Marijuana and Cannabinoids: Should Veterans Use Them?

The marijuana industry is booming, with expected earnings of more than $30 billion in 2021. Many servicemembers and veterans use it regularly, regardless of whether it’s legal in their state or current place of residence. Because of that, they may be placing themselves and their families at risk for a number of medical and legal reasons.

Just about everyone agrees that marijuana has medicinal properties that alleviate pain, anxiety, depression, among many other diseases and maladies. Recreational pot users have known for many years that it calms the nerves, relieves anxiety, soothes a stomach ache.

Unfortunately, the US government has stifled many research opportunities that could possibly reveal promising results and benefit millions of people. As the industry grows, though, we will likely see our own government ease restrictions, so more and more laboratories can conduct good, solid scientific work on the efficacy of marijuana and its cannabinoids.

Question for servicemembers and veterans is, should you use marijuana?

Think about it: you’re a fighter pilot who flies the F-22 Raptor. You rely on your crew chief and other support and maintenance personnel to keep your aircraft in the best shape possible. But what if your crew chief comes to work after smoking pot, even one joint?

He may not look it, but he is now under the influence of a drug that affects many different parts of the brain, including the regions involved in thinking and cognition. What if, during a deep inspection, he misses a chafed wire bundle or a loose part? And what if those damaged parts cause an in-flight emergency or worse, the loss of life and aircraft?

Like it or not, this scenario plays out every day in every branch of the armed forces, and it’s only going to get worse with the legalization of pot. Several Vietnam veterans I spoke with said they had smoked pot when they were on the job, on active duty. And they thought nothing of it. When I posed the hypothetical I just shared above, they paused and thought about it.

One laughed it off: “Sucks to be the pilot.”

“When you get rolling, you get in a groove with the job so when you’re buzzed it doesn’t matter. You just do your job same way as without the buzz,” said another.

Let’s consider those statements for a moment: neither man took any responsibility for their actions. That is troubling, because we rely on these men to perform at 100% in their jobs, but we know they are not when they ingest marijuana, regardless of whether they think they’re doing fine while “buzzed.”

This dilemma is what our military leaders must contend with in the coming years, as marijuana becomes accepted in all ranks of society, including our military. There’s only so much a commander can do when his troops are off on weekends, holidays or leave.

Arguably, pot is the world’s most popular cultivated illegal plant for drug use. It is also the most trafficked drug on the planet, and generates billions of dollars in illicit profits.

New Frontier Data states: “Despite the plant being illegal under federal law as a Schedule I drug, the U.S. legal marijuana industry was estimated at $13.6 billion in 2019 with 340,000 jobs devoted to the handling of plants.”

As of January 2021, pot is legal in 36 states, the District of Columbia, Guam, Puerto Rico and the US Virgin Islands. Fifteen of those states now allow recreational use of the drug, with more states considering the same. State guidance on pot use contradicts what the feds say, although federal legal measures are in place to restrict pursuing cases involving medical marijuana use in those states that allow it. It is unclear whether marijuana will ever be legal at the federal level.

Even though the book Marijuana and Medicine is now more than 20 years old, its message is still relevant today: “Scientific data indicate the potential therapeutic value of cannabinoid drugs, primarily THC, for pain relief, control of nausea and vomiting, and appetite stimulation; smoked marijuana, however, is a crude THC delivery system that also delivers harmful substances. The psychological effects of cannabinoids, such as anxiety reduction, sedation, and euphoria can influence their potential therapeutic value. Those effects are potentially undesirable for certain patients and situations and beneficial for others. In addition, psychological effects can complicate the interpretation of other aspects of the drug's effect.”

That’s the problem with using pot: you don’t always know what you’re getting, so you can’t necessarily predict how you will react or whether the drug(s) will benefit you.

The industry has leaders and innovators who produce excellent products, with more on the way. These companies sometimes have in-house research labs that accurately test their own products, so they can label them with reasonable accuracy. This allows consumers to do their own research and test different products. People with diabetes may need a certain cannabinoid, maybe even low THC. Someone with stage-4 pancreatic cancer may need full-spectrum cannabinoids, with high THC.

Some states have a formal medical marijuana use registry where a patient applies for a “pot card” that legally permits them to purchase pot products at state-regulated marijuana dispensaries.

The state of Florida, for example, charges a fee to get a pot card, which must be renewed every twelve months. You can only buy pot products if your card is active. The holder must also get medical exams every seven months to be able to purchase products.

The state allows all manner of medical doctors to see you, check your medical records, and dispense a “recommendation.” Because federal law prohibits doctors from issuing formal prescriptions for Schedule 1 substances, states can only allow doctors to hand out recommendations.

