Should Our Veterans Have Access To Cannabis?
PTSD and chronic pain are all too common among veterans. War, deployment, and active duty in general place an extreme load on their bodies and push them to their mental and physical limitations. Veterans are those who deployed or prepared to defend this country and deserve, at the very least, some reprieve from the stress that being on active duty put on them during their active duty.
In the United States and Puerto Rico, there are nearly 19 million veterans, and according to a survey conducted by the National Center for PTSD, 7 out of 10 veterans will experience PTSD at some point in their lives. A significant majority of these veterans – over 75% – served during wartime, and those who deployed are three times more likely to develop PTSD.
The statistics become even more alarming when we consider the 2022 National Veteran Suicide Prevention Annual Report, which reveals that approximately 17 veterans take their own lives each day, a rate that is 57% higher than that of civilians.
Cannabis has demonstrated substantial potential in alleviating the symptoms of PTSD, offering an alternative approach, especially considering that 2 out of every 10 veterans with PTSD struggle with substance abuse issues. Despite the Schedule 1 listing of cannabis, which limits the U.S. Department of Veterans Affairs (VA) from prescribing or recommending it, ongoing research efforts persist.
As an increasing number of studies yield promising results, the use of medical marijuana or CBD treatments is gaining traction among military personnel.
Understanding the Challenges of Those Facing PTSD
When trauma or extreme stress is experienced, the body has an intense reaction, referred to as the fight or flight instinct. Fear, stress, and other strong emotions trigger a massive surge of adrenaline and cortisol. Once this surge of hormones passes, the body enters a recovery state where the nervous system typically ‘resets’ or flushes itself. This reaction can cause some immediate effects such as vomiting that disappears after a short period of time. It is when something goes wrong with this reset, or prevention of entering this recovery phase and staying in the fight or flight state, that causes PTSD.
Post-traumatic stress disorder (PTSD) is a severe reaction that happens after a person experiences some form of extreme stress-related incident. The symptoms of PTSD are similar to that of severe stress or fear that happened during the incident and usually involve recurring thoughts about the emotions during that time. There are four major symptoms of PTSD:
- Intrusive thoughts such as involuntary memories, flashbacks, or dreams that replay the traumatic event. Sometimes these memories can be vivid enough to feel like a repeat of the event.
- Avoiding people, places, activities, objects, and situations that could trigger traumatic memories. They then resist talking about the event and their feelings during and after that time.
- Alterations in cognition and mood such as being unable to remember certain aspects of the traumatic event, life shortly before or after, and negative thoughts towards the self and other people. These thoughts can lead to continuous feelings of anger, grief, horror, or guilt, and prevent joy in previous activities that they enjoyed previously.
- Alterations in behavior and reactivity such as having angry outbursts, behaving in a reckless way, being overly suspicious of their surroundings, lack of sleep, or difficulty concentrating.
These four symptoms are recurring and can affect a person with PTSD every day. They can be minor in that only a small number of these conditions are experienced, or serious enough that the person becomes a threat to themselves and the people around them due to the intensity of symptoms.
Cannabis and PTSD: What the Research Says
THC has a chemical structure that is similar in structure to the brain’s chemical anandamide. This allows the body to interact with THC as it does anandamide (or, the “bliss” molecule), which in turn, alters normal brain communication. While this might seem like a bad thing, this altering is not necessarily harmful to the brain. Rather, this altering may reduce overactivity that causes many of the severe effects of PTSD while also stimulating happy emotions.
Several studies suggest that cannabis holds promise for treating PTSD in veterans, but it's important to acknowledge that limited research has been conducted in this area due to the current scheduling of cannabis. Currently, cannabis can only be obtained from the National Institute of Drug Abuse (NIDA), the sole FDA-approved cultivator of cannabis, and its potency is notably lower than what is available in most medical markets. Nevertheless, the findings so far are encouraging.
Researchers at Washington State University utilized data from Strainprint, a self-reporting cannabis journaling app that assesses the effectiveness of cannabis for managing symptoms. They analyzed the short-term effects of cannabis on PTSD using data from 404 medical cannabis patients who tracked over 11,500 sessions over 31 months. These sessions revealed that cannabis provided short-term relief for PTSD symptoms, resulting in a 50% reduction in symptom severity immediately after cannabis use. However, it's important to note that long-term effects were not measured, and more conclusive studies are required.
