Pubdate: Sun, 24 Jul 2011
Source: Kennebec Journal (Augusta, ME)
Copyright: 2011 MaineToday Media, Inc.
Contact: 
http://www.kjonline.com/readerservices/Send_a_Letter_to_the_Editor-KJ.html
Website: http://www.kjonline.com/
Details: http://www.mapinc.org/media/1405
Author: Michael Shepherd
Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal)

WOUNDED VET TOUTS MARIJUANA

AUGUSTA -- Ryan Begin was checking a report of an improvised 
explosive device in Iskandariya, Iraq., on Aug. 1, 2004.

Then the U.S. Marine Corps corporal saw one. It detonated, blowing 
apart his right arm.

More than 30 surgeries later, Begin said he has regained some use of 
his arm. But the psychological damage has taken a harsher toll, 
including drug addiction and violence.

Begin told doctors in federal health centers high-grade medical 
marijuana was his only hope for tamping down the innumerable 
nightmares, flashbacks and fears that followed him from the battlefield.

"My mood's stable now -- no peaks and valleys, just stable ups and 
downs," he said.

His mother, Anna -- "a little bit apprehensive" about medical 
marijuana at first -- is a believer.

"When he started the marijuana, it was like having my son back," she said.

Doctors in the federal veterans' health care system aren't as 
convinced. The substance remains illegal under federal law, and 
guidelines for federal health centers don't support medical marijuana,

That ended Begin's relationship with the federal health system.

Battle scars

Today, Begin is unemployed, and one of 1,807 patients registered with 
the state to use marijuana medicinally.

He entered the Marines in November 2001, and served two tours in 
Iraq, from March to June 2003, then from July to August 2004.

Begin, 31, of Jackman, was given an early look at war.

He said his first day in Iraq, March 23, 2003, was the battle of 
Nasiriyah -- one of the Iraq invasion's first large battles. Six 
soldiers, including Pfc. Jessica Lynch, whose capture and rescue were 
well-documented, were taken prisoner. More were killed.

"Every day, someone new would die," Begin said.

When civilian families attempted to leave by running military 
checkpoints, they were often blown up and killed. Begin said there 
were times he had to clear charred bodies.

"At the time, I was taught to not let emotion get involved," he said. 
"You just do it."

He was honorably discharged in 2007 with the rank of sergeant, and 
returned home to Jackman.

What followed was a string of reckless behavior Begin attributes, in 
part, to his treatment.

"I was a mess," he said. "I had so much anger. I just couldn't cope with it."

On a cocktail of medications, he also drank heavily. One day in July 
2007, he said he had two bottles of whiskey, took 90 valium pills and 
took to the roads in his truck. He got pulled over and tried to 
assault the officer.

He was sentenced in 2010 to 43 days in Somerset County Jail after 
being found guilty of assault for that incident.

Begin also was arrested on a charge of violating bail conditions in 
November 2007.

He said it was for possession of marijuana, which he was using to 
illegally self-medicate.

Then, Begin was sentenced to 180 days, all suspended, with two years 
of probation for an incident involving aggravated criminal trespass 
on Jan. 13, 2008.

According to records, his wife got a protection-from-abuse order 
against him after he threw an ashtray that struck her.

Seeking relief

Meanwhile, Begin was being treated for battle injuries both physical 
and psychological.

He provided medical records to the Kennebec Journal that detail 
treatment at Northampton VA Medical Center in Massachusetts and Togus 
VA Medical Center.

The records detail military history, mental health narratives and 
medications. Begin was being treated for post-traumatic stress 
disorder in addition to physical injuries.

Begin said he was harmed by the drugs he was prescribed and the 
psychological treatment he was offered.

In addition to opiates such as morphine for pain, Begin was 
prescribed dextroamphetamine "for concentration, attention and mood."

"They focused on improving your memory," he said. "Why would you 
improve someone's memory who has bad memories?"

In the records, he is quoted as saying he was addicted to prescribed 
opiates from 2004 to 2007.

After years struggling with violent behavior and ineffective 
treatment, Begin in March got a state license to use medical 
marijuana after seeing Dustin Sulak, a Hallowell-based doctor known 
statewide as an advocate for medical marijuana.

While records show Begin's federal doctors had known about his past 
recreational marijuana use, Begin admitted he set up the appointment 
with Sulak without notifying his VA doctors.

And Sulak wrote Begin's recommendation for chronic pain in his right 
arm, not for PTSD.

That's because PTSD isn't on Maine's list of qualifying conditions 
for the medical marijuana program.

"I knew (marijuana) would work for PTSD because it worked for me in 
the past," Begin said.

When he finally told VA doctors he had registered as a medical 
marijuana user, Begin said they gave him a choice.

