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PTSD: Could Cannabis Be the Answer to a National Health Emergency?

Evidence suggests that between 6 and 10% of Americans will experience PTSD in their lifetime with the number jumping to 18% for service members who participated in the wars in Iraq and Afghanistan.

However, America’s veterans are not the only victims. The American Psychiatric Association estimates over 11 million citizens are currently afflicted with posttraumatic stress that disrupts their lives.

Cannabis activists have known that the plant can be useful for patients with PTSD for years. Now, thanks to somewhat relaxed rules on cannabis research studies and the hard work of researchers, a new clinical study is working to determine the most beneficial treatments.

The protocol for the new study describes chronic, treatment-resistant PTSD among veterans as a “national emergency.”

Posttraumatic Stress Can Be Deadly
PTSD can be a debilitating and possibly lethal condition. Those afflicted by posttraumatic stress range from battlefield combatants to domestic violence survivors, from first-responders who make trauma their primary focus to people who never imagined they would experience a serious trauma in their lives.

Symptoms of PTSD include depression, anxiety, nightmares, insomnia and high stress levels. Cannabis is unique in being an effective treatment for all of these symptoms.

Bryan Krumm, a psychiatric nurse practitioner out of New Mexico, works with that state’s medical cannabis program to help patients cope with the symptoms of serious posttraumatic stress. He developed a class on the subject for Green Flower last December. In his view, cannabis is saving lives.

“Unmanaged PTSD symptoms are highly correlated with suicide,” Krumm told GFM. “We lose over 100 citizens every day to suicide – 22 of those are veterans.”

Krumm delivers his argument with a sobering message: “We’ve lost more active duty troops to suicide than we have to Al Qaeda, the Taliban, and ISIS combined.”

In 2004 alone, the U.S. Veterans Administration spent $4.3 billion on PTSD disability payments.

Cannabis is Already Used to Treat PTSD
Krumm takes a special interest in cannabis for posttraumatic stress, including helping to write New Mexico’s medical cannabis law and petitioning the federal government to remove cannabis from Schedule I so that more veterans can take advantage. He believes cannabis to be the only way to effectively treat the symptoms of PTSD.

Thirteen states, including New Mexico, list PTSD as a qualifying condition for medical cannabis use, with four additional adult-use cannabis states where patients can legally self-medicate. This puts over 35% of Americans in a state where they can legally manage the symptoms of posttraumatic stress with cannabinoid therapy.

Statistics are lacking on how many Americans with PTSD treat their symptoms with cannabis, but anecdotal evidence suggests it is widespread. However, perhaps not widespread enough if we want to save lives.

The First Federally Approved Study
On February 6, the first of 76 U.S. veterans diagnosed with chronic PTSD began smoking cannabis in the controlled environment of Scottsdale Research Institute in Phoenix, AZ. This trial, conducted by the non-profit Multidisciplinary Association for Psychedelic Studies (MAPS), is the first of its kind. It will continue to shape how medical professionals and individuals view medical cannabis use.

Marcel Bonn-Miller, the Coordinating Principal Investigator (PI) for the study said in a statement, “As this is the first placebo-controlled trial of cannabis for PTSD, we are breaking important ground needed to identify improved treatment options for veterans with PTSD."

Researchers will be testing four different potencies in a controlled environment to judge the actual effectiveness of smoked cannabis in managing the symptoms of posttraumatic stress. The results will assist doctors in determining the best course of cannabis treatment for their patients.

Funding for the trial came by way of a $2.156 million grant from Colorado’s Department of Public Health and Environment (CDPHE), even though neither trial site is located in Colorado. Since it became the first of eight states to legalize both medical and adult-use cannabis, Colorado lawmakers have been pushing for more studies on the potential dangers and benefits of cannabinoid therapy.

A Long Time Coming
The study is the result of over seven years of lobbying on the part of MAPS. Dr. Sue Sisley and Rick Doblin first began discussing the subject of cannabis for PTSD in 2009. Approval for medical cannabis research is required from numerous federal agencies including the Food and Drug Administration, Department of Health and Human Services, the National Institute of Drug Abuse and the Drug Enforcement Agency.

After the DEA finally approved Johns Hopkins University in Maryland and Scottsdale Research Institute as the trial sites, the National Institute for Drug Abuse provided federally approved cannabis in August, 2016.

The study will complete 17 visits for subjects over 12 weeks followed by a checkup after six months. We can’t wait to see what the results show.

If you'd like to learn more about cannabis and PTSD, Bryan Krumm has two different online classes streaming on Green Flower INSIDER.

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Cannabis and Post-Traumatic Stress Disorder (PTSD)

Throughout its prohibition, cannabis has been considered a self-medicated “coping” drug, especially in individuals with anxiety disorders like post-traumatic stress disorder, or PTSD. Government funded studies examining the link between cannabis and PTSD frequently use the term “marijuana abuse disorder,” a co-occurring problem in need of rehabilitation.

There is overwhelming evidence that PTSD and cannabis go hand-in-hand. But while most studies point out the prevalence of marijuana abuse among PTSD patients, a minority of emerging research is looking at the question in reverse: could cannabis be effectively treating PTSD?

Living with PTSD
PTSD, or post-traumatic stress disorder, is an anxiety condition caused by disturbing episodes, such as military combat or sexual assault. Three classes of symptoms characterize PTSD: re-experiencing, avoidance, and hyper arousal (e.g., flashbacks, social isolation, insomnia). The persistence of PTSD over time is attributed to changes in brain chemistry that occur at the time of the trauma, when adrenaline and stress hormones are hyper-responsive.

Since age nine, Ben Nichols has experienced debilitating PTSD symptoms, and with it came a tangle of other issues like insomnia and ADD. Ben takes Adderall to help with concentration difficulties caused by PTSD, but turns to cannabis to treat the anxiety.

“It helps with daily tasks like school, work, and relationships,” Ben said. “My mind races and cannabis helps me slow down and think through the trauma rather than hide from it. I can tell it's helping me because my sleeping patterns are normal and I don't have anxiety attacks.”

Ben is fortunate to live in a state with legal medical cannabis, but not all PTSD sufferers have access to its unprecedented relief. Combat veterans have an especially high propensity for PTSD, and statistics show that about 1 in 5 military personnel deployed in Iraq and Afghanistan experience it. Given cannabis’ federally prohibited status, veterans are instead steered toward antidepressants and antipsychotics, medications that have had very little success in treating severe PTSD symptoms.

“The drugs that they were giving them … they couldn’t get up in the mornings,” said Army first sergeant Gregory Westbrook. “Most of the guys weren’t the type of soldiers who had issues before Iraq or even in Iraq, but they bring them back and put them on these drugs, and they’re falling asleep in the chair. There was no way they could function, especially in a civilian job. So maybe marijuana is an alternative.”

How Cannabis Can Help Treat PTSD
Currently there are no specialized, effective medications available for PTSD patients, but with new discoveries in our body’s therapeutic hotspot — the endocannabinoid system — research is beginning to pave new avenues of understanding and treating PTSD.

One investigator of PTSD and cannabis is the Multidisciplinary Association for Psychedelic Studies(MAPS). Martin Lee is a MAPS affiliate and director of Project CBD, and has studied PTSD and cannabinoids in depth.

“Researchers found that people with PTSD had lower levels of anandamide, an endogenous cannabinoid compound, compared to those who did not show signs of PTSD,” Lee wrote, “Innate to all mammals, anandamide (our inner cannabis, so to speak) triggers the same receptors that are activated by THC and other components of the marijuana plant.”

In other words, one pillar of PTSD is an endocannabinoid deficiency: the body stops producing enough endocannabinoids to fill receptor sites, and this is where the cannabinoids found in marijuana play a therapeutic role. By replenishing these missing endocannabinoids with those found in cannabis, researchers think marijuana pharmaceuticals might bring PTSD patients relief from their memories.

“Scientists have determined that normal CB-1 receptor signaling deactivates traumatic memories and endows it with the gift of forgetting,” Lee said, “But skewed CB-1 signaling, due to endocannabinoid deficits (low serum levels of anandamide), results in impaired fear extinction, aversive memory consolidation, and chronic anxiety, the hallmarks of PTSD.”

Accessing Medical Marijuana for PTSD
PTSD patients are advised to first consult a medical professional before treating symptoms with cannabis. Consumers unaccustomed to marijuana may find that THC aggravates anxiety symptoms. Cannabidiol, better known as CBD, is a marijuana cannabinoid that counteracts some of THC’s effects, including paranoia and anxiety. Further research examining the relationship between THC and CBD could lead to more tolerable variants of cannabis pharmaceuticals for high anxiety individuals.

The damage caused by PTSD cannot be fully unraveled by any medication, but for some, cannabis provides respite when nothing else can. Despite a strong need for development of more effective medication without adverse side effects, the promising pharmaceutical possibilities in cannabis are continually dismissed by government-backed research organizations. However, forward momentum builds as education about cannabis’ healing properties spreads.
B.C. study among the first to compare the effects of different strains of cannabis on PTSD
  • The UBC study led by Zach Walsh is one of the first to compare how two different strains of marijuana might affect patients with PTSD.ISTOCK/GETTY IMAGES
B.C. scientists are conducting a study that is one of the first to compare the way different strains of marijuana might affect patients suffering from posttraumatic stress disorder (PTSD).

Four questions with psychologist and cannabis researcher Zach Walsh
Leading the team of researchers is Zach Walsh, a clinical psychologist and an associate professor at the University of B.C.’s Okanagan campus.

For Walsh, the need for research that backs up claims made by veterans’ groups, patients, and advocates has reached a critical point.

“It’s the patients leading the way on this, and they’re using cannabis, so it’s our job as health scientists to figure out if it’s working,” Walsh tells the Georgia Straight by phone.

He says the need for empirical data is one that can’t be ignored in light of the disorder’s prevalence in Canada: in 2016, the British Journal of Psychiatry reported that among a group of 16 countries—including the United States, Australia, South Africa, Iraq, and Israel—Canada had the highest lifetime PTSD–prevalence rate, at 9.2 percent.

Typically, Walsh says, PTSD patients are prescribed a cocktail of pharmaceuticals that can include antidepressants, sleeping pills, and even antipsychotics.

Although some drugs can be helpful in mitigating symptoms, there are no drugs specifically formulated for patients with the disorder. (Health Canada has approved one antidepressant drug, Paroxetine, for PTSD, but studies have shown that it can lead to increased thoughts of suicide among patients.)

“The nice thing about cannabis, in comparison, is that the side effects line up much more favourably,” Walsh says.

“Some might have a tough time with the cognitive effects caused by the high, but for most people, that’s a much more tolerable side effect compared to those of other treatment options.”

Walsh hopes that through the trial, patients will be able to reduce or eliminate symptoms like irritability, anxiety, insomnia, nightmares, and traumatic flashbacks.


Zach Walsh is a clinical psychologist and an associate professor at the University of B.C.’s Okanagan campus.
The trial won’t focus specifically on armed-forces veterans but on patients with PTSD of any cause. They’ll include assault victims, first responders, and victims of motor-vehicle accidents, among others.

Every participant in the triple-blind study received a vaporizer and is using two of three treatments for a period of three weeks each. The first is a placebo without active ingredients. The second, a tetrahydrocannabinol (THC)-dominant strain, contains 12 percent of the well-known compound. The third strain contains 12 percent each of THC and cannabidiol (CBD). All cannabis is provided by Tilray, a Nanaimo-based licensed producer that has partnered with UBC for the trial, which is the largest of its kind to take place in Canada during the last 40 years.

Walsh says that although the cannabis industry seems obsessed with comparing the efficacy of different compounds and strains, few studies, if any, have taken that obsession to heart.

Dr. Ian Mitchell, an emergency physician in Kamloops and the clinician working on the trial, is responsible for the medical safety of the patients involved.

Mitchell says it’s too early to tell what the results will be, but anecdotal evidence from patients with PTSD in his own clinical practice has shown cannabis to be helpful. He has been referring patients to Canada’s ACMPR (Access to Cannabis for Medical Purposes Regulations) program for the past three years.

“I have a lot of patients who are enthusiastic to be using it. I’m seeing a lot of RCMP veterans in my practice with PTSD who are able to sleep again—but you get a double effect, because it also helps with pain,” Mitchell tells the Straight by phone.

He adds that when patients come to him, they have often tried five or six different medications. He says cannabis not only can help with their PTSD symptoms but has also been effective in mitigating symptoms of withdrawal from those other drugs.

“We’ve got drugs that can cause [side effects such as] sudden death, obesity, hypertension, and it can be very damaging for people,” he says.

“So many people I see have not gained benefit from them—and many of them have very unpleasant withdrawal symptoms, so we don’t encourage patients to go cold turkey.”

The popularity of cannabis among PTSD patients has even prompted the federal government to conduct its own study for Canadian Armed Forces veterans.

As for the study Walsh and Mitchell are working on, it is expected to conclude in spring 2018.
How veterans are helping advance marijuana-PTSD research

PHOENIX — The waiting room at the Scottsdale Research Institute in Arizona could be any doctor’s office, except for the faint smell of marijuana.

