In the Green

A new initiative seeks to ensure veterans' access to medical cannabis

Former US Army soldier Michael Pell used to wake up from naps with drool running down his chin. He blames the problem on pharmaceutical drugs prescribed to him by doctors at the veterans' hospital after he was diagnosed with posttraumatic stress disorder.

Panic attacks and nightmares began impacting Pell's life shortly after 9/11. The symptoms of PTSD made it impossible for the former personnel sergeant to leave his house. For eight years, Pell, 45, says he could only make short trips to nearby stores to pick up more medication. Inside the pharmacies, Pell remembers sweating and feeling nervous.

"I was constantly looking over my shoulder," he says. "I'd forget what I'd gone to Walmart or Walgreens to get in the first place."

As time passed, it became clear that heavy doses of opiates were taking a toll on his life. Pell says he knew it was affecting his relationships. For months, he considered replacing his anti-anxiety Xanax prescriptions with medical cannabis, but initially his family didn't support that option. In 2009, his daughter, then 11 years old, told him she was adamantly against marijuana, and his parents called the state's program "reefer madness."

But on the day police tactical teams were called to Pell's Rio Rancho home during a self-described psychotic episode, he says he decided to enroll in New Mexico's Medical Cannabis Program.

After disclosing his marijuana use to a social worker assigned to his case at the US Department of Veterans Affairs, Pell learned the woman had written a note on his chart stating she believed his medical marijuana use was "just an escape."

In a way, Pell agrees.

"Whether I take a pill or smoke a natural plant, it is an escape. It's a way to get relief from the panic attacks," he says.

Policies in place at the VA didn't help Pell get access to cannabis. Government doctors in the VA system are currently prohibited from prescribing cannabis to treat people with PTSD. Their patients simply have to find another doctor to refer them to the state Department of Health's Medical Cannabis Program.

Now, the Drug Policy Alliance—a national organization that advocates for “sensible drug policy reform”—wants to make sure that, once enrolled, veterans like Pell will have easy access to medical marijuana and avoid workplace discrimination.

Last month, in partnership with current and former elected officials, and business organizations, DPA-NM launched “Freedom to Choose”—a statewide campaign designed to educate veterans, military families, government officials and the public about the benefits of medical cannabis.

“Medical marijuana is a legitimate health care choice,” DPA Policy Coordinator Jessica Gelay tells SFR.

Former New Mexico Gov. Gary Johnson, who supports legalizing all drugs, supports the campaign.

“It’s ridiculous that VA doctors can’t refer patients to the state program,” Johnson tells SFR. “All of the marijuana laws are ridiculous. People should be able to treat whatever conditions they want, as long as they don’t hurt other people.”

Johnson, who has started hosting Google Hangouts to discuss national issues like reforming drug laws, believes other states will eventually follow Washington and Colorado’s lead and start legalizing cannabis even for recreational purposes.

“People will start to realize the sky isn’t falling,” Johnson tells SFR. “The world will be a better place when it’s totally legal.”

The education component in DPA’s campaign is key. Former Marine and Santa Fe resident Tim Origer, 65, lost his leg during the Tet Offensive in Vietnam in 1968. He’s suffered from chronic pain and PTSD for nearly four decades, but was initially reluctant to try medical cannabis.

“I enrolled this summer after getting diagnosed with cancer,” Origer says.

He still hasn’t smoked any marijuana, but says he’s purchased some edibles to eat when he eventually needs pain relief.

Origer says the state should prepare for an epidemic of people suffering from PTSD. He’s right: Nearly a quarter million men and women who fought in Iraq and Afghanistan have been diagnosed with PTSD since their return to the United States. And, according to the VA’s own reports, suicide in the veteran population has increased 20 percent since 2007, with an average of 22 former service members and one active duty member killing themselves each day.

Origer says that, over the years, he’s seen veterans being treated with various pharmaceutical drugs, and he didn’t like what he saw.

“When they use these bizarre cocktails, they often end up with patients who have more issues than when they started treatment,” he says.

When the 6-foot-5 veteran—who wears a prosthetic leg decorated with the Marines’ iconic bulldog mascot and slogan Semper Fi—asked his doctors if there were any new medications to treat phantom pain, he says they told him about a new pill, but warned him he’d have to take it every day for the rest of his life.

“I have no desire to be addicted,” Origer says. “The only thing I’ve taken for the past 22 years is Ibuprofen.”

