“One of the difficulties with post-traumatic stress disorder is that the readiness or need for treatment may emerge years after the trauma. Therefore, veterans and their families need long-term treatment options and long-term access to treatment, even if symptoms are not present at their time of discharge.” -William H. Braun, from Veteran’s for Medical Marijuana
Post Traumatic Stress Disorder (PTSD) wreaks misery on soldiers and families. Military training, combat experience and traumatic events like sexual abuse often radically change cognitive functioning. Unable to process peacetime situations without infusing combat conditioned responses, PTSD sufferers live chaotic, often isolated lives. Approximately 6500 veterans and 349 active service members committed suicide in 2012. The United States Veterans’ Administration (VA) is tasked with providing medical care for all honorably discharged veterans. This includes some psychological care.
A veteran with PTSD faces life and career altering choices. The VA does not dissuade this notion, advising on their website. “You may think that avoiding your PTSD is critical to keeping your job. But if your PTSD symptoms are getting in the way of doing your duties, it is better to deal with them before they hurt your military career. Getting help for PTSD is problem solving.”
The VA outlines several treatments, “cognitive processing, prolonged exposure treatment, mindfulness practice” to name a few, but provides more extensive information for psychiatrists prescribing Selective Serotonin Reuptake Inhibitors (SSRIs), antidepressants and other prescription drugs. “The only two FDA approved medications for the treatment of PTSD are sertraline (Zoloft) and paroxetine (Paxil). All other medication uses are off label, though there are differing levels of evidence supporting their use…” In a series of videos linked to the site, Psychiatrist Matthew J. Friedman of the VA National Center for PTSD explains that his patients “usually use these medications indefinitely.”
“David” is a former Army Corporal 1st Cavalry who served two terms in Iraq as a chaplain’s assistant in a 900 troop infantry unit. He started suffering from night terrors during basic training after performing sleep deprivation exercises. “I’m dead asleep, having a nightmare. They call me back. I try to explain to them that my time is done. Then I’m in Iraq and it’s hitting the fan and I can’t find my weapon! I don’t remember the rest, but if someone comes into my room or makes the slightest noise, I jump up in the fighting position, screaming, cursing, telling them that I am going to rip them in half. I’ve punched people, thrown stuff. My brother has kicked my ass my entire life, whenever it happens he’s terrified.”
Before enlisting, David was a teetotaling Protestant and devout believer in “George Bush, the War in Iraq, all of it.” Responsible for protecting unarmed rabbis, priests, imams and monks as they performed their duties, he screened soldiers seeking spiritual advice to make sure they weren’t a threat. “They told me all the stories, so I know how every one of their buddies died in detail. Then I would prepare their memorial services.” With the clergy’s help, David implemented a system to make sure those close to a fallen comrade didn’t sleep where they could see their friend’s empty bunk, a common trigger for night terrors. Many soldiers were simply “too far gone,” and referred to psychiatrists.
“More often than not, that’s the route that ends up happening. These people cannot handle it. They were not right for the situation. They thought they wanted to kill people without having any idea what that means. And then the reality bomb hit them so hard that they just couldn’t recover from it.”
For David, healing from the trauma of seeing friends grotesquely killed, sexual harassment from a senior officer, a broken engagement during his first tour, and the shock that George Bush was “just a spokesman for the oil industry” was found primarily through frequent sessions “talking for hours with a Rabbinical scholar while smoking joints.” After a few months processing the theological, political and personal ramifications of the war this way, he realized his night terrors were becoming less frequent. “I wasn’t smoking every night, so I didn’t see a correlation that it was stopping the night terrors.”
Four years back in the US and still waking violently to the slightest sound, David “just couldn’t take it anymore” and sought help from the VA. He told a physician’s assistant that he suspected marijuana might be helping, but worried about side effects. “All the research I had done said it was safe. The guy was very casual, but he recommended that I stop using it because they had stuff that would do the trick.”
The assistant prescribed diphenhydramine (Benadryl), an allergy and sleep aid, and “some blood pressure pills to make my heart slow down and stop the nightmares.” The treatment didn’t stop the problem and left him groggy and dysfunctional in the morning. “Benadryl hazes you, whereas weed, especially Sativa, makes me think clearer.”
David worries that he might “start liking marijuana too much and abuse it,” but prefers to take that risk over a lifetime experimenting with prescription medications. “I don’t subscribe to that way of thinking. I am completely 100 percent sure that marijuana cured my night terrors. My brain operates at a higher level than normal about my surroundings and I think about things in a much more peaceful way. My roommates can walk into my room now when I’m asleep and I’m like, “Hey, Dude.”
Years of persistent lobbying by the advocacy group Veterans for Medical Marijuana goaded the US Veteran’s Administration to clarify its stance in a January 2011 memo. “VHA policy does not administratively prohibit Veterans who participate in state marijuana programs from also participating in clinical programs where the use of marijuana may be considered inconsistent with treatment goals. Patients participating in state marijuana programs must not be denied VHA services. If a patient reports participation in a state marijuana program to a member of the clinical staff, that information is entered into the ‘non-VA medication section’ of the patient’s electronic medical record.”
Currently, the medical establishment waits to see if specific molecules can be isolated from cannabis and used to treat specific symptoms. With new strains bred daily across a multi-billion dollar global industry, testing with scientific certainty is an elusive goal. Several small studies are currently being funded and undertaken by federal and private researchers. For veterans and those close to them experiencing PTSD, research into treatment opportunities is crucial to finding a path to recovery.
Experimenting with treatment for mental disorders is extremely dangerous. Cannabis Now does not advocate or repudiate any particular course of treatment, but all available studies have shown that talking to friends, loved ones and professionals about PTSD triggers is vital to recovery. Veterans for Medical Marijuana urges those seeking treatment to, “Be assertive, every veteran deserves any, and all, medical and/or psychological help.”
Looking for more resources?
United States Department of Veteran’s Affairs National Center for PTSD
Veterans for Medical Marijuana Access
Multidisciplinary Association for Psychedelic Studies Medical Marijuana Research Page
PTSD Forum – Chat rooms, information, videos and music
American Academy of Cannabinoid Medicine
This story was originally published in the print edition of Cannabis Now.