The scent is the only indication that the small space, inside a nondescript gray building in an industrial park on Phoenix’s northern border, is home to a groundbreaking scientific study that could have far-reaching effects. When it’s over, researchers aim to have a definitive answer of whether marijuana effectively treats post-traumatic stress disorder.

The study’s subjects – and its biggest champions – are veterans.

“This is the first randomized, controlled trial in the world looking at cannabis for PTSD,” said Dr. Sue Sisley,the psychiatrist running the study. “Hopefully, we’ll be able to finally answer the question, ‘Does cannabis help with PTSD?’ That’s our goal. That’s why we’ve been fighting so hard to get this underway.”

After seven years of struggling to gain approval from the U.S. Food and Drug Administration and Drug Enforcement Agency, of starting the institute, of finding funding and a landlord willing to rent them space, the study has finally started.

It’s launching at a time when veterans have been at the center of a national conversation on medical marijuana. The American Legion is attempting to apply political pressure to support marijuana research, and just yesterday, Department of Veterans Affairs Secretary David Shulkin said at the White House that he was open to looking at – and learning from – any evidence marijuana could be used to treat veterans.

Still, researchers are fighting through potential setbacks.

They’re clamoring for participants after Johns Hopkins University in Baltimore dropped out of the study in March, transferring their half of the work to the small team in Phoenix. Meanwhile, the VA is not allowing researchers to recruit volunteers at the Phoenix VA Medical Center, citing federal law.

While the government-provided marijuana used in the study is adequate -- if not the potency researchers hoped for -- Sisley compared it to “trying to cook a four-star meal using Vienna sausages.”

In the last three months, the busiest for the study, Sisley has continued to treat patients at her private practice. She’s gained prominence in the medical marijuana field and maintains a full slate of interviews and speaking engagements, around the United States and internationally. In the middle of it all, she received news that she’s adamant won’t slow her down -- in April, she was diagnosed with breast cancer.

“I have my own medical practice, all this stuff going on, but there’s no question this is going to be my top priority for the next two years,” Sisley said of the study. “There’s no time to slow down. This work is too important.”

‘Nothing to lose’
Sisley’s interest in working with veterans stretches back to the late 1990s, when she was a resident at the Phoenix VA hospital. Later, she’d continue to treat veterans, among other patients, at her private practice.

About 10 years ago, she began witnessing the suicide epidemic among veterans first hand.

“I eventually started to see that a lot of these veterans were not responding to conventional medications, and then I began seeing a lot of deaths in my practice,” she said. “These were people who had already been through the gauntlet of medications and nothing had helped.”

According to the latest available VA data, an average of 20 veterans died from suicide each day in 2014.

Some of the veterans Sisley treated told her marijuana helped alleviate their symptoms of PTSD – feeding her curiosity into studying its effects. In the following decade, Sisley – a Republican who says she’s never tried marijuana -- would become an outspoken proponent of marijuana research.

Veterans who advocate for medical marijuana quickly took notice. And now, they’re hopeful Sisley’s study will legitimize what they’ve known for years.

Kim Petters, a 35-year-old mother of four, is one of those veterans.

Petters, who served in the Air Force for 10 years, was diagnosed with PTSD and medically retired. She spent four years taking anti-depressants and anti-anxiety medication, as well as prescription sleeping pills.

The medication took a toll, mentally and physically. Other veterans turned her onto marijuana.

An employee at a marijuana cultivation facility in Phoenix holds up a piece of extracted cannabis to show off its golden tint on Wednesday, May 3, 2017. Cannabis extract, more potent than marijuana plants, are made through extracting cannabanoids and other compounds from marijuana plants and concentrating them.

“With the pills, before you know it, you’re worse than you started,” Petters said. “I felt like I really had nothing to lose.”

She tried marijuana and used it to gradually stop taking her other medications. But Petters didn’t have legal access to it. Delaware law requires a psychiatrist to sign an application to use marijuana as a treatment for PTSD. Petters searched the state for eight months before finding a psychiatrist willing to sign.

The situation prompted her to create the Women Veterans Collective and join with other grassroots organizations in Delaware to draft legislation for easier access to marijuana. Their bill, which would allow any physician – not just a psychiatrist -- to verify an application for medical marijuana, passed the Delaware Senate on May 19.

If the legislation passes the state House, it would be a victory for veterans in Delaware, Petters said, but it won’t be enough for veterans in the bigger picture. For that, Petters has her eye on Sisley’s study.

“It’s been hard,” Petters said, pausing to sigh. “We’ve been waiting on her [Sisley’s] study, and she keeps hitting roadblock after roadblock.”

60 more vets
One afternoon in May, following a DEA inspection of the clinic, two veterans enrolled in the study were going through four-hour, FDA-required introductory sessions at the Scottsdale Research Institute. In separate rooms fixed up for comfort -- with couches, televisions, a PlayStation and shelves holding dozens of games and DVDs -- they smoked marijuana from pipes. Their vitals were checked every half-hour to ensure they were responding well.

At the same time, the small staff was busy screening other veterans to participate in the study. Veterans come in, sign a 20-page consent form and answer a series of questions.

There were more veterans in the office than employees.

“Every day we’re screening patients,” Sisley said. “All day, every day. We’re calling veterans all the time.”

The first veteran was enrolled Feb. 3. As of May 23, researchers had received calls from 1,300 veterans looking to volunteer. Of those, 200 went through telephone screenings and 16 were enrolled.

The Multidisciplinary Association for Psychedelic Studies in Santa Cruz, Calif., is administering the study. About 5,000 more contacts are needed, officials say, along with 950 phone screenings to find 60 more veterans for the study to be statistically significant.

The team in Arizona was forced to quicken its pace when Johns Hopkins dropped out, leaving the team without 38 veterans the university promised to enroll.

Johns Hopkins said that its goals were not in alignment with MAPS. The decision came after MAPS spoke out against the poor quality of government-provided marijuana and the National Institute on Drug Abuse’s monopoly on growing marijuana for scientific study.

“We’re focused on reforming public policy and doing quality science, and they’re focused strictly on the science, which is fine,” Sisley said. “Because of the blockades to this research, we’ve been forced to become activists, but we didn’t want that role. I just wanted to do the study. Even though I was forced to become an activist, I’m not pro-cannabis. I’m pro-research.”

Finding participants
Researchers have a small pool of veterans to recruit from for the study.

Participants must be diagnosed with PTSD and are required to meet with doctors 10 times over 18 weeks. They have to live within 50 miles of the Phoenix facility.

The research tests different potencies of marijuana – all weaker than what’s available in Arizona commercially -- and some veterans will receive a placebo.

Because Arizona has legalized the medical use of marijuana, some veterans going through the screening process have access to it. Sisley says some vets haven’t been willing to give up the marijuana they have to smoke only what researchers give them.

The location that Sisley sees as the biggest recruitment site, the Phoenix VA hospital, is off-limits. Sisley believes vets there could be trying and failing with conventional treatment methods and would be open to the study.

“The Phoenix VA has continued to block our recruitment and are unapologetic about it,” she said.

Federal law currently prohibits the VA from providing or researching marijuana – regardless of state laws.

A MAPS spokesman said the organization didn’t believe that the VA was intentionally impeding their trial.

Last year, Congress first approved, then removed, a measure from the VA funding bill that would allow VA doctors to discuss marijuana as a treatment option in states where it’s legal.

“Leadership at the Phoenix VA Health Care System advised Dr. Sisley that, in accordance with federal law and VA policy, they could not refer patients to the research project,” a VA spokesman said in a statement.

An unlikely ally
Through their work, the researchers and other medical marijuana advocates have gained an unlikely ally: the American Legion. Near the end of May, the organization was attempting to arrange a meeting with Sisley and the VA central office staff in Washington to discuss the issue with the Phoenix VA.

With its connections in Washington and network of 2.2 million veterans across the country, the American Legion is the group best-positioned to help reduce the stigma and further the cause of medical marijuana, Sisley said.

“The efficacy of the Legion in this whole effort – it hasn’t even been fully realized yet,” she said.

The Legion decided in August 2016 that it would advocate to remove marijuana from the list of Schedule I drugs, which, along with heroin, LSD and Ecstasy, are designated as having no medical use.

The organization is attempting to wield some of its political influence -- with the VA and with President Donald Trump.

The Legion had its first in-person meeting with Trump on March 17, when he met with representatives from 10 veterans groups. That meeting was followed by others between veterans organizations and White House staff.

On March 30, the American Legion sent a request to the White House seeking its first one-on-one meeting with Trump – specifically to discuss alternative treatment for veterans, namely marijuana. By the end of May, the Legion had not received a response. The White House press office did not respond to Stars and Stripes’ requests for comment.

“We’re going to ask what it would take to change the administration’s policy on cannabis,” said Louis Celli, national director of veterans affairs and rehabilitation at the Legion. “We want to let the administration know that because we care about our veteran suicide rate, because we care about the veterans who are disabled because of the stressors they’ve endured, it’s important to us we try to make them as whole as possible through any means necessary.”

Joe Plenzler, communications director for the American Legion, said he thought Shulkin’s comments Wednesday could help advance their cause.

“I believe everything that could help veterans should be debated by Congress and medical experts,” Shulkin said. “If there is compelling evidence that is helpful, I hope the people look at this and come up with a right decision, and we will implement that. There may be some evidence this is beginning to be helpful."

The Legion’s decision in August drew widespread attention to the organization, partly because of the perception that the Legion is conservative. That perception isn’t wrong, Celli said.

Celli concedes he was “very skeptical” when he received a cold call in 2015 from veterans wanting the organization to support medical marijuana. The veterans knew the American Legion had clout on Capitol Hill, and they thought they could make progress with support from a major veterans service organization.

“Immediately, the first thing in my head was, ‘This isn’t going to go anywhere,’” Celli said. “I was absolutely convinced – mistakenly convinced – our organization was going to be too conservative to be open to having the conversation. I just didn’t think they would even consider it.”

Celli served 22 years in the Army, and he’s a former sheriff’s deputy. He knew little about how marijuana was used medically.

In the months after the call, a few things convinced him: a column by former Navy SEAL Nick Etten that said every veteran deserves access to medical marijuana; a CNN special with Dr. Sanjay Gupta about marijuana’s effects on children suffering seizures; and a presentation from Sisley.

“I wanted to make a good-faith effort, an attempt to see if there’s anything to this,” Celli said. “That’s when I found Sue Sisley. She already had a well-developed presentation she shared with me. After I looked at it, I was sold. At that point, I thought there was really an opportunity for science here.”

Sisley would make that presentation three more times, first to the Legion’s 15-member PTSD and traumatic brain injury committee, and then to a commission of 150 members.

She received only positive feedback, Celli said.

“At this point, I knew we were actually onto something as an organization,” he said.

The Legion’s annual convention in Cincinnati at the end of August 2016 drew members from posts across the country. It was used as a campaign stop by Trump and former Democratic presidential candidate Hillary Clinton, and it’s where thousands of veterans voted to take up cannabis research as a priority.

Sisley was told that with the presidential candidates there, she had no guarantee of getting on the main stage. On the convention’s last day, she was squeezed in for five minutes between two other speakers.

Afterward, the crowd quickly voted on – and unanimously approved – the resolution.

Still, as Celli puts it, the Legion is “not advocating for bongs at the VA.”

The organization is looking at marijuana as a possible solution to combat the opioid epidemic. Accidental deaths due to overdose have reached a high in the U.S., and it’s largely driven by opioid addiction, according to the American Society of Addiction Medicine. Information from the VA in 2014, states veterans are twice as likely to die from an accidental overdose than non-veterans.

The VA in recent years has been attempting to curb opioid prescriptions by making alternative treatments for chronic pain more accessible, including chiropractic care, acupuncture and yoga.

“We’re talking about the federal government, about physicians and scientists being able to research a new drug,” Celli said. “We know opioids and narcotics are not the answer. We believe it’s the government’s responsibility to seek out what those long-term solutions are, and we want to work with the VA to try to help them open new study paths and alternative and complimentary therapies. Cannabis could be one of them.”

AMVETS, another of the country’s largest veterans organizations, has also issued its support for medical marijuana. Through a resolution, it called on the VA to provide access to marijuana for veterans in states where its legal.

A question of quality
In addition to asking for marijuana’s reclassification, the Legion’s resolution hit on another controversial topic – the federal government’s monopoly on marijuana production for scientific research.

For decades, all of the marijuana used for clinical research in the U.S. has come from a single source -- a well-secured University of Mississippi farm, run by the National Institute on Drug Abuse.

The DEA announced in August that it intended to end that monopoly.

The Legion’s resolution urged the DEA to license privately funded medical marijuana operations to expand marijuana research.

In a document explaining its decision, the DEA said there has been increased interest from researchers to study the chemicals unique to marijuana, called cannabanoids. Some studies have indicated that cannabanoids could be used to treat seizures and other neurological disorders.

“A growing number of researchers have expressed interest in conducting research with extracts of marijuana that have a particular percentage of CBD and other cannabinoids,” the DEA wrote in the document, published on the Federal Register. “DEA fully supports research in this area.”

Scientists have found more than 100 cannabanoids in marijuana. Allowing more production sites means researchers may be able to produce and study specific strains of marijuana to determine whether certain cannabanoids treat certain ailments.

