Cannabis...A Ray of Hope for Veterans

By Peter Bie

Long after leaving the battlefield — or just being in an area that is labeled a “combat zone” — veterans are often left to grapple with the invisible wounds of post-traumatic stress disorder (PTSD) and anxiety. Fortunately, there is a growing body of evidence suggesting that cannabis may offer a ray of hope for those individuals

Many veterans with PTSD and anxiety traditionally have relied on pharmaceutical medications, but these are all too often accompanied by a range of side effects, some of which can be debilitating. Cannabis, with its active compounds like CBD and THC, offers a more natural alternative with CBD showing promise in reducing anxiety without the psychoactive effects of THC. In short, reducing the anxiety without getting high.

One of the hallmarks of PTSD is the re-experiencing of traumatic events through nightmares and flashbacks. But military vets aren’t the only ones who can suffer from these symptoms: first responders, rescue workers, police, doctors, nurses, or just about anyone who has survived a traumatic incident (or series of them), is more than likely to have some form of PTSD and its accompanying anxiety. Cannabis, particularly strains rich in CBD, can help alleviate these symptoms. One potential benefit is that it may interrupt the cycle of nightmares, allowing veterans to get more restful sleep.

As many a veteran will attest, the anxiety that goes along with the PTSD often leads to mood swings, irritability, and a sense of unease. Here again, cannabis can act as a mood stabilizer, helping the individual to regain a true sense of emotional balance. The endocannabinoid system in the body plays a major role in regulating mood, and cannabinoids in cannabis may assist in this process.

Veterans with PTSD can experience a heightened state of alertness and hyperarousal, which can be exhausting and detrimental to their daily lives. As one Vietnam vet put it, “I’m always super-vigilant and aware of my surroundings, even when I’m home. And it's been over 50 years since I was there.” Cannabis may help in reducing this hyper-awareness, promoting relaxation and a sense of calm.

Recent studies have shown that cannabis could be a reliable and effective treatment for not only PTSD, but provide for less reliance on prescription or over-the-counter medications.

2019 over 500 military vets (primarily recruited from Massachusetts, which permits the use of cannabis for both medical use and for those ages 21 and older) participated in an anonymous survey conducted by the journal Clinical Therapeutics.

According to the survey data, 91 percent of respondents said that “medicinal cannabis treatment helped them to experience a greater quality of life, have fewer psychological symptoms and fewer physical symptoms. Twenty-one percent said their use of medical cannabis resulted in a reduction in their opioid use. Veterans who were Black, who were female, who served in active combat, and who were living with chronic pain were more likely to report a desire to reduce the number of prescription meds they were taking.” It is no surprise that this finding runs consistent with dozens of other studies over the past decade or so. The authors concluded that the data “should inform clinicians who work with the veteran population, as cannabis may be an effective means of helping veterans.”

In 2020 there were about 19 million vets living in the U.S. when studies showed PTSD affecting upwards of 20 percent of vets of the Iraq and Afghanistan wars, 12 percent of Gulf War vets and 15 percent of Vietnam War vets. The most alarming stat of all: upwards of 20 vets (active, inactive, retired) per day commit suicide, many due to their overuse of prescription meds, consumption of alcohol, illegal drugs, or a combination of all three along with other stress and anxiety-related problems. While the Pentagon, the armed forces and the VA have made it a priority over the past several years to prevent these suicides, the numbers remain high.

So, where do we go from here in having medicinal cannabis as an alternative and, according to various studies, what appears to be an effective treatment for vets suffering from PTSD and associated symptoms? For starters, it needs more study with more vets already in the system.

But we won’t get far if Uncle Sam continues to list marijuana (cannabis) as a Schedule 1 drug, putting it right up there with cocaine, LSD, and heroin and defined as having no accepted medical use and high potential for abuse. Because of that status, VA clinicians are prevented from even recommending medical marijuana and can only prescribe medications approved by the FDA for medical use. Most products containing THC or CBD or a combination thereof, along with other cannabinoids are not approved for this purpose by the FDA. The same VA clinicians can’t even complete the paperwork or any forms required for VA patients to participate in state approved marijuana programs. (As of this writing, 40 states and Washington D.C. have medicinal cannabis programs and 23 states and two territories recreational or adult-use of cannabis.)

On the other hand, no veteran will be denied VA benefits if they use marijuana. And vets are encouraged to discuss cannabis use with their VA providers. And even though the VA health care providers will record marijuana use in the vet’s VA medical record, this is all confidential under patient privacy laws and cannot be used as a basis for denial of treatment.

Is there a light at the end of this very long tunnel? Maybe. In late August, the Department of Health and Human Services came out with a recommendation that cannabis should no longer be a Schedule 1 controlled substance. Instead, and this is the major change, it should be re-classified as a Schedule 3 substance — defined as having a lower potential for abuse. Among that group are anabolic steroids and painkillers with small amounts of codeine.

Yet, HHS stopped short of recommending decriminalization on the federal level. How do you square moving cannabis from Schedule 1 to Schedule 3, effectively putting it on the prescription-only shelf along with several steroids and Tylenol with codeine, yet maintain the same Schedule 1 arrest and punishment laws on the books? Not to mention the states that have already legalized medical cannabis and, in many instances, have halted or reduced their enforcement of certain cannabis related laws.

In October 2022, President Joe Biden, while calling for reforming cannabis laws, noted that “no one should be in jail for using or possessing marijuana. Sending people to prison for possessing marijuana has upended too many lives and incarcerated people for conduct that many states no longer prohibit.” It gives me a tiny ray of hope that the DEA, which will have the final say on this rule change, will eventually work this out to the country’s benefit.

While cannabis shows promise in helping veterans with PTSD and anxiety, it is essential to emphasize that it is not a one-size-fits-all solution. Different individuals may respond differently, and it should be used in consultation with healthcare professionals.

Additionally, more research is needed to fully understand the complexities of the drug’s effects, especially when it comes to the use of cannabis based topical oils (for physical ailments) and micro-dosing with edibles (for any number of mental and/or internal ailments). Even the most ardent antidrug person should see the benefit in that.

We call our vets heroes and thank them for their service. Rightfully so. But beyond the cheers, the smiles, and handshakes, we owe them a much deeper debt of gratitude and our unflagging support for their physical and mental care long after they have served. They deserve no less when it comes to the use of cannabis to help relieve their pain and suffering.

[For more about how cannabis can be utilized to prevent and/or treat TBI (Traumatic Brain Injury) in our military, see the story in the Spring 2021 Issue of Cannabis By The Sea]

Peter Bie served in the U.S. Army from 1967-1970 with two tours in Vietnam.