"'If you're pot-positive, we're not writing you any prescriptions for 
anything,'" he said they told him. "They told me, 'Prescription pills 
or medical marijuana.'"

He chose the latter, and said he hasn't been to Togus since.

Stress factor

A fact sheet from the Vietnam Veterans of America and Veterans of 
Modern Warfare said 300,000 veterans of the Iraq and Afghanistan wars 
are expected to suffer from PTSD or major depression.

Charles Wynott, executive director of the Westbrook-based Maine 
Medical Marijuana Patients Center, said he gets calls from veterans 
with PTSD "all the time," lamenting its exclusion from Maine's condition list.

"I sympathize with them and tell them I'm doing everything I can to 
get (the list of qualifying conditions) changed," he said. "It's 
definitely at the top of our list."

Gordon Smith, executive vice president of the Maine Medical 
Association, said his group would likely support expansion of the law 
into PTSD and mental health conditions -- provided experts agree.

Recent proposals would allow doctors to recommend marijuana for any 
condition they see fit.

"I think there's a feeling that that puts the law into a whole new 
realm," Smith said. "I could see us getting involved if there was science."

Wynott said, "We have a lot of PTSD. We have a lot of veterans. And 
it's only going to get worse as they're taking troops out."

And Sulak said, "A lot of people outside my profession don't realize 
how prevalent PTSD is."

Sulak said he has seen approximately 400 patients with PTSD 
accompanying pain come through his office.

He calls PTSD "the second-most common condition people want marijuana 
to treat."

Pain is why Sulak says he can recommend a PTSD patient get marijuana.

"Half of the people who come in with pain have it for traumatic 
reasons," Sulak said. "We often think of remembering as important to 
health. Forgetting is just as important."

Tolerated, not allowed

As a federal hospital, the Togus VA center is at a crossroads between 
state and federal law when it treats Maine veterans.

Though patients who go there may be state-authorized to use medicinal 
marijuana, state law doesn't apply there.

Marijuana is an illegal drug in the eyes of the feds -- protected by 
state law or not. And possessing medical marijuana on VA property is 
a criminal offense.

Furthermore, a January directive from Undersecretary for Health Dr. 
Robert Petzel said the Veterans Administration believes marijuana has 
no currently accepted medical use.

In a statement issued Friday, VA spokesman Josh Taylor said "the 
Department of Veterans Affairs understands the importance of 
alternative treatments," but that VA personnel are not allowed to 
authorize or recommend medical marijuana."

Still, "VA patients will not be denied service because of their 
participation in a state-approved medical marijuana program," the 
statement said.

The 2011 directive says that any prescriptions for chronic pain must 
be managed under the auspices of the VA's "stepped-care" model, and 
that VA doctors make no recommendation for medical marijuana.

That model, outlined in 2009, outlines a three-step program that 
includes development of a network of primary caregivers, timely 
access to specialists and "advanced pain medicine diagnostics." 
Opioids are listed as one of the main pharamacological interventions.

"The use of addictive pain medication, particularly opioid pain 
medication, has been the primary means of pain management for a 
significant period of time," according to a VA slideshow presentation.

Begin asks, "Do they actually want people to get better, or do they 
just want them in a pill haze?"

Sulak said he had been receiving referrals from Togus -- not for 
marijuana, but for other integrative medical services his offices provide.

Then he said he received an "opinionated" letter from the hospital 
saying it wouldn't route patients that way.

"Someone in the referral office decided marijuana was bad," he said. 
He said he stopped getting referrals from Togus this past winter.

Benefits of bud?

Begin buys his marijuana from a caregiver. For $235 an ounce, he gets 
a high-grade product from which he says he gets real relief from PTSD.

And he isn't bashful about it. At a recent meeting, standing well 
outside his truck with his 4-year-old daughter leaning out the 
window, he lit up a marijuana cigarette in a parking lot and showed a 
reporter jars of pot and a tincture bottle.

It's a normal occurrence. He said he even smokes while driving, and 
claims marijuana doesn't adversely affect him.

"It puts memories in a safe in your mind. You can access that safe, 
but it isn't tormenting you every minute," he said. "It's not 
pounding away at the back of your eyeballs."

Begin said he devotes his time to advocating wider use of medical 
marijuana. He wants PTSD added to that qualifying list of conditions 
and also calls for alternative pain treatment -- not the prescription 
medication he said impeded his progress.

He said he knows many veterans who use black-market marijuana to 
treat various ailments.

When he tells them to register, they bristle.

"They're scared. They don't want to tell their doctors," Begin said. 
"They don't want to lose what they have."
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MAP posted-by: Jay Bergstrom