The current situation – in place since 1968 -- is limiting.

Sisley waited 20 months to receive the shipment of marijuana to use in the MAPS study. She and Kady Bentz, a research laboratory associate, recalled receiving it in a large Styrofoam box in the mail, with the marijuana wrapped in gallon-sized Ziploc bags.

“When we received the product from NIDA, it was a fun day,” Bentz said. “We were excited.”

The marijuana – loose, not on buds sticky with THC-rich resin, as marijuana consumers may be familiar with -- wasn’t as potent as MAPS had requested. Researchers sought for the most potent strain to have 12 percent THC, the compound that gets users high. That amount of THC is far lower than what’s available at commercial dispensaries in Arizona.

In Sun City, about 13 miles west of the Scottsdale Research Institute, a half-dozen people inside the licensed marijuana dispensary White Mountain Health talked with “budtenders” about the strains of marijuana available. Behind a glass counter were dozens of varieties of edibles, THC-infused sodas, cannabis topicals and bubble baths.

The marijuana contained about 20 percent THC, said Jordan Edelstein, who helps run the dispensary.

“If I was only selling 12 percent TCH to patients, they would be very, very disappointed,” he said.

The MAPS study intends to replicate real-world use of marijuana, though the potency is lower than what veterans could find elsewhere.

Bentz takes the marijuana from the Ziploc bags and repackages it into small jars, then weighs, dates it and labels it with a veterans’ subject number before distributing it. The participants are allotted 1.8 grams each day, but they can choose how much to smoke.

“They can smoke it in response to symptoms, or if they’re anticipating symptoms,” she said. “They’re completely empowered.”

For now, Sisley is happy to have any marijuana available to study. And the DEA’s announcement in August gave her some optimism – though she’s cautious about how long it will take to award new licenses to grow.

She plans to apply for a license to produce marijuana.

“I think we can do better,” she said. “Imagine if we had access to all types of cannabis that aren’t available through the University of Mississippi. That would create a renaissance of cannabis research in this country. We could answer legitimate clinical questions about, ‘How does cannabis work?’ and ‘What strains are best for what illnesses?’ That’s what we’re missing now.”

‘A lot of work to do’
MAPS, and Sisley, received approval from the FDA in 2011 to do their study.

Two years later, the Colorado Department of Public Health and Environment granted $2 million to enable it to happen. Around the same time, her sudden termination from the University of Arizona -- which she maintains was prompted by her interest in studying marijuana -- drew nationwide attention.

The DEA gave its approval for the study in spring 2016.

Sisley described the past seven years as a “saga.” She worries the barriers that she and MAPS have faced could deter other researchers – underscoring the need for change in marijuana policies at the federal level.

“No scientists who have seen what we’ve been through want to embark on this work,” she said.

It will be two years before MAPS has gathered evidence and can publish its findings.

Sitting in the institute’s waiting room May 2, Sisley described her days in the clinic – with the study underway -- as “pure joy.”

“I walk in here every day and feel so honored,” Sisley said. “I can’t even tell you … just finally seeing the study implemented and the gratitude of these veterans.”

One month after the first veteran received marijuana for the study, Sisley was diagnosed with breast cancer. On May 3, she had surgery and was walking laps around her hospital unit the next day, ready to return to work.

“I’m so determined to get out of this hospital,” she said over the phone that day. “There’s a lot of work to do.”

Twitter: @nikkiwentling

About the study
The Multidisciplinary Association for Psychedelic Studies, based in Santa Cruz, Calif., is administering a study into whether smoking marijuana relieves veterans’ symptoms of chronic post-traumatic stress disorder. The study is randomized, triple-blind and placebo-controlled, and approved by the U.S. Food and Drug Administration, the Department of Health and Human Services and the Drug Enforcement Administration.

Researchers will test the effects of four potencies of marijuana on 76 veterans. The veterans will visit the Scottsdale Research Institute in Phoenix 10 times over 18 weeks, and then will be scheduled for a six-month follow-up.

Researchers intend to publish their findings, including raw data, in about two years. The Colorado Department of Public Health and Environment is funding the study with a $2.2 million grant.

What Wounded Veterans Need: Medical Marijuana

The American Legion, representing millions of wartime vets, calls on Trump to loosen federal restrictions on medical marijuana research to help those suffering from PTSD, TBI, opioid abuse, and more.

After 16 years of war in Afghanistan and Iraq, many Americans view post-traumatic stress disorder, or PTSD, and traumatic brain injury, or TBI, as the “signature” wounds of these conflicts. The Department of Veterans Affairs has spent billions of dollars to better understand the symptoms, effects, and treatments for these injuries. But despite advances in diagnostics and interventions in a complex constellation of physical, emotional, behavioral and cognitive defects, TBI and PTSD remain leading causes of death and disability within the veteran community.

There is something else the U.S. can do for suffering veterans: research medical marijuana.

Many Afghanistan and Iraq veterans have contacted the American Legion to relay their personal stories about the efficacy of cannabis in significantly improving their quality of life by enabling sleep, decreasing the prevalence of night terrors, mitigating hyper-alertness, reducing chronic pain, and more. This is why the 2.2 million members of the American Legion are calling on the Trump administration to instruct the Drug Enforcement Agency to change how it classifies cannabis, release the monopoly on cultivation for research purposes, and immediately allow highly-regulated privately-funded medical marijuana production operations in the United States to enable safe and efficient cannabis drug development research.

Currently, medical researchers face onerous Food and Drug Administration, Drug Enforcement Administration, and National Institute on Drug Abuse bureaucratic hurdles to conducting research. Additionally, due to cannabis’ classification, all researchers must source their cannabis from the University of Mississippi – who holds a monopoly on producing the drug for federally-sanctioned research.

The opioid epidemic that continues to grip veterans is yet another reason to ease the federal government’s outdated attitude toward America’s marijuana supply. The Trump administration should lead a new effort to combat opioid abuse, and it should include the elimination of barriers to medical research on cannabis. The result, potentially, could provide a non-addictive solution to the most common debilitating conditions our veterans— and others in society— face, including chronic pain, PTSD, and TBI.

For nearly 90 years, the federal government has deliberately hindered medical research into therapeutic aspects of cannabis, and veterans struggling with PTSD and TBI today are suffering because of this misguided policy. Cannabis, which has been used by humans for food, oil, textiles, medicine, and religious purposes since at least 6,000 BCE, has suffered an image problem over the past century starting with America’s first drug czar Prohibition Agent Harry J. Anslinger’s race-baiting demonization of the drug during the Great Depression.

Today, despite considerable evidence to the contrary, the U.S.persists in listing cannabis alongside heroin, LSD, and ecstasy, as a Schedule I substance with no currently accepted medical use and a high potential for abuse. By comparison, many of the highly addictive medications frequently prescribed to veterans are a direct pathway to the abuse of cocaine derivatives, methamphetamine, methadone, Demerol, oxycodone and, fentanyl that are classified as Schedule II drugs. These widely over-prescribed, powerful, and dangerous substances are currently fueling today’s opioid and heroin epidemics in America.

Cannabis’ Schedule I listing is disingenuous given the fact that the federal government cannot produce any research or evidence justifying its classification - which significantly hampers medical research into the therapeutic aspects of the drug. It’s a classic Catch-22.

The Legion is asking Congress to amend legislation to remove marijuana from Schedule I and reclassify it in a category that, at a minimum, will recognize cannabis as a drug with potential medical value.

A recent comprehensive study by the Committee on the Health Effects of Marijuana at the National Academies of Sciences, Engineering and Medicine found that there is, “conclusive or substantial evidence that cannabis or cannabinoids are effective for the treatment” of chronic pain, reducing nausea and vomiting during chemotherapy, and lowering spasticity in multiple sclerosis sufferers, that there is “moderate evidence” that cannabis is effective in treating sleep apnea, fibromyalgia, and chronic pain, and “limited evidence” that cannabis improves symptoms of posttraumatic stress disorder and creates better outcomes after traumatic brain injury.

We need to know more. With 20 veterans committing suicide every day, we cannot afford to delay research into this promising potential solution.

To date, more than 28 states have legalized cannabis for the treatment of medical conditions, and this April, Reps. Matt Gaetz, R-Fla., and Darren Soto, D-Fla., introduced bipartisan legislation in the House to make marijuana a Schedule III drug – removing significant hurdles currently hindering medical research.

With 90 percent of Americans supporting legalization of medical marijuana today, it is time for Congress to act so that scientists may conduct advanced research into cannabis and PTSD/TBI and enable the American people to have a fact-based adult discussion about the therapeutic value of cannabis. Inevitably, cannabis will become a federally endorsed medical treatment for pain, epilepsy and a variety of other disorders. The only question is will this administration lead? Our veterans suffering from PTSD and TBIlives depend on it.

Joe Plenzler is director of media relations for the American Legion National Headquarters, in Washington, D.C and a 20-year combat veteran of the U.S. Marine Corps.

Lou Celli is director of veterans affairs and rehabilitation for the American Legion National Headquarters, in Washington, D.C., and a 22-year veteran of the U.S. Army.

The American Legion, founded in 1919, is the Nation’s’ largest wartime veteran service organization comprising 2.2 million members and 13,000 posts around the world.
Brain-imaging study links cannabinoid receptors to post-traumatic stress disorder: First pharmaceutical treatment for PTSD within reach
May 14, 2013
NYU Langone Medical Center
In a first-of-its-kind effort to illuminate the biochemical impact of trauma, researchers at NYU Langone Medical Center have discovered a connection between the quantity of cannabinoid receptors in the human brain, known as CB1 receptors, and post-traumatic stress disorder, the chronic, disabling condition that can plague trauma victims with flashbacks, nightmares and emotional instability.

In a first-of-its-kind effort to illuminate the biochemical impact of trauma, researchers at NYU Langone Medical Center have discovered a connection between the quantity of cannabinoid receptors in the human brain, known as CB1 receptors, and post-traumatic stress disorder, the chronic, disabling condition that can plague trauma victims with flashbacks, nightmares and emotional instability.

Their findings, which appear online today in the journal Molecular Psychiatry, will also be presented this week at the annual meeting of the Society of Biological Psychiatry in San Francisco.

CB1 receptors are part of the endocannabinoid system, a diffuse network of chemicals and signaling pathways in the body that plays a role in memory formation, appetite, pain tolerance and mood. Animal studies have shown that psychoactive chemicals such as cannabis, along with certain neurotransmitters produced naturally in the body, can impair memory and reduce anxiety when they activate CB1 receptors in the brain. Lead author Alexander Neumeister, MD, director of the molecular imaging program in the Departments of Psychiatry and Radiology at NYU School of Medicine, and colleagues are the first to demonstrate through brain imaging that people with PTSD have markedly lower concentrations of at least one of these neurotransmitters -- an endocannabinoid known as anandamide -- than people without PTSD. Their study, which was supported by three grants from the National Institutes of Health, illuminates an important biological fingerprint of PTSD that could help improve the accuracy of PTSD diagnoses, and points the way to medications designed specifically to treat trauma.

"There's not a single pharmacological treatment out there that has been developed specifically for PTSD," says Dr. Neumeister. "That's a problem. There's a consensus among clinicians that existing pharmaceutical treatments such as antidepressant simple do not work. In fact, we know very well that people with PTSD who use marijuana -- a potent cannabinoid -- often experience more relief from their symptoms than they do from antidepressants and other psychiatric medications. Clearly, there's a very urgent need to develop novel evidence-based treatments for PTSD."

The study divided 60 participants into three groups: participants with PTSD; participants with a history of trauma but no PTSD; and participants with no history of trauma or PTSD. Participants in all three groups received a harmless radioactive tracer that illuminates CB1 receptors when exposed to positron emissions tomography (PET scans). Results showed that participants with PTSD, especially women, had more CB1 receptors in brain regions associated with fear and anxiety than volunteers without PTSD. The PTSD group also had lower levels of the neurotransmitter anandamide, an endocannabinoid that binds to CB1. If anandamide levels are too low, Dr. Neumeister explains, the brain compensates by increasing the number of CB1 receptors. "This helps the brain utilize the remaining endocannabinoids," he says.

Much is still unknown about the effects of anandamide in humans but in rats the chemical has been shown to impair memory. "What is PTSD? It's an illness where people cannot forget what they have experienced," Dr. Neumeister says. "Our findings offer a possible biological explanation for this phenomenon."

Current diagnostics for PTSD rely on subjective measures and patient recall, making it difficult to accurately diagnose the condition or discern its symptoms from those of depression and anxiety. Biological markers of PTSD, such as tests for CB1 receptors and anandamide levels, could dramatically improve diagnosis and treatment for trauma victims.

Among the 1.7 million men and women who have served in the wars in Iraq and Afghanistan, an estimated 20% have PTSD. But PTSD is not limited to soldiers. Trauma from sexual abuse, domestic violence, car accidents, natural disaster, violent assault or even a life-threatening medical diagnosis can lead to PTSD. The condition affects nearly 8 million Americans annually.

