VETS CONFOUNDED BY DUELING MEDICAL MARIJUANA RULES

Veterans Affairs Allows It in Some States While Justice Department
Cracks Down

For two years, John Riccio worried that smoking marijuana to relieve
his chronic back and shoulder pain would get him in trouble with the
Department of Veterans Affairs.

Then the department last year began allowing former service members to
use medical marijuana -- in states that have laws permitting it -- in
conjunction with their regular treatment. Riccio, a Navy veteran
living in South Park, says he sleeps easier now that he can talk about
it with his VA doctor without risking his benefits.

The policy clarification has veterans like Riccio wondering why the
government continues to classify marijuana as a Schedule 1 drug
alongside heroin and deny that the plant has any medicinal use. In
October, the four U.S. attorneys in California announced a massive
crackdown on marijuana growers and storefront dispensaries.

"It's complete hypocrisy and it's a war on people," said Ricco, a
31-year-old Wisconsin transplant who left the Navy in 2008. "It's a
war on good, compassionate, law-abiding people."

The directive on medical cannabis has added a new wrinkle to a
years-old dispute between the federal government and a growing number
of states that allow marijuana for sick and dying patients.

The Justice Department has stressed that it would not focus federal
resources on sick individuals in shutting down dispensaries. Federal
authorities point out that not only is marijuana illegal under federal
law, but they say in California it has become pervasive, profit-driven
and abused by people who are not sick.

There are laws allowing medical marijuana in 16 states and Washington,
D.C.,

Medical pot advocates have lamented a series of memos from various
federal agencies challenging the rights of patients to do everything
from possess a firearm and ammunition to receive federal housing
assistance. There's also the risk to one's job or being dropped from a
list of people waiting for a liver transplant, said Michael Krawitz,
executive director of Veterans for Medical Marijuana Access, which
worked with Veterans Affairs to craft the policy.

"There's the sentiment out there that you've lead these vets almost
into a trap," said Krawitz, whose organization is based in Elliston,
Va. "You've got vets that were told they were going to be respected
when it comes to their medicine. And when you start closing the noose
around everybody, you are closing it around these vets as well."

The Food and Drug Administration in April approved a study to test
whether marijuana could ease symptoms associated with post-traumatic
stress disorder, including nightmares, insomnia, anxiety, anger and
flashbacks. Those plans were dashed when HHS refused to sell
researchers the marijuana needed for the study.

The Food and Drug Administration remains the sole institution that
approves medication in the U.S. Rafael Lemaitre, communications
director at the Office of National Drug Control Policy, said the
veterans directive and the crackdown by federal prosecutors both deal
with the reality of states working outside the Food and Drug
Administration.

"We can't control whether a patient does or does not participate in a
state-approved marijuana program," said Michael Valentino, chief
consultant for pharmacy benefits management services at the Department
of Veterans Affairs. "What we have attempted to do is recognize the
fact that veterans do, and other people do, and then to provide
guidance to our staff on how to deal with those situations when they
occur."

While the policy, which was thoroughly vetted by the Office of
National Drug Control Policy, is not intended to be a green light,
Valentino said, it's also not intended to be a red light, either.

Department rules says veterans could be denied pain medications if
they used illegal drugs. The marijuana policy created the first
written exception. It does not allow department doctors to recommend
marijuana nor does it allow veterans to use the drug on federal grounds.

Under the new policy, participation in a state medical marijuana
program may require a veteran's treatment team to modify their
program. But doctors would ensure they continued to receive regular
benefits such as VA-provided health care. That includes veterans
diagnosed with PTSD.

"It's really going to be up to the providers and the treatment teams
to decide whether participation in a state program is going to require
modification of what we are doing on our end," Valentino said.

"The last thing in the world that we want to do is provide some kind
of guidance that gets veterans embroiled and entangled in criminal
issues. That's what we are trying to avoid," he added.

Even if the Justice Department isn't focusing on sick individuals, its
crackdown has affected them, said Daante Tirado, 50, of San Diego. The
disabled Air Force veteran served one tour in South Korea and left the
military after four years. He began using marijuana in conjunction
with Flexural and Vicodin after suffering two severe neck and back
injuries.

Tirado said his VA treatment team made little fuss when he came clean
about the marijuana use. "Just as it should be," he said.

But the elimination of nearly every storefront dispensary in his path
has made getting the medical marijuana more difficult and potentially
more expensive.

"Without any medication, this pain level, this torture level, I want
to kill myself," he said. "I won't. But I want to. Just to stop the
pain. I just cringe at the fact that I might not be able to relieve
that pain."

It's unknown how many of the 22 million veterans use marijuana,
Krawitz said. For many who spent years serving in the military, with
its zero tolerance for illicit drugs, there can be a stigma associated
with medical pot. The Veterans Affairs directive, coupled with
increased federal enforcement, are indicative of the minified of
ambiguities regarding medical use in California, lawyer Katherine
Clifton said.

She is preparing a lawsuit against the city of San Diego seeking to
contain the flow of legal action against dispensaries and their landowners.

"The laws are all over the map, they are constantly changing, and
nobody, even the federal government, really understands what the
bottom-line legal issues are," Clifton said.

Riccio said he bathes in hemp soap, cleans his dishes with hemp, eats
hemp bread and smoothies and takes hemp supplements. In addition to
relieving his pain, his overall health has gotten better by the day.
He goes for routine checkups, practices yoga, rides his bicycle and
eats a health diet. Riccio was a counseling intern at the Veterans
Village of San Diego and also served in the Wounded Warrior fellowship
program as a community representative in the 51st District.

Now, his biggest concern is having to return to pharmaceutical drugs
or turn to the black market for his marijuana.

"It wouldn't matter if I had a card or not," he said. "It would be
illegal."