VA DOCTORS PROHIBITED FROM PRESCRIBING MEDICAL POT

ALBUQUERQUE, N.M.-When Paul Culkin came home to New Mexico after serving
with an Army bomb squad in Iraq, he tried counseling and medications
offered by the Department of Veterans Affairs to cope with his post
traumatic stress disorder.

Nothing worked very well. Then he found a new alternative: marijuana.

New Mexico is the only state that explicitly allows people with PTSD to
smoke pot under its medical marijuana law-an issue that is getting
attention around the country at a time when traumatized vets are coming
home from wars in Iraq and Afghanistan in large numbers.

New Mexico's medical marijuana law has created a conundrum for the Veterans
Affairs, which does not allow its doctors to prescribe pot because the drug
is illegal in the eyes of the federal government. So, patients like Culkin
must seek out an endorsement from a private doctor.

PTSD accounts for more patients than any other of the state's 16 eligible
debilitating conditions approved for medical marijuana treatment.

Culkin wishes the VA could provide it.

"Oh my God, it would be so helpful," said Culkin, 30, who heads the New
Mexico Medical Marijuana Patients Group formed last December as a support
and education group.

If the VA handled all needs-including medical cannabis-care for veterans
would improve, he said, because the doctor would know everything about the
patient.

"If these guys fought the hardest they could, why not give them the best
medicine, or an alternative medicine you can?" Culkin said.

States where medical marijuana use has been approved have been trying to
determine what ailments the drug will help. Those efforts have resulted in
a mishmash of regulations.

For instance, a Colorado House committee in March rejected following New
Mexico's lead in specifically listing PTSD to qualify for medical
marijuana. California doctors can recommend medical marijuana for a variety
of conditions and "any other illness for which marijuana provides relief."

The American Medical Association has called for controlled studies of
marijuana for patients whose conditions it might help. The association also
wants a review of marijuana's status as a Schedule 1 drug so clinical
research can move ahead.

The Department of Veterans Affairs says it is developing a national policy,
and the head of Veterans for Medical Marijuana Access believes a VA policy
allowing medical marijuana "is inevitable."

"We're all on the same side," said Michael Krawitz of Virginia. "My goal is
a good outcome for the veteran, and that's their goal."

"The irony in this ... is it's a common thing for veterans to tell me, 'The
VA is telling me if I just stay away from medical marijuana, we'll give you
all the pills you want, morphine, whatever,'" he said.

Krawitz, 47, was severely injured in a motorcycle accident while stationed
in Guam with the Air Force about 20 years ago and eventually received a
medical discharge.

He is an advocate for marijuana's medicinal benefits.

"It makes it so you can put down a lot of the pain pills. It helps with
nerve pain, that really bad spasming and twitching."

He praises the care he's gotten from the VA, but adds: "I feel sorry for
the VA; they're caught in the middle ... They have a clear mandate to take
care of veterans."

Given their inability to get medical marijuana from the VA, New Mexico
veterans are finding their own go-to physicians, including Dr. Eve Elting
in the central part of the state.

"I have guys coming to see me from all over the state, five or six hours'
drive, just to be legal," said Elting, of Truth or Consequences. "It's bad
enough they have something that makes life so challenging. On top of that
they're discriminated against, made to feel like they're doing something
wrong."

Elting said veterans hear about her by word of mouth since she will see
people who aren't regular patients. About a quarter of those who come to
her want medical marijuana for PTSD. One day she saw eight veterans-five
for PTSD.

New Mexico doctors do not prescribe medical cannabis. Rather, they certify
someone has one of the approved conditions and that standard treatment
doesn't work. Patients then apply to the state program. If an application
is approved, the patient gets a registry ID card that allows possession of
up to 6 ounces of medical marijuana.

A psychiatrist's diagnosis must be included for PTSD. For chronic pain,
X-rays or CT scans are required and both a primary doctor and a specialist
have to sign off.

"Even though the VA has prohibited them from signing the documents, I don't
see why a physician treating the veteran would not be willing to sign a
piece of paper attesting that the patient had that condition," said Elting,
who did her residency at a VA hospital and serves on New Mexico's
eight-member medical advisory board for the program.

Veterans armed with Elting's signature would still have to find a private
psychiatrist or other specialist to sign.

"Everyone's happy to give them a million narcotics, anti-psychotics. It's
frustrating," she said.