These findings were made possible through the collaborative efforts of researchers at NYU School of Medicine, Yale School of Medicine, Harvard Medical School, the Department of Veterans Affairs National Center for PTSD and the University of California at Irvine.

Story Source:


provided by NYU Langone Medical Center. Note: Content may be edited for style and length.

Journal Reference:

  1. A Neumeister, M D Normandin, R H Pietrzak, D Piomelli, M Q Zheng, A Gujarro-Anton, M N Potenza, C R Bailey, S F Lin, S Najafzadeh, J Ropchan, S Henry, S Corsi-Travali, R E Carson, Y Huang. Elevated brain cannabinoid CB1 receptor availability in post-traumatic stress disorder: a positron emission tomography study. Molecular Psychiatry, 2013; DOI: 10.1038/mp.2013.61
By Chris Simunek May 25, 2015


Twenty percent of veterans who served in Iraq or Afghanistan suffer from some degree of post-traumatic stress disorder. At present, no reliable pharmaceutical treatment exists for PTSD, but cannabis has been shown to provide relief. While some doctors in the US Department of Veterans Affairs turn a blind eye to their patients’ use of marijuana, others take a hard stand against it, and federal law makes it illegal to prescribe cannabis as a treatment. Meanwhile, an ambitious program in Canada helps veterans in that country get medical marijuana prescriptions and provides a communal setting for them to recover. Some soldiers credit it with saving their lives.


It’s January during another dreaded polar vortex, and I’m experiencing for the first time in my life the throbbing ache that occurs in one’s face when the temperature drops below -9°F on a windy day. There are mountains in the distance, but urban sprawl has displaced most of the Acadian forest here in Oromocto, New Brunswick. Any ground that is not regularly stepped on or driven over is a glassy sheet of pure white ice.

Oromocto is a military town, home to the Fifth Canadian Support Base Gagetown, one of the largest training bases in the Commonwealth. Opened in 1956, the facility was meant to train soldiers in case Canada was called upon to fulfill its NATO obligations and defend Western Europe from Khrushchev’s commie hordes. I was invited up here by Fabian Henry, an ex-sergeant in the Canadian Armed Forces and the founder of Marijuana for Trauma (MFT), a group that helps 800 wounded veterans and first responders obtain access to medical marijuana—up to 10 grams a day, in fact, delivered to their door and paid for by Veterans Affairs Canada.

MFT’s headquarters is located in a nondescript strip mall. The only thing that might distinguish it from a dentist’s office is the occasional group of vets standing in the parking lot imbibing their medicine. There’s a camaraderie here, a shared sense of joy and relief.

This is the one part of their day these guys know won’t be a struggle.

The Canadian veterans don’t seem to mind me sitting in on their sessions with Fabian as they describe their gripes with the VAC, their problems at home, their outbursts on the job. Sitting at his desk, a keffiyeh wrapped around his neck, Fabian rests his black-bearded chin on his knuckles and listens with the patience of a man who has been where they are. The back of his jacket reads: “This veteran is medicated for your protection.”

There’s a soldier from the local base named Andrew sitting in Fabian’s office, shaking violently, the victim of a nervous disorder related to his multiple symptoms of PTSD, social anxiety and panic syndrome. Andrew has never seen combat; his affliction is the result of the way he’s been treated during his years of service here in Oromocto. He tells the story about the time he was promoted and, rather than pinning the new commendation on his uniform, the commanding officer dropped it on the floor in disgust. Mental abuse, isolation, degradation—the whole ordeal has landed him in the middle of a silent, lonely, neurological hurricane. Andrew came to Fabian for help and eventually hooked up with Nina, a high-CBD strain that, I am told, tightens his screws.

“All I have to do is smoke a CBD joint and the shaking goes away,” Andrew tells me.

“This, I want to see,” I reply.

So now we’re in the parking lot watching Andrew fumble with a lighter while his hand jerks back and forth like it’s glued to an invisible Pac-Man joystick. Fabian helps him out, putting a cherry on the joint. Within four minutes—half the spliff—I notice that when Andrew takes the Bic again and goes to relight, his hand is surgeon-still. He’s been cured like some Christ-touched leper—problem solved, at least temporarily. And I’m standing there like Thomas the Apostle, a reformed doubter, convinced now that it has become my mission to spread the Word.


In 2000, a 20-year-old Fabian Henry found that he no longer had the money to continue going to college. He landed a job on the local military base in Oromocto and, as a lifelong hockey fan, started playing on a civilian team against the local soldiers. He liked the idea that they were encouraged to play hockey as part of their physical training. With not a whole lot of other options open to him, he enlisted in the Canadian Armed Forces and became a combat engineer. After being deployed in peacekeeping and humanitarian missions to Haiti, Pakistan, Eritrea, and East Africa, Fabian did two tours in Afghanistan, where it was his job to locate and neutralize landmines and improvised explosive devices.

“Afghanistan is where my traumatic event happened,” he says. “On Easter weekend 2007, six infantrymen blew up 500 meters from our position. Two days later, I got two Canadian soldiers killed.”

As Fabian tells it, it was his job, as the senior engineer, to clear the roads ahead of his convoy. On this day, he managed to locate and explode one mine without incident. Night came, and since he knew from experience that there was always a secondary mine in this kind of setup, he told a sergeant major to pass a message along to the waiting vehicles: They shouldn’t cross until first light, after Fabian had a chance to prove the route.

Unfortunately, the message relayed wasn’t the one Fabian had given to the sergeant major. The convoy moved out, and an armored Coyote reconnaissance vehicle hit a double-stacked TC-6 antitank mine that flipped the vehicle on its side. Two of the passengers were dead by the time the Blackhawk helicopter arrived to evacuate them. Fabian’s decision to entrust an intermediary with that message, rather than take it directly to the convoy himself, was a mistake that he would replay over and over in his head for the next three years.

The trauma did not manifest itself immediately. The battlefield, after all, is a desensitizing place, and it was Fabian’s job to inspect blast sites and pick through the bloody wreckage. The images were filed away in his mind like invoices to be paid at a later date.

“When I came home, I tried to connect with my kids and my wife, but I couldn’t stop being hyper-vigilant; I couldn’t stop thinking about some of the decisions I made,” he recalls. “As I looked into things deeper, I found out that one of the guys [who died in the convoy] was from here. His hometown was here and his parents are here, you know? I spent a lot of sleepless nights thinking about that. And what you try to do is find a substance or something to eliminate that feeling. You inflict pain, or you want somebody else to inflict physical pain on you—because, emotionally, you’re hurting worse than anything that anybody could do to you.” Out of desperation, Fabian finally tried cannabis, and “when it hit my lungs, it was like phssssshhhhh,” he says of the breakthrough moment. “I don’t know what winning the lottery would be like, but I imagine it is something like that.”

The strain that worked best for his PTSD was Bubba Kush, a strong indica. Worried that the source of his newfound peace would dry up, Fabian paid $37,000 to have 10 pounds of it delivered to him.

“When I had the right concentrated amount of cannabis, it leveled out my receptors immediately,” he continues. “When you’re going from zero to 10 and you’re angry and you’re going to punch somebody out, you can take a puff, and it sits you back and allows you to relax for a minute and think about things before you punch somebody in the face, or kill yourself, or kill someone else.”

Separated from his wife, Fabian now had a lot of time to research his condition. He came across a study by Dr. Alexander Neumeister of New York University’s Langone Medical Center that linked PTSD to cannabinoid receptors—specifically the CB1 receptors—in the human brain. Cannabinoid receptors are part of the endocannabinoid system (named for the cannabis-plant compounds that led to its discovery), a network of chemicals and signaling pathways that promote homeostasis in the body and help regulate the nervous system, among other things. The endocannabinoid system is deeply connected to memory, mood, pain and other functions affected by PTSD. Through brain imaging, Dr. Neumeister discovered that PTSD sufferers have an elevated number of CB1 receptors in the brain regions associated with fear and anxiety, and lower concentrations of the neurotransmitter anandamide (taken from the Sanskrit word ananda, meaning, “joy, bliss, delight”), which binds to these receptors. Dr. Neumeister found that the use of cannabis caused a spike in anandamide, which, in turn, corrected this imbalance.

In a statement accompanying the publication of his study, Dr. Neumeister said: “There is not a single pharmacological treatment out there that has been developed specifically for PTSD. That’s a problem. There’s a consensus among clinicians that existing pharmaceutical treatments such as antidepressants simply do not work. In fact, we know very well that people with PTSD who use marijuana—a potent cannabinoid—often experience more relief from their symptoms than they do from antidepressants and other psychiatric medications. Clearly, there’s a very urgent need to develop novel evidence-based treatments for PTSD.”

It was almost as though the brain researcher had given Fabian Henry his marching orders. Fabian’s kitchen table soon became a combination office, library and proving ground, the place he invited other veterans to try the plant that had worked for him. As he gauged its effects on his friends, he found that cannabis not only helped with PTSD, but also chronic pain, traumatic brain injury, irritable bowel syndrome, erectile dysfunction, nervous disorders, and alcohol and drug addiction. Before long, wives were thanking Fabian for giving them their husbands back; kids were commenting that their dads were present in their lives again. Considering the calamitous suicide rate among Canadian vets, Fabian felt it was his duty to take things to the next level—and so he founded Marijuana for Trauma.

Not only did Fabian help other veterans get their medical pot prescriptions, he showed them how to get it paid for by Veterans Affairs Canada and delivered to their door. He pored over sections 2.1 through 2.4 of the New Veterans Charter, which deals with psychiatric impairment, and started coaching vets on how to receive payments from the VAC that they had no idea they were entitled to. He searched out doctors who enthusiastically prescribed marijuana and psychologists who thought outside of the pharmaceutical box. He even enlisted his old friend Matt Ferris, a nutritionist, to help the guys break their lousy eating habits.

Along with microbial biologist and cannabis breeder Dr. Darryl Hudson, Fabian devised the “Platinum Kush” program, which researches the strains that work best for PTSD. By giving their volunteers unlabeled strains, they discovered a definite hierarchy of effectiveness. The pair continued their trials at the 2014 High Times Cannabis Cup in Denver, and today they list Chemdog, Rockstar OG Kush, Master OG Kush, Chem Chem and Chem ’91 as providing the most relief. MFT also enlists veterans experienced with the program as “peer-support cannabis coaches” to help guide newcomers to the most effective medicine.

It is Fabian’s belief that marijuana alone is not enough; its use needs to be combined with other types of therapy. To that end, he’s starting Veterans for Healing, a nonprofit organization that will pay for veterans to undergo a 30- to 60-day treatment program in a lodge on Cranberry Island in rural New Brunswick. There, they’ll have access to hyperbolic oxygen therapy, neuro-feedback therapy and cranial-sacro-massage therapy. The retreat will also include a sweat lodge, music studio and gym, along with programs for yoga, fishing, art therapy, swimming and primitive camping. He hopes to open it later this year.

“The problem with a lot of vets is that they’re isolating—it’s part of PTSD,” Fabian says. “The army let them down, the military let them down, and then they take off to the woods and do whatever. They need something to be a part of to clean their act back up. We’re not saying we have a cure, but we have a better chance of increasing your quality of life than anything I’ve seen.”


About 500 meters from the MFT office is the local outpost of the Royal Canadian Legion. Its official badge, featuring a maple leaf, a royal crown and the Latin motto Memoriam Eorum Retinebimus(“We Will Remember Them”), is displayed prominently on the sky-blue building. A Korean War–era C1 105mm Howitzer is parked out front.

Fabian visited the Canadian Legion a few times, but he was looking for something more than booze, darts and grin-and-bear-it stoicism. Now, thanks to the recent installation of an onsite vapor lounge, MFT presents an alternative for younger vets who choose pot over alcohol as their preferred social lubricant and self-administered medicant.

“When you go in the old Legion, you still feel like you’re out of place,” says Trevor Bungay who retired from the armed forces in 2014 after 17 years. “They still see marijuana as Woodstock and they just can’t get it. Don’t get me wrong, there are some people there that get it, but they’d never come out and say it, because they don’t want to ruffle feathers. This is the new Legion, let’s face it, right? If you wanna feel comfortable, smoke your marijuana and talk to people who know what you’re going through, where else are you going to go?”

Trevor did seven tours—Bosnia, Haiti, Eritrea, Ethiopia and four deployments to Afghanistan. The first time he was shot at, in Kandahar, he just stood there in a daze as bullets hit the dirt around him like raindrops.

“I was laughing with the guy next to me like, ‘This is the real deal. Someone is trying to kill us,’” he remembers. He volunteered to go back to Afghanistan and rose through the ranks to become a sergeant, in charge of 40 men. Coming home after his fourth deployment, Trevor knew something was wrong with him. The VAC told him the darkness was normal and it would pass. It didn’t. His friends started killing themselves. He was eating 12-15 OxyContins a day. One night he found himself sitting on his couch with a rifle and a bottle of whiskey, not expecting to ever see morning again. He dropped the gun, waking up his wife who dragged him to the hospital. Having served with Fabian in Afghanistan, Trevor trusted him enough to try cannabis therapy. Today, Trevor runs Trauma Healing Center in Nova Scotia, a program similar to MFT.

“If it wasn’t for marijuana,” he insists, “I would be dead. One hundred percent.”


