Breaking News
January 20, 2018 - UCLA researchers describe herpes virus structure associated with Kaposi’s sarcoma
January 20, 2018 - New study enrolls first patient to evaluate potential of WaveCrest LAAO System
January 20, 2018 - New review explores effects of exposing developing brains to general anesthesia
January 20, 2018 - GW Pharmaceuticals Announces Acceptance of NDA Filing for Epidiolex (cannabidiol) in the treatment of Lennox-Gastaut syndrome and Dravet syndrome
January 20, 2018 - Weight-Loss Surgery Approaches Offer Similar Results
January 20, 2018 - Free online access to millions of documents on chemical toxicity
January 20, 2018 - CE marked MAST Toxoreagent kit for detection of Toxoplasma antibodies
January 20, 2018 - DNA study sheds light on longstanding puzzle of cell division
January 20, 2018 - Montefiore provides specialized medical care to parents of adopted children
January 20, 2018 - Enzyme discovery provides new horizon of therapeutic opportunities across disease spectrum
January 20, 2018 - New smartphone app successfully enables remote monitoring of surgical wounds
January 20, 2018 - Liquid Biopsy Shows Promise for Colon Cancer
January 20, 2018 - Surgery death rates in Africa are twice global average: study
January 20, 2018 - New isothermal amplification kit using LAMP technology
January 20, 2018 - Pretreatment improves outcomes in high-risk stage 3 melanoma, study shows
January 20, 2018 - Health Highlights: Jan. 17, 2018
January 20, 2018 - House Opioid Task Force has Big Plans for 2018
January 20, 2018 - Perfectionism among young people significantly increased since 1980s, study finds
January 20, 2018 - Evidensia Sweden orders Sectra cloud-based PACS for reviewing all medical images
January 20, 2018 - Researchers test new anti-malaria medication
January 20, 2018 - Small Joint Surgeries Drop among RA Patients
January 20, 2018 - Young people with shared residency have fewer mental problems
January 20, 2018 - Childhood physical activity may have far-reaching implications
January 20, 2018 - Overweight female kidney donors of childbearing age may have greater preeclampsia risk
January 20, 2018 - MSU scientists seek to identify brain mechanisms related to psychosis
January 20, 2018 - Scientists find how potential new eczema treatment could also alleviate asthma
January 20, 2018 - Older hospitalized patients less likely to be tested for influenza
January 20, 2018 - Syndax Pharmaceuticals Announces Clinical Collaboration to Evaluate Entinostat in Combination with anti-PD-L1 Cancer Immunotherapy in Breast Cancer
January 20, 2018 - Endoscopes Over Microscopes in Retinal Surgery: Ophthalmology Times
January 20, 2018 - Technology not taking over children’s lives despite screen-time increase
January 20, 2018 - Study finds extensive contamination around lead battery recycling plants in 7 African countries
January 20, 2018 - Flu may pass to others through exhaled breath, study shows
January 20, 2018 - Neuronal loss very limited in Alzheimer’s disease, new study shows
January 20, 2018 - Novel robot can aid treatment of rare birth defect
January 19, 2018 - TherapeuticsMD Announces Submission of New Drug Application for TX-001HR
January 19, 2018 - Fighting Infant Mortality | Medpage Today
January 19, 2018 - Researchers offer new evidence on four-year-old children’s knowledge about ecology
January 19, 2018 - Analysis finds overlooked crucial factor in determining prognosis for DIPGs
January 19, 2018 - Review explores consequences of genetic testing and cancer risk-reducing surgery
January 19, 2018 - Morning Break: HHS Div. of Religious Freedom; Trump’s Heart Health; Minister of Loneliness
January 19, 2018 - Parkinson’s disease ‘jerking’ side effect detected by algorithm
January 19, 2018 - New analysis finds dramatic increases in maternal mortality rates
January 19, 2018 - Study provides more evidence for link between increased cancer risk and advanced gum disease
January 19, 2018 - Study reveals key mechanism of how cancer metastasis happens
January 19, 2018 - Weight-Loss Surgery’s Benefits Wane Over Time for Diabetics
January 19, 2018 - Cath Lab Recap: Sapien 3 Delivery System Recall; Transatlantic PCI Smackdown
January 19, 2018 - Parkinson’s treatment could be more effective, student finds
January 19, 2018 - New vaccine approach offers effective protection against tuberculosis
January 19, 2018 - Home care agencies often wrongly deny Medicare help to the chronically ill
January 19, 2018 - One hundred percent fruit juice does not alter blood sugar levels
January 19, 2018 - Prebiotics could enhance learning and memory skills in infants
