Letter from Veterans Affairs, opioid treatment and MMJ (2010)

Department of Veterans Affairs
Under Secretary for Health
Washington, DC 20420

July 6, 2010

Mr. Michael Krawitz
3551 Flatwoods Road
Elliston, VA 24087

Dear Mr. Krawitz:

This is a follow-up response to your letter requesting clarification of the Veterans Health Administration’s (VHA) policy regarding the practice of prescribing opioid therapy for pain management for Veterans who provide documentation of the use of medical marijuana in accordance with state law.

If a Veteran obtains and uses medical marijuana in a manner consistent with state law, testing positive for marijuana would not preclude the Veteran from receiving opioids for pain management in a Department of Veterans Affairs (VA) facility. The Veteran would need to inform his provider of the use of medical marijuana, and of any other non-VA prescribed medications he or she is taking to ensure that all medications, including opioids, are prescribed in a safe manner. Standard pain management agreements should draw a clear distinction between the use of illegal drugs, and legal medical marijuana. However, the discretion to prescribe, or not prescribe, opioids in conjunction with medical marijuana, should be determined on clinical grounds, and thus will remain the decision of the individual health care provider. The provider will take the use of medical marijuana into account in all prescribing decisions, just as the provider would for any other medication. This is a case-by-case decision, based upon the provider’s judgment, and the needs of the patient.

Should you have further questions, please contact Robert Kerns, PhD, National Program Director, New England Healthcare System at (203) 932-5711, extension 3841.


Robert A. Petzel, M.D.
Original letter on Department of Veterans Affairs letterhead; retyped from pdf file created February 7, 2013, entitled “Post-Traumatic Stress Disorder And The Oregon Medical Marijuana Program, An overview of research and testimony regarding Post-Traumatic Stress Disorder and the use of medical marijuana to treat symptoms.”

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