The obvious question is whether there will ever be a similarly progressive program for American vets. There’s a meme floating around on social media right now that reads, “If Congress committed suicide at the same rate as veterans, there would be no one left after 25 days.” An average of 22 American vets kill themselves every day. It’s a white-hot crisis the scandal-scarred Department of Veterans Affairs has proven incapable of stemming. Some VA doctors turn a blind eye to marijuana use, but others have made patients choose between marijuana and their prescribed medications.

The Veterans Equal Access Act is a bill sponsored by Rep. Earl Blumenauer (D-Ore.) and Rep. Dana Rohrabacher (R-Calif.) that, if passed, would allow VA doctors in medical states to sign the paperwork needed to qualify vets for medical marijuana. (As federal employees, both veterans and VA doctors are currently subject to federal laws prohibiting cannabis). And while this legislation would be a start, only 23 out of the 50 states have legalized medical marijuana. Florida’s vets did not go to war for Mickey Mouse and the Marlins alone-— they did it for America. A national problem needs a national solution.

Every 65 minutes, a veteran takes his own life. The time for a legal, moral or clinical debate about medical marijuana has passed. If it helps even a fraction of vets recover, it’s the VA’s moral responsibility to help them gain access. Soldiers don’t choose their wars. The least we can do is allow them to choose their peace.
Fabian, Mike, and the rest of the original group did exceptional work getting cannabis to veterans. MFT has changed substantially since this article, with the people in the article no longer associated with it.

The new mgmt has changed the org into a number of small regional clinics, and are currently cutting off former clients associated with the closed clinics. Fortunately there are many more options available for cannabis information and prescriptions, but the original MFTgroup did great work. I've never been a client but have followed them closely.
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This is the veteran and a cannabis activist for PTSD in our local area. IMO a true hero in every sense of the word. He used to own the cannabis medical dispensary Rainer Express. He was forced out of business due to regulations. This article was from a while ago.

2017 Best of Olympia: Twenty22Many
Readers' Pick: Best Military Supporter: Best Veteran Organization
By Margaret Bicker on February 23, 2017


Former marine, Patrick Seifert, fights to save veterans’ from suicide by any means necessary. Photo credit: Twenty22Many

Sometimes, the wounds of war are obvious. Missing limbs, broken bones, facial scars can be hard to miss. But all too often, the wounds of war can be hidden scars left on a warrior's soul, invisible to those around them. These injuries can be nearly as devastating and even more resistant to treatment.

Former marine, Patrick Seifert, knows all too well what it is to suffer from invisible wounds. The veteran of the first Gulf War was diagnosed with Post-Traumatic Stress Disorder (PTSD), but rather than surrender to the pain, he decided to do something about it. After learning that this country loses an average of 22 veterans every day to suicide as a result of PTSD and/or Traumatic Brain Injury (TBI), Seifert founded Twenty22Many (pronounced "Twenty-Two Too Many") to bring attention to this national crisis and to advocate for alternative remedies for the debilitating symptoms of PTSD and TBI and for the needs of veterans in general. Their tagline is: "By All Means Necessary - End Veteran Suicide."

the unassuming storefront headquarters located at 322 4th Ave. E. in Olympia, which it shares with Olympia Hempfest Central, Twenty22Many is "fighting to end veteran suicides. Education and empowerment programs are absolutely vital to saving broken veterans," said Seifert, whose organization seeks to support all veterans through veteran advocacy, homeless outreach, governmental interaction, and veteran support groups.

One of their more recent advocacy projects was the passage of SB 5379 that added PTSD and TBI to the list of conditions eligible for treatment with medical marijuana. Based on a growing body of anecdotal evidence, as well as increasing scientific research, Twenty22Many "advocates on behalf of veterans to bring awareness to ... alternative and holistic therapies such as cannabis to assist in decreasing the rash of suicides affecting our veteran communities," said Seifert.

The work of Twenty22Many survives on donations. "All we do now depends on donations," said Seifert. "Please go to our website (twenty22many-olympia.org) to donate on Pay Pal." Seifert continues, "We have our own hotline (360.545.7849) that will help any veteran anywhere in the world if we get the call. Need gas money? Need help with your rent? Need help getting benefits? Need help staying warm? Need help eating? There's absolutely no reason that we would ever turn any veteran away."

Upcoming events sponsored by Twenty22Many include a march to bring awareness to PTSD and the veteran suicide crisis, scheduled for the July 22 on the Capitol Grounds in Olympia, and a fundraising poetry slam scheduled for Saturday, Feb. 26.

"For the Love of Poetry" will be held from 6-10 p.m. at the Green Lady Shoppe and CBD Espresso Bar located at 3044 Pacific Ave. SE in Olympia. It will feature a presentation by poet laureate Amy Solo and music by DJ Pasquan. The top three contestants of the open poetry reading will receive hundreds of dollars worth of goodies from Kush Creams and Olympia Hempfest Central. Admission is by donation; $5 donations are encouraged. VIP tickets are available for $22.00 and will entitle the bearer to hors d'oeuvres, wine from The Wine Loft, Kush Creams, Kangen Water, and a variety of CBD products. For more information, check out their Facebook page: facebook.com/events/658903320938698/.

Twenty22Many, 10 a.m. to 2 p.m., Monday-Thursday; noon-8 p.m., Friday-Saturday; 10 a.m. to 4:20 p.m., Sunday, 322 4th Ave. E., 253.777.5857, HOTLINE: 360.545.7849
The Opinion Pages | OP-ED CONTRIBUTOR
Make Pot Legal for Veterans With Traumatic Brain Injury


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  • an infantryman in Iraq and Afghanistan. Stuff to numb me from the world all around.

    The T.B.I. brings on almost daily migraines, and when they come, it’s as if the blast wave from the explosion in Afghanistan is still reverberating through my brain, shooting fresh bolts of pain through my skull, once again leaving me incapacitated. Initially the prescriptions helped — as they do for many veterans. But when I continued to feel bad, the answers from my doctors were always the same: more pills. And higher dosages. And more pills to counteract the side effects of those higher dosages. Yet none of them quite worked.


    Sgt. Thomas James Brennan after sustaining a concussion from a rocket-propelled grenade explosion during a battle against Taliban insurgents in southern Afghanistan in 2010. CreditFinbarr O'Reilly/Reuters
    One thing did. In 2013, a friend rolled a joint and handed it to me, urging me to smoke it later. It will relieve your symptoms, he promised. That night I anxiously paced around my empty house. I hesitated to light it up because I’d always bought into the theory of weed as a “gateway drug.” But after a few tokes, I stretched out and fell asleep. I slept 10 hours instead of my usual five or six. I woke up feeling energized and well rested. I didn’t have nightmares or remember tossing or turning throughout the night, as I usually did. I was, as the comedian Katt Williams puts it, “hungry, happy, sleepy.”

    Continue reading the main story

    With the help of my civilian psychiatrist, I began trading my pill bottles for pipes and papers. I also began to feel less numb. I started to smile more often. I thought I had found a miracle drug. There was just one problem: That drug was illegal.

    In 21 states, including North Carolina, where I live, any use of marijuana is forbidden under state law. The current punishments for those who possess or cultivate cannabis — even for medical purposes — may include a felony conviction and imprisonment, loss of child custody and permanent damage to their livelihood. The V.A. encourages veterans to discuss their cannabis use with their doctors, but because cannabis is also prohibited under federal law, the V.A. cannot prescribe it in any form — thereby denying countless veterans relief to many mental health symptoms and other service-connected disabilities.

    In recent years, the V.A. has worked to reduce the number of opioids prescribed to veterans and increase the promotion of alternative therapies such as yoga and mindfulness, and it has made significant improvements in access to health care.Dr. David Shulkin, the V.A. secretary, has publicly supported the evaluation of emerging cannabis research, acknowledging that patients may benefit from marijuana use. But the department is prohibited from prescribing medical cannabis for veterans even in states where it is legal. (In those states, veterans can get prescriptions from private doctors, but at their own expense.)

    Most of the major veterans groups, including the American Legion, Iraq and Afghanistan Veterans of America, Veterans of Foreign Wars and Disabled American Veterans, support regulated research into the medical uses of cannabis. But the research is slow in coming: Since 1968, the University of Mississippi has been home to the only licensed facility to produce cannabis for clinical research. In March it was reported that the university’s cannabis was contaminated with lead, yeast and mold — substances that jeopardize research efficacy and patient safety.

    What I know is that it works for me. If I hadn’t begun self-medicating with it, I would have killed myself. The relief isn’t immediate. It doesn’t make the pain disappear. But it’s the only thing that takes the sharpest edges off my symptoms. Because of cannabis, I’m more hopeful, less woeful. My relationship with my wife is improving. My daughter and I are growing closer. My past is easier to remember and talk about. My mind is less clouded. More than anything, it feels good to feel again. My migraines and depression don’t control my life. Neither do pills.

    But I live in fear that I will be arrested purchasing an illegal drug. I want safe, regulated medical cannabis to be a treatment option. Just like the sedatives and amphetamines the V.A. used to send me by mail. And the opioids they still send to my friends.

    Thomas James Brennan, a former sergeant in the Marine Corps, is the founder of The War Horse, a veterans’ news site, and a co-author of “Shooting Ghosts: A U.S. Marine, a Combat Photographer, and Their Journey Back from War.”
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  • an infantryman in Iraq and Afghanistan. Stuff to numb me from the world all around.

    The medical benefits of marijuana for the more than 360,000 post-Sept. 11 veterans who have brain injuries are not universally recognized. (As many as one in five veterans are thought to have post-traumatic stress.) But medical experts like Dr. Frank Ochberg, a psychiatrist and former associate director of the National Institute of Mental Health, believe that “medical marijuana absolutely belongs in the pharmacy for post-traumatic stress and brain injury treatment.” The V.A., Dr. Ochberg said, “is failing veterans by not making cannabis a treatment option.

    In recent years, the V.A. has worked to reduce the number of opioids prescribed to veterans and increase the promotion of alternative therapies such as yoga and mindfulness, and it has made significant improvements in access to health care.Dr. David Shulkin, the V.A. secretary, has publicly supported the evaluation of emerging cannabis research, acknowledging that patients may benefit from marijuana use. But the department is prohibited from prescribing medical cannabis for veterans even in states where it is legal. (In those states, veterans can get prescriptions from private doctors, but at their own expense
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The point should be about not messing up peoples lives not about medicating them after they get back. I am not saying that MJ doesn’t have its place just that the need for it should not be any larger then absolutely necessary.
Sigh.....it blows my mind that this long, long list of medications is considered a 'better' alternative to something natural. :disgust:

There is a real good video at the beginning of the article, 'Understanding PTSD,' if any are interested in understanding PTSD further. I could not embed it.

Veterans Can Get All Of These Prescription Drugs To Treat PTSD, But Not Weed

Around the nation, thousands of veterans and active-duty military personnel are waging their own personal battles against post-traumatic stress disorder. Typically triggered by a horrific incident either witnessed or experienced by the person, PTSD comes with a debilitating set of physical and psychological symptoms.

Many service members are hesitant to seek professional help due to the social stigma surrounding mental illness. Those who do are often dosed with an ever-expanding list of prescription drugs, which, paired with therapy, are frequently the first course of action against certain ailments stemming from PTSD.

"It's a daunting list," Dr. Sue Sisley, a psychiatrist in Phoenix, told The Huffington Post about the staggering number of medications available for PTSD.

The Department of Veterans Affairs' national formulary, a catalog of drugs and supplies commonly prescribed by VA doctors overall, contains more than 1,500 items, ranging from gauze pads to many of the medications listed below. Yet it is not comprehensive. VA doctors can prescribe non-formulary drugs to treat PTSD if they feel that previous treatment regimens have been ineffective or harmful. While these medications have been approved by the Food and Drug Administration, that doesn't mean their specific use as a treatment for PTSD -- and particularly combat-related PTSD -- is fully understood. Doctors often rely on trial and error to figure out what works for an individual patient.

"When I show this list to our military veterans, they were completely nauseated because they have frequently been the target of so many of these medication trials,” Sisley said.

Many of the medications used to treat serious PTSD symptoms such as anxiety, depression, flashbacks and insomnia come with risky side effects, especially when combined with one another. One of the most dangerous is an increase in suicidal thinking.

There is another drug not prescribed by any VA doctor anywhere. Yet some veterans with PTSD say it has helped them tremendously, even reducing their reliance on prescription medications. The drug is marijuana. While it's not entirely harmless, it is known to be far more benign than many potent pharmaceuticals already approved for use.

But the government classifies marijuana as a Schedule I drug with no medical value and explicitly prohibits VA doctors from recommending marijuana to their patients, even in states that have reformed their marijuana laws. Some doctors are now arguing that the federal ban on pot is blocking veterans with PTSD from a valuable treatment option.

During a recent interview on NBC’s "Dateline," U.S. Army veteran Matt Kahl, who served two tours of duty in Afghanistan, said the VA had prescribed a wide assortment of drugs to treat his PTSD. Kahl said the drugs made him feel like a "zombie," and 10 months after returning from duty, he attempted suicide. A short time later he began to self-medicate with marijuana.