Some of those doctors are chiropractors, orthopedic surgeons, pediatric physicians, ophthalmologists, etc. In sum, just about any medical doctor can qualify to become a “pot doc.” Sounds like a racket, huh? It is.

I talked with one pot doc whose been consuming pot for decades, so he advises patients based on his personal experience with different strains, concentrations, formulations, etc. He was very forthcoming about other docs, too: “Some guys don’t know the first thing about pot, but they need extra cash so they get this gig. One woman works at an eye clinic most days, then moonlights here when she can. I tell people to ask if their doc actually uses the product themselves. I would not trust any doc out there if they didn’t use pot, because they couldn’t possibly know all the products and what they do. All they do is read the literature given to them by the clinic or dispensary that hires them. It’s the wild west right now. Good luck.”

One of the biggest problems with the medical marijuana industry is that there are so few studies that tell us definitively what each chemical constituent of marijuana actually does. When we take an 800-mg tablet of ibuprofen, we know it will greatly reduce inflammation after that 12-mile road march. We know from experience that it will help heal microtears in muscle and attached connective tissue. We also know that we cannot take it every day because it may damage our kidneys.

We know all this because ibuprofen has a proven track record at different doses. So we can use it smartly and accurately without harming ourselves.

Can we say the same for marijuana products? Do we know their long-term affects and how we personally will react to using various types and concentrations of them?

A 2017 study conducted on veterans produced this conclusion:

“Although cannabis is increasingly available for medical and recreational use, there is very little methodologically rigorous evidence examining its effects in patients with chronic pain or PTSD. Limited evidence suggests that cannabis may alleviate neuropathic pain, but there is insufficient evidence in other populations.

“There is insufficient evidence examining the effects of cannabis in PTSD populations. Among general populations, limited evidence suggests that cannabis is associated with an increased risk for potentially serious mental health adverse effects, such as psychosis. Data on its effects on long-term physical health vary; harms in older patients or those with multiple comorbidities have not been studied.”

Fact is, no one really knows because the marijuana industry is too new to have produced these answers.

So we rely on the “stoners” and “potheads” to advise us what each strain does, how much to consume, how often, etc. The BigPot industry hires stoners as advisors on the qualitative effects of pot on the human body. It’s not widely publicized but it’s a fact.

Do you want to rely on a stoner for medical advice? Seems we already do.

Even the pharmaceutical companies that mass-produce pot for medicinal and recreational purposes can’t tell us exactly what we need for what ails us. So they team up with the VA to actively recruit veterans for research studies.

We veterans have always been used as guinea pigs. That’s how the VA has become such a prolific producer of innovative medical products and services.

So perhaps it will be us veterans who once again lead the way to newfound knowledge about how marijuana affects the human body.

Veterans have unique issues, both physical and mental, and they don’t always have adequate treatments for their problems. Maybe medical marijuana is a good avenue for them. Given the paucity of current scientific and medical information on the use of marijuana, our nation’s veterans are left experimenting on their own.

So the question remains: should veterans use marijuana? Yes, if proven to be medically beneficial to a veteran. Even then, the veteran must track the efficacy of his treatment over time, and make adjustments as necessary.

Remember: it’s the wild west, so tread carefully.

References:

Boden, M. T., Babson, K. A., Vujanovic, A. A., Short, N. A., & Bonn-Miller, M. (2013). Posttraumatic stress disorder and cannabis use characteristics among military Veterans with cannabis dependence. The American Journal on Addictions, 22, 277-284.

Cougle, J.R., Bonn-Miller, M. O., Vujanovic, A. A., Zvolensky, M. J., & Hawkins, K. A. (2011). Posttraumatic stress disorder and cannabis use in a nationally representative sample. Psychology of Addictive Behaviors, 25, 554-558.

Institute of Medicine. (1999). Marijuana and Medicine: Assessing the Science Base. Washington, DC: The National Academies Press.

Kendall, D.A. & Alexander, S.P. H. (2009). Behavioral neurobiology of the endocannabinoid system.Current topics in behavioral neurosciences. Heidelberg: Springer-Verlag.

New Frontier Data. Potential Cannabis Market Job Growth. https://newfrontierdata.com/cannabis-insights/potential-cannabis-market-job-growth. Accessed and vetted April 27, 2020.

United States Drug Enforcement Agency (DEA). Drug Scheduling. https://www.dea.gov/drug-scheduling. Accessed and vetted April 27, 2020.

Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. B. (2014). Adverse health effects of marijuana use. New England Journal of Medicine, 370, 2219-2227.

AUTHOR: Bo Riley reports on issues of interest to veterans and active-duty personnel. He’s a former Army Ranger with the 1st Ranger Battalion, 75th Ranger Regiment, and lives in the Tampa Bay area.