Origer says that before enrolling in the Medical Cannabis Program, he listened to his peers’ own experiences with the Department of Health and some of the state’s 23 nonprofit licensed growers. Now that he’s in the program, he can’t believe the cost.

“When I came back from Vietnam, marijuana used to cost $7 an ounce. Now it’s $360 an ounce,” Origer says.

“I don’t know if I can afford it. And, unlike my other medications’ co-pays, the insurance companies don’t cover cannabis,” he adds, frustrated.

To help reduce the cost of cannabis in New Mexico, state Rep. Antonio “Moe” Maestas, D-Bernalillo, wants the DOH to consider increasing the supply. He’d like to see Health Secretary Retta Ward either increase the number of producers licensed to grow marijuana, or double the number of plants current producers are allowed to cultivate at any given time.

“We’ve learned, over the past few years, that medical marijuana is good for veterans who suffer from PTSD,” Maestas says. “Every policymaker should support expansion of the program so veterans can improve their quality of life.”

Maestas isn’t surprised to hear that the number of patients enrolled in the state program has more than tripled under Gov. Susana Martinez. As of July 1, 2013, DOH reported 9,333 total patients. Of those, 3,930 qualified for the program with a PTSD diagnosis; another 2,707 were enrolled for chronic pain.

He’s more concerned about workplace discrimination—especially in government agencies.

“We’re asking all businesses to treat cannabis like any other [prescription] drugs,” he explains. “It’s legal for medical marijuana patients.”

Take Iraq War veteran Augustine Stanley, who was fired by the Bernalillo County Metropolitan Detention Center last year and lost his appeal for reinstatement earlier this year. During a press call with DPA, Stanley said he was diagnosed with PTSD in 2011, “after a few bad episodes with my wife.”

The couple asked the VA for help. His doctors put him on prescription pills.

“But they didn’t help me,” says Stanley, who recently started a tow truck company. “The pills made things worse.”

He insists cannabis changed his life.

“I can wake up in the morning and do the things I used to enjoy prior to being put on medications that made me like a zombie,” Stanley says.

Maestas says the former guard’s case indicates how a bad policy can go wrong.

“He was following state law,” Maestas reminds SFR. “It didn’t prohibit his ability to do his job.”

MDC officials say Stanley wasn’t necessarily fired for testing positive for THC. Instead, they say it was because he didn’t notify his superiors about his cannabis use.

In 2010, New Mexico was the first state to make PTSD a qualifying condition for its cannabis program. But two years later, patients got a wakeup call. An Albuquerque-area psychologist, Dr. William Ulwelling, filed a petition with the DOH’s Medical Cannabis Advisory Board, asking them to remove PTSD from the list of approved conditions. The board rejected the petition, but on April 30, Health Secretary Ward reaffirmed PTSD as a qualifying condition.

“There is insufficient medical and scientific evidence in the petition to move forward with the removal of PTSD as a qualifying condition,” she said at the time.

DPA’s Gelay says several states with cannabis programs have followed New Mexico’s lead in allowing PTSD as a qualifying condition, including Delaware, Connecticut, Oregon and others.

US Rep. Michelle Lujan Grisham, D-NM, says she supports the Freedom to Choose campaign and will promote New Mexico’s program model to states without medical cannabis laws, as well as advocate for greater access for patients—like vets suffering from both PTSD and chronic pain.

“You can have the right safeguards. You can create a list of conditions that is limited enough to have the right infrastructure in place, but not so limiting it can cause some patients not to have full access,” Grisham says.

In New Mexico, cannabis patients have a new concern. On Aug. 16, the state Medical Board will consider stricter rules for doctors who refer patients to the cannabis program.

Gelay says DPA appreciates the board’s role in protecting public health, but is  concerned that the proposed changes won’t align with DOH’s own rules.

“It seems illogical to have two sets of conflicting rules for medical providers to abide by. We anticipate the additional rules set forth by the Medical Board will only confuse and burden medical providers and patients unnecessarily,” Gelay writes in an email to SFR. She worries that, if adopted, the rules will create new barriers to people who need cannabis the most.

“It seems to us the board is making medical marijuana a second-class medicine, requiring physicians to jump through hoops they don’t have to for other medicines.  Unfortunately, the seriously ill patients are the ones who will ultimately suffer,” Gelay says.

Pell, for his part, says his symptoms are back under control and he’s rediscovering the world beyond his house.

“After about a year in the program,” he says, “I was able to take my son and daughter to the movies for the first time in years.”

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