Kahl, who now lives in Colorado, the first state to legalize marijuana, told "Dateline" that he was able to eliminate many of those prescription drugs once he began using cannabis.


Roughly 20 percent of military veterans who served in the Iraq and Afghanistan wars suffer from PTSD and depression, according to a 2012 VA report. A study published earlier this year found that the suicide rate among those veterans suffering from PTSD is 50 percent higher than the national average.

Some preliminary research has suggested that marijuana may help alleviate some of the primary symptoms of PTSD, including anxiety, flashbacks and depression.

Dr. Deborah Gilman, a recently retired physician who spent 22 years working for the VA, told HuffPost that she sees significant promise for marijuana as a treatment for PTSD.

"The most common symptoms that vets turn to conventional meds for are sleep problems, nightmares, chronic anxiety, intrusive memories ('flashbacks'), chronic anxiety including social situations and other places, irritability, depressed mood and pain. Pain can be related to combat wounds or not," she said in an email. "In my opinion, all of them could be benefitted to some degree by various properties in marijuana. Marijuana is useful for pain as well as for psychiatric problems."

In an open letter to Congress earlier this year, Gilman urged congressional lawmakers to approve a measure that would give veterans easier access to the plant, both for PTSD and other medical conditions. She argued that marijuana poses a significantly decreased risk of dependence as well as fewer side effects than traditional medications. Cannabis may also be effective at reducing patients’ reliance on narcotic painkillers and, in some cases, may be able to replace them altogether, Gilman said.

Shortly thereafter, the Senate Appropriations Committee approved an amendment to a broader military spending bill that would allow VA doctors to recommend medical marijuana to their patients in states that have already legalized the drug for medical use. While the vote was symbolic -- and in fact the first time the Senate had ever voted positively on marijuana reform legislation -- both the measure and the bill to which it was attached now face a number of hurdles before becoming law.

Not everyone is as enthusiastic as Sisley and Gilman about the potential for marijuana to treat PTSD. Even they aren't touting it as a miracle drug (though Sisley claims to have seen patients replace their psychiatric medications with marijuana alone, arguably a near-miracle). But the doctors can't help but notice that while the VA continues to hand out powerful prescription drugs that don't necessarily help and can harm the patient, marijuana remains a non-starter. Considering the growing anecdotal evidence from veterans who have treated their PTSD with marijuana, they say that's no longer acceptable.

Here's a list of prescription drugs that veterans may be prescribed to treat various PTSD-related symptoms. It's long, but by no means all-inclusive.


Antidepressants interact with the body and brain chemistry in a variety of ways and can treat a number of conditions. For people with PTSD, these drugs are primarily prescribed to combat the effects of major depressive disorder. They are also often prescribed for anxiety disorders and chronic pain.

Depending on which chemical compounds the medications contain, antidepressants can be classified in several categories, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs). While most of these are considered relatively safe, they have been associated with a range of side effects, such as insomnia, weight gain, loss of sexual drive and, most concerning, an increased risk of suicidal thinking. In 2007, the FDA asked makers of the popular medications to strengthen suicide-related warnings on their labels to include young adults, as well as warnings about the possibility of actually worsening depression.

Antidepressants prescribed for PTSD include:

Amitriptyline (sold under brand names Elavil, Endep, Levate, others)

Amoxapine (Asendis, Defanyl, Demolox, others)

Bupropion or bupropion hydrochloride (Wellbutrin)

Citalopram (Celexa, Cipramil)

Clomipramine (Anafranil, Clofranil)

Desvenlafaxine (Pristiq)

Desipramine (Norpramin, Pertofrane)

Doxepin (Deptran, Sinequan)

Duloxetine (Cymbalta)

Escitalopram (Lexapro, Cipralex)

Fluoxetine (Prozac, Sarafem, others)

Flurazepam (Dalmane, Dalmadorm)

Fluvoxamine (Faverin, Fevarin, others)

Imipramine (Tofranil)

Maprotiline (Deprilept, Ludiomil, Psymion)

Mirtazapine (Avanza, Mirtaz, Zispin, others)

Nortriptyline (Sensoval, Aventyl, Norpress, others)

Paroxetine (Paxil, Pexeva)

Phenelzine (Nardil, Nardelzine)

Protriptyline (Vivactil)

Sertraline (Zoloft, Lustral)

Trazodone (Oleptro, Trialodine)

Trimipramine (Surmontil, Rhotrimine, Stangyl)

Venlafaxine (Effexor)

Vilazodone (Viibryd)

Vortioxetine (Brintellix)

Anti-anxiety drugs

These psychoactive drugs, also called anxiolytics, are designed to treat a range of anxiety disorders experienced by veterans with PTSD. The most commonly prescribed are benzodiazepines, which apart from treating anxiety are also used for their sedative, anticonvulsant and muscle relaxant properties. A 2013 report found that almost one-third of veterans being treated for PTSD were prescribed benzodiazepines, despite VA guidelines advising against their use for the condition.

Regular use of benzodiazepines -- which include such brand-name drugs as Xanax, Klonopin and Restoril -- has been linked to side effects including sexual dysfunction, lost cognition and behavior problems. And studies suggest that chronic users may develop a tolerance, even dependence and addiction. Outside their prescription use, benzodiazepines are recreationally used and abused.

Plus, cessation of benzodiazepine use has been linked to a host of withdrawal symptoms, ranging from comparatively minor issues like insomnia, gastrointestinal problems and spasms, to much more severe symptoms like depersonalization, depression, seizures, psychosis and suicidal behavior.

Anti-anxiety drugs prescribed for PTSD include:

Alprazolam (Xanax)

Buspirone (Buspar)

Chlordiazepoxide (Librium)

Clonazepam (Klonopin)

Diazepam (Valium)

Estazolam (ProSom, Eurodin)

Hydroxyzine (many names)

Lorazepam (Ativan, Orfidal)

Midazolam (Dormicum, Hypnovel, Versed)

Oxazepam (Serax, many others)

Temazepam (Restoril)

Triazolam (Halcion, Trilam, others)


These drugs are used primarily for the treatment of the psychotic symptoms, such as intense nightmares, intrusive thoughts, emotional reactivity and hyperarousal, that some veterans with PTSD may experience. There are two primary types of antipsychotics -- typical (or first-generation) and atypical (or second-generation) -- both of which function by blocking the brain's dopamine receptors. Some atypical antipsychotics have also been prescribed to treat major depressive disorder.

Antipsychotic medications have been linked to a number of side effects, including headaches, dizziness, lethargy and weight gain. More significant complications like tremors and movement disorders -- such as parkinsonism, a syndrome accompanied by debilitating muscular rigidity and loss of mobility, and tardive dyskinesia, a disorder often accompanied by uncontrollable facial tics and other movements -- have been more commonly associated with earlier typical antipsychotics.

In April 2010, AstraZeneca, the maker of Seroquel, agreed to pay $520 million to settle federal claims that it had minimized risks and pitched the medication for off-label uses, including to treat insomnia. The drug was removed from the VA's approved formulary list in 2012 after being linked to a number of questionable deaths and other health concerns. In 2013, however, the Army began evaluating how it could be fit back into approved treatment.

Antipsychotic drugs prescribed for PTSD include:

Aripiprazole (Abilify)

Asenapine (Saphris)

Fluphenazine (Prolixin, Modecate)

Haloperidol (Haldol, others)

Iloperidone (Fanapt)

Loxapine (Loxapac, Loxitane)

Lurasidone (Latuda)

Olanzapine, sometimes in combination with fluoxetine (Zyprexa, Zypadhera, or Symbyax)

Perphenazine (Trilafon)

Pimozide (Orap)

Prochlorperazine (Compazine, Phenotil, more)

Quetiapine (Seroquel)

Risperidone (Risperdal)

Thiothixene (Navane)

Ziprasidone (Geodon, Zeldox, Zipwell)


Several bottles of prescription medications including Seroquel sit on the kitchen table at the home of Iraq war veteran Andrew White, who died in his sleep in 2008 while taking a regimen of powerful drugs to treat PTSD. (AP Photo/Jeff Gentner)

Mood stabilizers

The term "mood stabilizer" refers to a broad set of psychiatric drugs that includes some atypical antipsychotics as well as the anticonvulsant agents listed below. These drugs are often prescribed for the mood swings or coexistent bipolar spectrum disorders that some veterans with PTSD experience. Doctors may also opt for anticonvulsant mood-stabilizing treatment if antidepressants have proven ineffective for a patient.

Mood stabilizers have been connected to a variety of more minor side effects, including dizziness, weight gain and vomiting, as well as more serious symptoms, such as an increased suicide risk.

Mood stabilizing drugs prescribed for PTSD include the following anticonvulsants, as well as some atypical antipsychotics listed above:

Carbamazepine (Tegretol, Carbatrol, others)

Divalproex sodium (Depakote)

Lamotrigine (Lamictal)

Oxcarbazepine (Trileptal)

Valproic acid (Depakene, Valproate)


Lamotrigine is a generic anticonvulsant prescribed in the treatment of clinical depression. Its most prominent side effect is a skin rash, which affects 5 to 10 percent of patients. On rare occasions, these skin conditions can develop into life-threatening reactions, including drug-induced hypersensitivity syndrome, Stevens-Johnson syndrome and toxic epidermal necrolysis.

Sleep aids

Sedative-hypnotic medications designed to help induce sleep include a variety of drugs listed in previous categories, such as some anxiolytics and particularly benzodiazepines, as well as antipsychotics. There are also other drugs that are prescribed specifically to veterans with PTSD to help with insomnia or other sleeping issues, like nightmares. Among these sleep aids are a newer class of Z-drugs, like Ambien, Lunesta and Sonata, which are largely thought to be safer than benzodiazepines.

Z-drugs and other non-benzodiazepine hypnotics come with their own list of potential side effects, including dizziness, gastrointestinal problems and prolonged drowsiness, as well as less common, though more concerning, effects like parasomnias -- activities like sleepwalking or sleep-eating. Concerns have also been raised that these drugs may be habit-forming.

Sleep aids prescribed for PTSD include the following, as well as a number of drugs listed above:

Butabarbital (Butisol)

Eszopiclone (Lunesta)

Prazosin hydrochloride (Minipress, Vasoflex, others)

Ramelteon (Rozerem)

Zaleplon (Sonata)

Zolpidem (Ambien)


Alarms have been raised over Ambien's list of side effects such as aggressive behavior, confusion, hallucinations and possible worsening of depression.

Three Military Veterans Explain What Weed Does for Their PTSD
These Vets Who Use Cannabis Talk About How It's Saved Lives—Specifically, Theirs
by Tobias Coughlin-Bogue


The VA is quick to prescribe antianxiety drugs, antidepressants, and sedatives but that hasn’t done much to stem the tide of veteran suicides. LUCY BELLWOOD

Twenty-two veterans a day commit suicide in the United States. Why anyone commits suicide is something only they can know, ultimately, but it wouldn't be a stretch to surmise that post-traumatic stress disorder (PTSD) might have something to do with it.

The US Department of Veterans Affairs (VA) health system is quick to prescribe antianxiety drugs, antidepressants, sedatives, and other meds for PTSD, but that hasn't done much to stem the tide of veteran suicides. Cannabis, despite promising results for many vets who are dealing with PTSD, is off the table. Possession of weed is still a federal crime, and the VA is a federal agency. However, veterans across the country are speaking up in favor of pot, saying that it's succeeded where pharmaceutical meds have failed.

In California, there's a medical marijuana cooperative called Santa Cruz Veterans Alliance that distributes free pot to veterans. The group has about 200 members. Here in Washington State, a medical cannabis dispensary in Olympia that caters specifically to veterans, Rainier Xpress (rX), does something similar. Patrick Seifert, who runs rX, says he gives out about an eighth of weed a month to his patients free of charge. He says he's worked with more than 3,000 patients.

A widely syndicated Associated Press story recently documented the rise of pot use among veterans nationwide, even in states where it is illegal. As the story noted, while weed is increasingly popular with vets as a PTSD treatment, there is scant scientific evidence to support it.

Before allowing vets to use medical marijuana, the VA would probably need to see randomized, controlled studies. Obviously, cannabis has been illegal for quite some time, and so those studies couldn't happen. But two such studies are currently under way in Colorado, and the international scientific community has also been active on the issue. Studies by Dr. Raphael Mechoulam, a prominent Israeli cannabis researcher, have shown that the body's endocannabinoid system plays a major role in fear regulation and memory retention, and that cannabis seems to have some positive effect on PTSD. The research is by no means definitive, but it would seem to suggest that the self-medicating many veterans have been doing is not misguided.

Many veterans are still denied access to pot. Those who are lucky enough to live in a state where medical marijuana is legal and where PTSD is an approved condition can try it, but only about half the states with medical marijuana programs allow its use for PTSD.

Washington State didn't allow the use of medical marijuana for PTSD until recently, and it took plenty of campaigning to get that accomplished. Seifert, of rX, also founded a nationwide organization called Twenty22Many, created to call attention to the staggering rate of veteran suicides in America and the potential to use cannabis as a solution. In 2015, the group campaigned loudly for PTSD to be added to our state's list of qualifying conditions, and it won.

