaporization as an alternative to smoking cannabis. After a 6-year process, PHS/NIDA rejected Chemic’s protocol design—disabling them from obtaining 10 grams (less than half an ounce) of marijuana—and asked the lab to conduct about $60,000 worth of studies to prove the calibration of its instruments—costs that Dr. Doblin has said were not necessary for the pilot study. Due to the frustrating process and unlikely approval, Chemic decided to stop trying to conduct the research.
Due to the PHS/NIDA protocol review procedure, when FDA accepted MAPS’ protocol, it also told the research organization that its IND application would continue to be on clinical hold until it provides information on the chemistry, manufacturing, and controls of NIDA's marijuana, also known as CMC information.1
“That information is held/owned by NIDA, which will not share it with us unless the PHS/NIDA protocol review committee approves the protocol,” said Dr. Doblin.
MAPS sent its protocol to PHS and NIDA for review on the afternoon of April 28, and has not yet received feedback on timeframes or the identities of the reviewers. “I am starting to think we have a 50/50 chance of the protocol being approved after a fair, scientific evaluation,” said Dr. Doblin. “I’m proud of the design; it's complex and will generate lots of useful data, and the patients/veterans are a socially powerful group. I expect the process will take about a year—exceedingly slow, compared to FDA, which is required to review protocols within 30 days. After it all, we could easily get rejected.”
Quality and Price of Research Material
If the MAPS protocol is approved by PHS and NIDA, it still is “deeply concerned” about the quality of NIDA’s marijuana, said Dr. Doblin. Published research, in addition to concerns voiced by respected marijuana researchers as well as Dr. Doblin, have stated that NIDA marijuana contained abundant stems and seeds; is dry and often several years old; had thick, pungent, and pervasive smoke; been of inconsistent potency and adversely affected research; and been of “such poor quality” that research could not proceed.2
The organization also has concerns regarding the price of the research material. “I’ve asked NIDA about the expected price about 6 months ago and haven't heard back,” said Dr. Doblin. “I anticipate about $7—$8 dollar per gram. In large scale medical marijuana production facilities in Israel, production cost is around $1 a gram, [and is] of a much higher quality.”
Additionally, MAPS is also troubled with spending around $10 million on medical marijuana research while being prohibited by NIDA and DEA from producing its own marijuana. Because NIDA retains a monopoly on the production of marijuana for prescription use, it could theoretically charge high prices, with no competition on quality.2
Protocol and Future of Planned Study
The research that MAPS hopes to conduct is a randomized, triple-blind, placebo-controlled, crossover study testing smoked and vaporized marijuana for management of chronic, treatment-resistant, military service-related PTSD in 50 combat veterans.1
Persons who have experienced past traumatic events—childhood abuse, natural disasters, car wrecks—can develop PTSD, which is an anxiety disorder with symptoms such as nightmares, flashbacks and intrusive thoughts and feelings, emotional numbness, sudden anger or fear, and difficulty sleeping.3 Soldiers who have fought in combat often return home with PTSD. For non-military civilians, PTSD occurs in 6-to-10% of the population; for US soldiers who fought in the Iraq War, it was 18%.1 As of 2004, the US government was sending disability payments totaling about $4.3 billion to 215,000 veterans, most of whom fought in the Vietnam War. These numbers and the financial and emotional costs associated with PTSD are expected to continue to rise with the wars in Iraq, Afghanistan, and now, also in Libya.
According to the MAPS’ protocol, THC (tetrahydrocannabinol)—one of the principal active components in marijuana—triggers a response from certain receptors in the hippocampus, amygdala, and prefrontal and anterior cingulate cortex, suggesting that THC is involved in “regulating anxiety, attention to and response to stressful situations, and may be involved in the extinction of conditioned fear.”
While a few therapies, like cognitive behavioral counseling and selective serotonin re-uptake inhibitor drugs, are used to treat PTSD, some patients are not helped by these interventions. MAPS thinks that marijuana treatment might help these types of PTSD sufferers by reducing nightmares and improving sleep and mood.
“Marijuana has the effect of suppressing dream recall,” noted Dr. Doblin. “For people with nightmares, that's a benefit. Marijuana also helps people focus on the here and now, which reduces the power of the traumas of the past. But, as with all drugs, marijuana isn't for everyone and some people with PTSD will find that it doesn't help at all, and can even make things worse. When it works, it’s mostly used on a daily basis that reduces symptoms but doesn’t cure.”
If NIDA and PHS eventually approve MAPS’ protocol, both the study’s lead researcher, Sue Sisley, MD, and the pharmacist working where the marijuana will be stored must obtain a controlled substances license from DEA. According to Dr. Doblin, MAPS would then purchase the marijuana from NIDA, submit the CMC information to FDA, seek approval from an institutional review board, raise funds, and start treating subjects.