January 19, 2018 - CMS May Cover MRI With Cardiac Devices Across the Board
January 19, 2018 - As income rises, women get slimmer—but not men
January 19, 2018 - Researchers develop adhesive materials to prevent bracket stains on teeth
January 19, 2018 - Flu can be spread without coughs and sneezes
January 19, 2018 - AMSBIO’s new recombinant protein shows great promise for organoid culture
January 19, 2018 - AbbVie’s Upadacitinib Granted Breakthrough Therapy Designation from the U.S. Food and Drug Administration for Atopic Dermatitis
January 19, 2018 - ASH: Pomalidomide Dose Escalation Improves Response
January 19, 2018 - Is your child’s school an obesity risk?
January 19, 2018 - Scientists describe groundbreaking training effect on the innate immune system
January 19, 2018 - MAST announces new AmpC, ESBL & Carbapenemase Detection Set
January 19, 2018 - Signaling molecules likely involved in concussions, rodent studies show
January 19, 2018 - Mast introduces Carba plus for CPE and OXA-48 confirmation
January 19, 2018 - Paleolithic diet helps overweight women maintain weight loss
January 19, 2018 - Agios Submits New Drug Application to the FDA for Ivosidenib for the Treatment of Patients with Relapsed/Refractory AML and an IDH1 Mutation
January 19, 2018 - This Flu Season, Don’t Forget About Tamiflu
January 19, 2018 - Amsterdam wins battle to host EU medicines agency after Brexit
January 19, 2018 - Study suggests movement as accurate method to diagnose neurodevelopmental disorders
January 19, 2018 - Maximize resolution in deep imaging for neuroscience research with Olympus TruResolution objectives
January 19, 2018 - Bilingualism may benefit children with ASD
January 19, 2018 - FDA Alert: Levofloxacin in 5 Percent Dextrose 250mg/50mL by AuroMedics: Recall
January 19, 2018 - USPSTF Not Backing Ankle-Brachial Index, CRP, or Coronary Calcium
January 19, 2018 - Higher omega-3 fatty acid intake tied to lower glaucoma risk
January 19, 2018 - Findings reveal conventional cancer therapy as double-edged sword
January 19, 2018 - Health Highlights: Jan. 16, 2018
January 19, 2018 - Morning Break: Anti-Emetic Warning; Uninsured Rate Jumps; Flu Worsens Saline Shortage
January 19, 2018 - Increased use of ambulatory surgery centers for cataract surgery
January 19, 2018 - Not-for-profit hospitals coming up with their own generic medicines to combat shortages
January 19, 2018 - $500 cancer detection blood tests may soon become reality
January 19, 2018 - Chronic traumatic encephalopathy may start early even without signs of concussions
VA clears the air on talking to patients about marijuana use

VA clears the air on talking to patients about marijuana use

image_pdfDownload PDFimage_print

“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 their use of 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 refer veterans to state-approved medical marijuana programs, since the drug is illegal under federal law, with no accepted medical use.

That disconnect makes veterans wary, said Michael Krawitz, a disabled Air Force veteran in Ironto, Va., who takes oxycodone and marijuana to treat extensive injuries he suffered in a non-combat-related 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 at a White House briefing last May, who said 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 VA is not “able to prescribe medical marijuana.”

Cashour declined to provide further information about the new directive.

Under federal law, marijuana is classified as a Schedule 1 drug, meaning it has no accepted medical use and a high potential for abuse. Heroin and LSD are other Schedule 1 drugs. Doctors aren’t permitted to prescribe marijuana. Instead, in states that have legalized the use of 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 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 legally for medical purposes. Patients who have a disease or condition that’s approved for treatment with marijuana under the law 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 announced last week he would rescind 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 muscle spasms associated with multiple sclerosis.

“I believe that there are chemicals in marijuana that have medicinal properties,” said Dr. 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 1 drugs.

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 Dr J. Michael Bostwick, a psychiatrist at Mayo Clinic in Rochester, Minn., who has written on medical marijuana use.


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Tagged with:

About author

Related Articles