I spoke with three veterans in Washington State who are similarly enthusiastic about medical cannabis. To illustrate how effective pot has been for them, these three vets were willing to share their very personal and often dark stories about living with PTSD. Of cannabis, each one said, unprompted and independently, "It saved my life."

Though they had no qualms about The Stranger publishing their full names in this article, they're still former federal employees, and they still depend on the federal government for benefits, so we have decided to publish only their first names.


Kevin grew up in the Northwest, Snohomish specifically. He was a bit of a wild one, he said, and while he didn't have a record, he had a reputation. After years of gangs, drugs, and crime, he decided to go straight.

"I was headed for an early grave or a prison cell," he said. He decided to do a complete one-eighty and pursue a career in law enforcement. However, his reputation caught up to him. About a year and a half into criminology courses at a community college, he took a class taught by a local detective who was well acquainted with his past. That, he said, was the end of that. His career in law enforcement dead in the water, he joined the army. After partying his face off all summer, he shipped off to basic training in the fall of 1998.

A few sleepy years of peacetime passed, and then 9/11 hit, and his world got crazy. He said he was extremely gung ho about combat. He signed up to be combat infantry despite the 200-plus other jobs available to him because, as he told the recruiter, "I wanna blow shit up and get paid for it."

And indeed he did, as part of a route clearance and IED-defusing unit in Iraq. Iraq, he said, was great.

"IEDs were kicking everybody's fucking ass at that time," he said. "We wrote the book on it. Now they have a handy-dandy woodchuck guidebook for how not to get blown the fuck up. That was one of the highlights of my career. It was a good tour; we were taken care of. General Milley, the current army chief of staff, was our brigade commander. He took great care of us. We were his only route planners and counter-IED asset."

After his time sussing out car bombs in Sadr City, he came home and then quickly redeployed to Afghanistan. That, he said, was a much less pleasant experience.

"It was a forgotten war," he said. "There were people in uniform [here in the United States] that didn't even know we were over there."

He complained of a severe lack of organization, saying that in contrast to Iraq, he felt like he was flying by the seat of his pants with no direction.

"I was a young E6 in charge of it all," Kevin said. "It was quite the responsibility. Millions of dollars of equipment, 20 to 30 lives at any given time. And we were known as a high-value target because of what we did."

However, he didn't lose a single one of those lives. "Everybody came home with all their shit intact," he told me. "Don't even ask me how."

"That's one of the burdens I don't carry," he said, referring to service members who've lost comrades. The sheer intensity of the mission, however, was enough to give him the PTSD that has plagued him since returning home.

"Here's the rub on that," he said. "When you're wired that tight, and you know the stakes every single minute of every single day of every single mission, you don't ever come back from that. I got back in 2007, but I never really came back. I'm still on patrol every single minute of every single day."

His return home was less of a graceful reentry and more of a crash landing.

"I dove into a fuckin' bottle, man," he said. "I'm a recovering alcoholic. I'm one of the worst fucking drunks there ever was."

At some point while he was working at Fort Bragg, he went on a bender, and a couple of officers had to track him down at a cheap hotel, where he was holed up with a couple of hired "friends" and the remainder of an ounce of blow.

"I don't remember any of it," he said. "What drives a man there?"

His commander was planning to give him a dishonorable discharge, but stripped him of his rank instead. Over the next couple of years, Kevin worked his way back up in rank. However, his high performance came at a price.

"I was already on a steady regimen of pills," he said. "Between 2007 and 2012, I was addicted to prescription amphetamines. You don't put in 100 hours a week in the battalion F-3 shop on coffee. I was cut off of that after I left Fort Bragg and went to Fort Polk, and I rapidly went downhill."

After his reassignment, he couldn't get speed anymore, as he'd switched doctors and his issues with substance abuse raised eyebrows with his new health-care provider. Faced with withdrawal, he said, his alcoholism deepened.

"All I had was alcohol," he told me. "I drank because I couldn't stand being in my own skin. The more I felt like that, the more I drank, and the more I felt like that."

His drinking, he said, was the only way he had to cope with symptoms of his PTSD, the only way he could unwind after being wired so tight. But, he said, he was coming unwound.

"It's a fucking death sentence," he said. "You tack on the seven different pills three times a day, and the side effects from all of those, and it makes you wish you were fucking dead."

Pot, which ultimately came to replace the pills and booze, first came back into his life on leave.

"Any time I could take an extended period of leave, two weeks or more, I could always go get a bag of reefer," he said. "I knew from the first time I did it, that was gonna be my shit."

"It has its pluses and minuses," he admitted, but said it was preferable to the alternative. "When you're as heavily medicated as I was, the side effects from all the pills [are worse]. I was in my mid-30s having to kick fucking Viagra. I was fat and lazy. It was the pills."

Now, he said, he goes to Alcoholics Anonymous five days a week and uses pot instead of booze to help cope. At some point, he went into the VA and informed them that he was done with pharmaceuticals and would be smoking medical cannabis from there on out.

"I'm on this regimen of pills [that I hate], and now I'm in a state where cannabis is legal and I'm going to pursue that," he told his psychiatrist. "Matter of fact, it's growing already."

They offered no comment, he said, just advice on how to safely detox from his prescriptions. That process was difficult, and he recalled one particularly tough episode where he got into a fender bender on I-5.

His anger took over and he got out of his car ready, he said, to beat the other driver to death on the side of the freeway. He didn't, thankfully, but that episode nearly scared him into going back on his medications. Nearly.

"It wasn't me; it was the pills," he said. He stuck with pot, and he credits it for turning his life around. Weed helps him calm down without the side effects other prescriptions have, he said. It also helps him stay off the sauce. If not for pot, he said, he'd be dead.

"If you put that bottle in my hand, I'd be dead, I'd be dead by the end of the weekend."

Now he grows his own high-CBD cannabis at home—he said he can't find enough through the recreational stores—and the pain relief it affords him allows him to get out and exercise, which further helps his mood. CBD has also been shown to be anxiolytic, meaning it reduces anxiety. Kevin freely admitted to his issues with anger and the potential to be a danger to himself or others. But weed helped him cope with that anger where prescription drugs hadn't.

"After four years [of cannabis], you wouldn't catch me in a doctor's office asking for a scrip for something to make me feel good," he said. "I know exactly who and what I am. That's the whole moral of the story. If I've got to be on something to regulate my mood and behavior for the rest of my life, this is going to be it."


Justin, who was a helicopter pilot in Iraq and elsewhere, had an eerily similar story. After flying in and out of combat zones and being constantly on alert, he found he couldn't turn it off when he got home.

"Basically, you get to this point where you're able to process everything so fast," he said. "You have half a second to react, technically a third. A third of a second to even process. That's how I know how to operate." Going through civilian life in a state of constant danger awareness was unbearable, he said. He had all the classic symptoms of PTSD: nightmares, insomnia, aggression, etc.

The VA's answer was pills.

"They just give you meds, and you take 'em and you take 'em and you take 'em, and if shit starts going bad, you just keep taking 'em," he said. "You get angry, angry, angry, and you just keep taking meds, and you go, 'Why am I angry?' Because you're taking meds."

The side effects and the negative interactions of the drugs he was on, he said, were making his life a living hell. At one point, he got serotonin syndrome, suffering constant and uncontrollable muscle spasms. When he would take all the pills he was supposed to, it would wreak havoc on his bowels, sending him to the bathroom hourly for periods as long as 13 hours.

He lost 60 pounds in a summer because he was afraid to eat and found himself completely devoid of energy. One medication made him feel overwhelmed with depression, he said, like he was drowning all the time. He failed out of college thanks to Prazosin, a medication that prevents PTSD-induced nightmares, because the drug would leave him stuck in bed for three hours every morning, he said. The medication suppresses adrenalin spikes, and while he would wake up at a normal time, whatever it did to suppress those spikes left him completely without motivation. Though he wanted to, he simply couldn't make himself get out of bed.

On his initial cocktail of VA medications, he said, "The difference between a good day and a bad day is like skating on thin ice. Above the surface is the reality of suicide. It happens all around, got it, people die, people choose. Then right beneath that ice, you're instantly going, 'Suicide, suicide, suicide.' That's real, versus the idea. That's how thin you are, whether you slip, fall, crack, or whatever. That was my medication."

Despite admitting to having suicidal thoughts, he said, the VA kept giving him more meds.

"'Fuck, you trust me with all this?'" he said to the VA, incredulously. "'I just told you I tried to kill myself a couple weeks ago. I put a gun to my head at 7:08 in the morning because I couldn't take it anymore, and then you give me more?'"

During his darkest times, when his cocktail of medications made death seem pretty peachy, he leaned on weed.

"I was already smoking pretty hardcore at that point," he said. "That was the only thing that kept it all together. I was having a crisis."

To get out of that crisis, Justin said, "I stopped drinking. I would drink a fifth of Black Label. It helped me pass out, and it helped me forget. I was trying to drown that shit. I had to [get off the pills]. Had I continued taking those things, I would have killed myself. I stopped and smoked weed."

Weed helped him slow down without the intense side effects of the other medications and the booze, he said.

He also decided to take a more active role in his medical regimen.

"Now I'm on Cymbalta" and a few other meds that work better together, he said. "I took control of my shit, and that got me going."

Despite his new meds, he knows PTSD is something he will live with forever. He doesn't see weed as a replacement for his medication, but he does see it as a vital supplement to it.

"Now I've found a good spot [with medication], but still there are certain things you can't deal with," he said. "You're used to working at 90 percent. Your anxiety level is up here, because there are people trying to kill you. You get so caught up in that, and life becomes just that—so when you come back home, you're still at 90 percent when the entire world is at 9 percent."

That transition from combat back to civilian life is the root of the problem, he said.

"That is where 22 veterans die a day," he said. "Nearly once an hour, you have a veteran dying. Whether you have a veteran or a person, it's shitty regardless, but these people fought for our country."

Though he didn't think weed was a miracle cure by any means, he said that it was an especially great way to help vets manage the sudden transition back to civilian life, in addition to its PTSD-related benefits.

"We need to slow down," he said. "No one teaches that." He added that he "unearthed 50 gallons of topsoil yesterday. I weeded 400 square feet of grass. Some Zen shit. Now I take the time to understand and process. It slows us down."

Thanks to pot, he said, "I'm able to be a person. I'm able to transition, to live a life in Seattle. I'm employed full-time. I'm gunning toward a promotion. I have guys who look up to me, guys who I've gotten jobs for, guys who I've stopped from killing themselves. If I wasn't smoking weed, if I was drinking—are you kidding me? Weed saved my life and a bunch of others too."


Andrew did six years of active duty in the army. His first three were with the 82nd Airborne, including a 30-day stint in New Orleans dealing with the aftermath of Hurricane Katrina.

"I saw some things here in the United States that I ultimately ended up seeing in Iraq," he said. Though he doesn't specify what those things were, it's not hard to tell from his tone that he didn't exactly cherish the memory.

On his first tour, he lost six comrades. After his deployment in Iraq and the end of that tour, he reenlisted with a support and reconnaissance unit at Fort Lewis, getting out in 2010. After the army, he headed to Wyoming to go to school.

"I was fine for a while," he said. "The first six months, I didn't notice anything unusual. I was getting 4.0s in school, things were good."

But then PTSD started gradually creeping in. All the symptoms of PTSD were there, though he hadn't identified them yet.

"It was a lot of sleeplessness, a lot of anger," he said. "I wasn't leaving my house; I started isolating a lot."

To cope with the symptoms, he said, "I started drinking a lot more just to sleep at night. Sometimes I would drink two fifths of whiskey and half a 12 pack just to be able to get a couple hours of sleep. I'd crawl into the bathtub with a .45 and a bottle of whiskey. I started really pulling away, withdrawing from society. I knew I needed help, so I went to the VA in spring of 2012."

There, he had a brief conversation with brusque doctor who couldn't be bothered to set down his keys or cell phone during the interview, he said. After five minutes and three questions, he had a diagnosis, and with the diagnosis came pills—lots of them.

The pills helped at first, he said, but he was still drinking and still having problems. His hands would shake uncontrollably. Whether it was the booze or the trauma is anyone's guess, but he knew something was wrong. He was enrolled in psychology classes at the time, and he began identifying some of the classic symptoms of PTSD in himself. PTSD had not been his diagnosis. Besides the lack of sleep, he was having intense anger outbursts and found himself in a constant state of hyperawareness.

At that point, he said, he was also using cannabis, but purely recreationally.

"I had a cocktail at that point," he said. "I was using alcohol, cannabis, and the VA's pharmaceuticals all at once. It was just kind of a roller coaster." That cocktail was nearly his undoing.

"I ultimately did try to take my life three times," he said calmly. "The third time, I was just like—I don't know what flipped or what happened—but I asked myself the hard question: 'What are you gonna die for?' The reality was, I wasn't going to die for anything. I lost six friends on my first deployment, and they at least died for me to be able to live." He credits that stark realization with his first steps to kicking booze.

"I don't know if that was what switched [for me], but I stopped drinking," he said. "Not like immediately, but I started being more aware of it, stopped with the hard alcohol." However, there were still the pills.

