It has been another rough couple of weeks for the Department of Veterans Affairs (VA). After the long-running scandals of shameful wait times, neglect to the point of lives lost, and the need for new leadership, they have faltered again recently with tone-deaf comparisons to Disneyland visits and mistakenly thinking that 4,000 living veterans had somehow expired, according to incorrect records.
Hardly comforting news for those who served, and to whom we owe so much, as Memorial Day is upon us.
Yet even that record, sad enough, speaks more of bureaucratic neglect and indifference, and not of policies doing active damage. The Obama administration's enabling of legal marijuana can become even worse, however, were the VA to support marijuana for afflicted veterans suffering from Post-Traumatic Stress Disorder (PTSD). Such action risks precisely committing "active damage."
No physician, of course, can actually prescribe marijuana, for medicinal purposes or otherwise, as it is not an approved medication, and has no demonstrated therapeutic value in the treatment of any condition, according to the Food and Drug Administration (FDA). There is further the clear safety risk in its use, not only from abuse potential, but from its association with adverse health outcomes, such as diminished quality of life and even premature death.
In particular, some of the strongest findings show an association with psychotic breaks, schizophrenia, and depression – that is, similar conditions to mental disabilities that some PTSD sufferers seek to overcome. In particular, marijuana can worsen outcomes for those with a "co-morbidity" condition, such as psychiatric disorders.
While marijuana may not be prescribed, and its use is, in fact, contrary to federal law, in so-called medical marijuana states it is possible for a "care-giver" to recommend marijuana to those whom they term "patients." And this is the proposal now before Congress, to enable federal VA psychiatrists to "recommend" use of marijuana to those receiving PTSD treatment.
This is a bad idea, in particular since it is an action purportedly taken to serve the needs of veterans. To be fair, VA physicians have not been enthusiastic in support of the measure. In fact, the official VA statement on the matter, from their National Center on PTSD, makes clear that "there is no evidence at this time that marijuana is an effective treatment for PTSD. In fact, research suggests that marijuana can be harmful to individuals with PTSD."
Yet even that demurral is not sufficiently strong, given what the research community now knows about how wrongheaded marijuana use is for PTSD sufferers. A recent example in the Journal of Clinical Psychiatry argues that marijuana can be, in reality, a danger to vets. After examining 2,276 veterans being treated for PTSD, they concluded,
"(I)nitiating marijuana use after treatment was associated with worse PTSD symptoms, more violent behavior, and alcohol use. Marijuana may actually worsen PTSD symptoms or nullify the benefits of specialized, intensive treatment. Cessation or prevention of use may be an important goal of treatment."
Increasingly THC, the active intoxicating compound found in marijuana, is seen as a potential toxin, and the new, highly potent forms of the drug produce their own mental disabilities for users. Finally, many in treatment for PTSD receive powerful psychotropic medications as part of their therapy. Where is the literature exploring the potential drug interactions with those who add THC to this potent mix?
Either those who support this development are simply misguided, and are unaware of the medical dangers that are well attested—in which case this action is just a mistake—or they are aware, but push ahead anyway. To insist on marijuana for America's veterans is the political equivalent of "friendly fire," and puts the VA in the position of doing active harm to their interests.
In the worst case, there appear to be those so focused on their political objectives – more drugs, more widely available—that they are willing to enlist political theater in support of their goals, putting before the public sympathetic groups (children suffering from epilepsy, or disabled heroes) as props to advance their purposes. For such as these, cynicism is a virtue.
There may be scientific developments associated with chemicals in marijuana that could be of medical value. If so, we should welcome them, but they will only come through the application of the proper medical research protocols. To date, this has not been done, and the integrity of the protocols is undermined once "medicines" are approved through political pressure, rather than by scientific understanding.
Compelling support for a drug associated with induced psychosis to treat sufferers of psychosis is at best a cruel blunder. The VA should honor federal law, not the least reason being for the good of our vets.