When Ricardo Pereyda returned home from Iraq, he knew he was having a hard time adjusting to life at home, but he didn’t know exactly why. He was angry, he was violent, and he could not connect with his family. “I was drinking too much, I was getting in bar fights for no reason, picking fights, driving like a maniac on the highway, driving people off the road, I was in need of help.” Eventually, Pereyda learned that he was suffering from Post-Traumatic Stress Disorder, or PTSD.
According to the Department of Veterans Affairs, PTSD affects between 11 and 20 percent of U.S. veterans. It is also estimated that veterans commit suicide at a rate of 20 per day, which is 21 percent higher than the civilian adult population. The death toll from suicide exceeds the number of soldiers killed during 14 years of war in Iraq and Afghanistan.
As those wars have wound down and their veterans have returned home, the legalization of medicinal cannabis has swept the United States. Over half of states in the U.S. passed laws acknowledging the medicinal benefits of cannabis, including for the treatment of PTSD.
As it stands now, the federal government’s schedule one classification for cannabis means VA doctors in states with legalized medical cannabis are allowed to discuss cannabis as an option with their patients, but they can’t prescribe it, and insurance won’t cover it. Veterans are supposed to receive full health care through the VA, so by forcing veterans to go outside the VA for medicinal cannabis treatment, they must manage two treatment touch points and incur real costs.
For example, in Arizona it is $300 a year for a medical cannabis ID card. When you add in the cost of medical cannabis, the total cost of care can easily exceed $2000 per year. Even when veterans decide to absorb these costs and seek medical cannabis on their own, it is really up to individual doctors and VA systems how they handle cannabis consumption. Some veterans have even lost access to VA treatment after testing positive for cannabis.
Veterans in states where medical cannabis is not legal are just out of luck. But of course, the trauma of war does not discriminate based on which state someone lives in. Incidentally, the lead indicator of addiction is trauma, and states with medical cannabis have seen a 23 percent reduction in opiate addiction.
When it comes to veterans, countless numbers have reported that the use of cannabis helped them replace a multitude pills. And yet, the federal government remains unmoved. Congress periodically pays lip service to the idea of approving medicinal cannabis for veterans on the federal level, but for reasons more likely related to big industry interests than for concern for veterans, those initiatives have not panned out.
In spite of the barriers, veterans like Pereyda have found their way to cannabis in the quest to take control of their health. “Necessity converted me to cannabis, I could continue to take the prescriptions the VA was giving me and become more and more hooked on them, building up my tolerance and all of a sudden having 12 or 13 lifetime medications at 23… but one little plant has taken the place of all of these different pharmaceuticals I was given. It really has allowed me to show up for my life,” Pereyda said.
While medical cannabis remains out of the hands of many veterans, the VA is paying billions of dollars to keep harmful opiates and anti-psychotic medication in the hands of veterans, even as an increasing number are speaking out about how much those prescriptions are harming them.
After returning from war, veteran Matthew Kahl went through almost a full year and an attempted suicide before he was diagnosed with PTSD. While the diagnosis was the end of one struggle, it ushered in a new one. “I was on so many medications, between 15 and 20 depending on the given month, that my liver started to shut down and my kidneys started to shut down also. It was literally killing me, I was dying before everyone’s eyes.”
Dr. Suzanne Sisley, one of the most outspoken advocates for the use of cannabis for PTSD, echoed Kahl’s experience, and explained how her experiences with veterans led her to see the plant’s potential to help.
“You can see how quickly this snowballs where patients find themselves within a year on 10-15 different psychiatric meds all to treat these various target symptoms, and what veterans were discovering on their own… veterans were teaching themselves about how marijuana seemed to be useful for managing their symptoms. Nobody was arguing it was a cure, but all of them were suggesting that they were getting some relief of their suffering, and eventually I couldn’t ignore it anymore.”
Earlier this year, the Multidisciplinary Association for Psychedelic Studies (MAPS) officially began a study, led by Dr. Sisley, on the treatment of PTSD among veterans using cannabis. After passing through years of bureaucratic red tape, the study was finally allowed to proceed, but only through the use of cannabis cultivated by the NIH’s National Institute on Drug Abuse (NIDA) at the University of Mississippi. This is certainly a first step toward getting cannabis where it needs to be so it can help veterans, but it is not enough.
The monopoly NIDA has on growing cannabis for medical studies means that it is impossible for enough studies to get to the FDA for approval so it can become a widely available medication offered by insurance. Now more than ever, Americans are at the whim of government for their healthcare options, but the fact that veterans are at the crosshairs of these archaic, slow-moving policies should not be acceptable to anyone.
Natalie Ginsberg, Policy and Advocacy Manager for MAPS, explained how the MAPS study is meant to address PTSD, and how veterans in the study are using it. “Our study focuses on smoked cannabis via self-titration. The veterans get an amount per week, and are encouraged to take what they need each day. Since PTSD is psychological, we want people to develop consciousness about how they feel.”
Self-titration is a fancy way of saying self-regulating. In other words, there is not a specific dosing requirement, but rather, participants in the study are encouraged to use cannabis in the way that helps them most.
Ginsberg went on to explain why it is important for individuals to use cannabis on a case-by-case basis, according to their needs. “PTSD is a cluster of many different symptoms. Cannabis helps different symptoms for different people, for some it helps with insomnia and nightmares -- for something as relatively simple as sleep, it can make all the difference. Some say it allows them not to be in a constant state of fear. “
A great option for veterans struggling with PTSD, especially those whose symptoms come on suddenly (like in line at the grocery store), are vape pens. Since the point of giving veterans access to cannabis is not necessarily to bring weed culture into the military, but rather to generate healing, finding methods for consumption that make people comfortable is important. Vaporizers and ingestibles are only two of the many possibilities that veterans struggling with PTSD might partake in to help them heal. Some companies are taking notice of this need among veterans; PAX now offers a permanent 20 percent discount on vape pens for military veterans.
Pereyda, Kahl, Sisley, and Ginsberg all agree that cannabis is not a cure-all for PTSD, but they all agree that it is one of the best, most natural options available. “Holistic practices like yoga, meditation, art, exercise, talk therapy, and being outside in nature are really important alongside cannabis use, and helps amplify its healing effects. A lot of people with PTSD report a lack of interest in talking with other people, and cannabis opens them up to have conversations, which is also therapeutic,” said Ginsberg.
Ultimately, both the federal government and the VA need to move to make medical cannabis accessible to all veterans. The next step is making sure veterans do not have to bear the financial burden for their medicine, and the final step is creating change within military and American culture so that getting treatment for PTSD is not just accepted, but actively encouraged.