"I was still really dependent," Andrew said. "I was still in the VA's system. At one point, they had me on 17 [pharmaceuticals] a day. That was benzos, SSRIs, narcotics—you name it, and I more or less have taken it."

They kept trying different medications, he said, but nothing was working for him. When he was 27, the VA came to him and asked, essentially, "What more do you want from us?" He'd taken every different type of trauma and anger-management class available, and tried nearly every pharmaceutical out there, to no avail.

"I don't know," he told the VA in response. "The system is obviously broken, but I don't know what's wrong."

"That was the lightbulb," he said. "I realized they were only going to treat my symptoms, they weren't going to help me heal."

He described one chilling episode where he was prescribed two medications with potentially fatal interactions:

"I was literally on the floor in the kitchen one night in tears, because the shit that they were giving me wasn't working and I was in so much pain. When I got to the VA the next day, they wanted to put me on tramadol [a potent opioid pain medication]. The doctor had me click something on the screen, and I didn't really think anything of it."

"When I got home," he went on, "I had two bottles sitting on the kitchen counter. I went into the bathroom and I came back out, and my sister had the two bottles in her hands and she was like, 'Have you taken these yet?' I said no. She was in school for nursing, and she flips open her drug-interactions book—and the two interactions are seizures and death for venlafaxine and tramadol. I was taking 325 milligrams of venlafaxine and they had given me a high dose of tramadol. It would have looked like an accidental death."

As he summed it up: "I was a problem child. Nothing they were giving me was working, so they sent me to an outpatient clinic that was closer to my house, and then they give me an accidental death cocktail, basically."

Thankfully, in 2013, he made his way to Washington State and found Rainier Xpress, Patrick Seifert's dispensary. Discovering the medical potential of cannabis was a game changer for him.

"I met Patrick, and they started introducing me at first into flower strains," he said. "Strains that were specifically grown for PTSD, like Nigerian Sunshine. I knew about CBDs just through my own research. I love books and I love research, so I started doing a lot of research and I kind of had an idea of what I wanted to do. With their help, they really helped me pinpoint it."

Weed also served as an effective substitute for booze. Considering that he was diagnosed with preliminary liver failure at 27, kicking pills and booze clearly was a lifesaving move. When he wanted to drink a beer, he said, he smoked a joint. If he craved a shot of whiskey, he'd do a dab. Some people said he was simply replacing one substance-abuse problem with another, but he rejects that idea.

"At the end of the day, the thing that I like to tell them is, 'What's the difference between me being hooked on the VA's drugs for the rest of my life or me being on something that's at least going to let me live?'" On weed, he said, he was able to finish his bachelor's degree within four years.

"I don't think I would have been able to do it without cannabis," he said. "If I continued down the path I was on in Wyoming with all the alcohol and stuff they had me on, I don't think I would have been able to finish school."

Or stay alive, he added.

He would have been dead "either by my own hands or by [the VA's] hands," he said. While he still has his bad days, where he cloisters himself at home and medicates all day, he has plenty more good ones.

"It's the cannabis," Andrew said. It has given him a drive and energy he hadn't previously thought possible. "For me, it's changed my life."

Asked about the VA's stance on treating PTSD with pot, he didn't mince words.

"For them to say that this is not medicine is absurd."
Inside the Fight to Study Marijuana for Vets with PTSD
The VA won't help recruit veterans for an FDA-approved trial.
Shelby Hartman Nov 10 2017, 6:57pm

In December 2014, Marcel Bonn-Miller, a longtime cannabis researcher at the VA in Palo Alto, California, sent a casual email to the head of research at the VA in Phoenix, Arizona. He, along with a team of researchers, had just received a $2 million grant from the state of Colorado to conduct the first-ever clinical trialinvestigating cannabis as a treatment for post-traumatic stress disorder (PTSD) in veterans.

Bonn-Miller’s message was brief and straightforward: we just received this money to do research on veterans near your hospital and we’d appreciate some help in recruiting volunteers. After doing cannabis research for nearly a decade at his local VA, he anticipated a supportive reply. Instead, after a follow-up call to Phoenix’s chief of research , Samuel Aguayo, he hadn’t heard back.

“I even put my fancy title in there to be like, ‘Hey, I’m a VA employee, I’m one of you guys,’” Bonn-Miller recalls. “When I didn’t hear back, I thought, this is kind of weird.”

Then, finally, he got a response. The Phoenix VA couldn’t help, Aguayo said, because cannabis is federally illegal.

Cannabis remains classified as a Schedule I substance which means, according to the federal government, it has no accepted medical use. However, the PTSD cannabis trial—the first of its kind to rigorously investigate the safety and efficacy of veterans’ claims about using cannabis for PTSD—is an FDA-approved study using cannabis given to the researchers by the federal government. These types of seemingly contradictory policies have created confusion and, some cannabis advocates argue, bureaucratic excuses which prevent progress in the arena of cannabis research.

After seven years of regulatory hurdles, the researchers finally began sending veterans through their trial in February without recruitment assistance from the VA. But now, they say they’ve exhausted all the veterans organizations near their lab and they won’t be able to find the roughly 50 more volunteers needed for the study without help from the Phoenix VA.

The leadership at the VA in Phoenix—the closest VA to the trial’s lab—still will not permit the researchers to hang flyers in their facility, talk to their clinicians, or do anything else that would inform veterans who go to their site about the study. According to Phoenix VA chief public affairs officer Paul Coupaud, that would change if Veterans Affairs Secretary David Shulkin told them to allow it.

That’s why the American Legion, the country’s largest veterans organization with more than 2 million members, has been calling on Shulkin for more than a year to tell the Phoenix VA to help. (It’s up to the Phoenix VA’s Director Rima Nelson to agree.) In late September, the Legion ramped up its efforts with a letter sent to Shulkin’s office: “…the Phoenix VA is in the best possible position to…reveal the existence of the study to potential participants,” the letter says. “We ask for your direct involvement to ensure this critical research is fully enabled.”

The trial’s principal investigator, Sue Sisley, and her team have screened more than 4,000 applicants, but only found 28 so far who are eligible. This is largely because the trial is only recruiting veterans with treatment-resistant PTSD, meaning people who have not gotten relief from the available medications and therapies. “Folks with severe PTSD are at home, isolated, living in fear every day, dealing with these dark, horrific thoughts,” Sisley says. “They’re not the ones who venture out every day so it’s really hard to find them.”

Meanwhile, inquiries about the situation to the VA’s Press Secretary Curt Cashour, who is at the federal level, have led to curt replies, including one most recently sent to Tonic stating:

“We have a hospital to run in Phoenix, and frankly [the] VA is not [Sisley’s] personal recruiting agent.” (It’s commonplace for VAs to refer veterans to non-VA studies.)

This recruitment challenge follows four years of approval processes for the study protocol and then another two years post-approval of waiting for the government to deliver the necessary cannabis. When the cannabis finally arrived last year, it was contaminated, delaying research for another four months until they confirmed it was not harmful for their volunteers.

“It’s not enough to just be a researcher when you’re trying to study cannabis,” Sisley says. “Cannabis is such a politically radioactive word that you’re forced to be in the public policy arena or you’ll never be able to do this work.”

Sisley and Rick Doblin, the founder of the Multidisciplinary Association of Psychedelic Studies (MAPS), the nonprofit sponsoring the study, say it’s their duty to not only fight for the approval to conduct their trials, but to help reform undue burdens for future researchers. That’s why, in March, after the PTSD cannabis trial was already underway in Arizona, they decided to publish the results of their independent testing of the federal government’s contaminated cannabis.

Just after they did, their trial faced another setback. Their partner, Johns Hopkins University—which was supposed to enroll half of the veterans and bolstered the study’s reputation because of their institutional prestige—withdrew from the study, citing research differences. This prompted two protests by veterans and a slew of letters from Weed for Warriors demanding a more thorough explanation. Sisley and Doblin say they think the university was concerned that being associated with researchers who criticized the government would put the federal funding they receive for other studies at risk.

Kiernan, president of Weed for Warriors and a veteran with post-traumatic stress disorder, sees Hopkins’ decision to withdraw and the Phoenix VA’s refusal to help recruit veterans as two branches of the same tree. They’re both part of the convoluted federal bureaucracy that prevents progress in cannabis research, he says.

“Is there a smoking gun?” Kiernan says. “Well, I would say it’s the lack of any movement.”

Cashour, the VA Press Secretary, has repeatedly sent the same statement to Tonic saying: “Federal law restricts VA’s ability to conduct research involving medical marijuana, or to refer Veterans to such research projects.” But Sisley and her team continue to have some unanswered questions about how this is possible when other VA sites around the country are currently conducting medical marijuana research. For example, Bonn-Miller, a co-investigator on the PTSD cannabis trial, is part of an ongoing observational study looking at veterans who use medical marijuana for their post-traumatic stress disorder at the VA in Denver, Colorado.

“I mean, if you read [Cashour’s statement] straight up for what it says then how have I been doing medical cannabis research within the VA for the past ten years?” Bonn-Miller asks.

Bonn-Miller says he’s also told the Phoenix VA that the federal government’s statement prohibits research involving medical marijuana from a state-licensed dispensary, not marijuana, which, like theirs, was provided by the federal government for a federally-approved study. The VA, locally and federally, has yet to clarify or expand their statements to account for this distinction.

“It’s like they’re saying ‘you can’t do a study on oranges’ and then I’m saying ‘well, I’m doing a study on apples’ and they’re saying ‘but you can’t do a study on oranges,” says Bonn-Miller, who’s also an adjunct assistant professor of psychology at the University of Pennsylvania.

The researchers now wonder if there’s some other reason the Phoenix VA is distancing itself from their trial, such as a bias against cannabis or their team specifically. Sisley hypothesizes it’s the former after having dealt with barriers to cannabis research for nearly a decade. But Coupaud, the head of public affairs at the Phoenix VA, implied in a phone conversation with Tonic that it’s the latter:

“I do know discussing with the director of our research department here, he has concerns about the research aspect of it. For example, Dr. Sisley operates a dispensary on her own and so that’s kind of a conflict of interest in research circles...it can kind of looks bias. I mean if she says [cannabis] is helpful, it’s like, well, obviously she’s going to say that because she owns a dispensary.”

When Tonic followed up with Coupaud about this statement, he replied via email saying that he’d heard concerns about Sisley’s bias among the research community more broadly, but not from the director specifically.

Doblin says leadership at the Phoenix VA has also told him they’re concerned Sisley might be biased because she owns a dispensary. He’s clarified with them that Sisley does not own a dispensary, but rather serves as a medical consultant for dispensaries. This is a common role among cannabis researchers and something Sisley declared to the FDA. But Doblin says that even if Sisley did own a dispensary, it would not be a valid scientific reason for hesitancies about the trial because the study protocol is designed to account for bias.

Sisley, along with the rest of the team, will be “blinded,” as required by the FDA. This means the researchers don’t have any control over the PTSD symptoms veterans report before or after the trial, and they won’t know which veterans have been given placebo and which ones received cannabis. They’ve also brought Paula Riggs, a substance dependence professor at University of Colorado School of Medicine and a vocal cannabis opponent, onto the trial to ensure that it is designed to eliminate bias.

“You have to criticize the methodology, you can’t just criticize the people, because that’s the whole point of science...the methodology eliminates bias,” Doblin says.

After months of back and forth like this with the Phoenix VA, Bonn-Miller finally decided to appeal to his contacts at the federal level in the VA’s clinical research department. His email was simple: “Thoughts? I remain perplexed by the existence of legal issues here.” They replied saying they understood the situation, but would not get involved, he says.

“Local says ‘we’re not going to do it.’ Oversight says ‘we’re not going to force their hand.’ I’m stuck,” Bonn-Miller says.

The fate of the trial now rests solely in the hands of Secretary Shulkin who, like the policies of his department, has been vague about his stance on cannabis. He said at a press briefing in May that “federal law does not prevent us at VA to look at [marijuana] as an option for veterans” and that “if there is compelling evidence that this is helpful, I hope that people take a look at that and come up with the right decision, and then we will implement that." (If the trial cannot enroll enough veterans, it will not shut down, but rather will start recruiting non-veterans with PTSD.)

Doblin said he and the rest of the team need to pressure Shulkin to tell the Phoenix VA to help them. “It’s our responsibility,” he says. “Because the VA is not doing its job.”

Meanwhile, some veterans feel like this fight is just one more development in a never-ending political saga: The government’s interference with the basic research needed to close the gap between the stories about cannabis’ efficacy and the science that could back it up.

Kiernan says that while the drama continues, dozens of vets continue to die daily from suicide and drug overdoses. Cannabis, he believes, can play an integral role in changing this, but the federal government just doesn’t care enough.

“Everyone says we need research, including the prohibitionists,” Kiernan says. “At some point we’re going to call you out on that and be like are you just being disingenuous?”

Correction 11/16/17: This story has been updated in three places. First, to reflect that the marijuana the researchers received was contaminated but was later found not to be harmful. If researchers cannot enroll enough veterans, it will enroll non-veterans with PTSD; it will not shut down. Lastly, the trial's lab is located in Phoenix, not Scottsdale. We regret the errors.

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