In 2020, a study funded by the Colorado Department of Public Health and Environment showed significant symptom improvements in individuals with PTSD. The study followed 150 people with self-identified PTSD for a year, with 75 participants using cannabis and 75 not using it. Check-ins were conducted every three months to assess the severity of PTSD symptoms. The researchers observed reductions in symptoms in both groups, but the reduction was more rapid in cannabis users. At the one-year mark, cannabis users were 2.5 times more likely to no longer meet the criteria for a PTSD diagnosis. Although this research focused on the civilian population rather than veterans, the results are highly promising.
Additionally, a small-scale double-blind study in Canada investigated the effectiveness of a synthetic cannabinoid in reducing nightmares among military personnel unresponsive to traditional treatments. Ten individuals were administered nabilone capsules over a 7-week period, followed by a 2-week break, and another 7 weeks of dosing. The researchers found a statistically significant decrease in the frequency and severity of nightmares over the monitored period. They concluded that further research is warranted to explore the potential of this synthetic cannabinoid for individuals with PTSD nightmares that do not respond to traditional treatment methods.
Cannabis and Chronic Pain: What the Research Says
Like PTSD symptoms, pain is also affected because of THC’s effect on the central nervous system. It tends to dull the pain signals in the body that are constantly occurring in chronic pain patients, which may lead to less pain being felt overall.
In 2020, researchers analyzed 131,582 self-reported medicating sessions collected via Strainprint. Those tracking used inhaled cannabis for either muscle pain, joint pain, or nerve pain. From these sessions, cannabis was found to decrease pain severity by approximately 42-49%. Interestingly, a larger decrease was noted for reporters who vaped versus smoked, and men reported larger decreases in pain.
A systematic review of evidence from 36 randomized clinical trials involving 4,006 participants was conducted to assess the benefits and risks of medical cannabinoids for pain management. The findings revealed that cannabinoids, when compared to a placebo, led to a significant reduction in pain, particularly during a treatment duration of 2 to 8 weeks. While oral cannabinoids showed a slightly larger reduction in pain compared to other forms of administration, the difference was not statistically significant. Overall, there is moderate evidence supporting the use of cannabinoids for chronic, non-cancer pain, but confidence in the long-term effects remains limited.
Discussing Marijuana with Your VA Provider
Despite marijuana’s listing as a Schedule 1 drug on the federal level, the US Department of Veterans Affairs (VA) will not prosecute or reduce your benefits if you discuss the usage of marijuana with your VA provider. Their website and policies dictate that VA clinicians are not allowed to prescribe, license, or endorse marijuana use, however, your VA doctor can discuss the potential benefits of cannabis with you. If you are concerned about discussing THC, the VA’s policies are as follows:
- Veterans will not be denied VA benefits because of marijuana use.
- Veterans are encouraged to discuss marijuana use with their VA providers.
- VA clinicians may not recommend medical marijuana.
- VA clinicians may not prescribe products containing THC, CBD, or any other cannabinoids.
Those who use marijuana to relieve their symptoms may be afraid to talk to the VA clinicians about their pot usage. Even if they are limited in their ability to recommend marijuana, they should know about any major changes you have made in your medicinal routine that could change how they approach your medical issues.
Of note, all marijuana use is prohibited on VA property — license or not. This is primarily due to its remaining Schedule 1 classification and the limits that are imposed on them.
Where Can I Get a Medical Marijuana License if Not Through the VA?
If you are a veteran interested in getting a medical marijuana license in a medical-use state, the specific steps to follow will vary state-to-state. Most state level medical marijuana programs require you to have a physician’s approval followed by a screening to get a license. Chronic pain, PTSD, and debilitating conditions can all qualify for a medical marijuana license. Some doctors may be more likely than others to recommend medical marijuana usage, so you should check reviews of doctors in your area before scheduling an appointment with them if you do not already have a primary care physician.
In the state of Florida, you must visit a recommending physician participating in the medical marijuana program. The physician will read your medical history and evaluate your qualifications based on the conditions and symptoms listed. If you are approved, they will then set up your profile with the Office of Medical Marijuana Use Registry, where all of your recommendations will be stored. Once your license arrives, you can purchase marijuana from any certified Medical Marijuana Treatment Center (MMTC), or medical dispensary, in your area. You can learn more about medical marijuana in Florida and the process of becoming a patient here.
Veterans and Medical Marijuana
As mentioned earlier, the VA clinicians cannot recommend marijuana in any form. Because of their limitations of prescribing and endorsing pot, many continue to prescribe opioid derivatives with serious long-lasting and addictive properties. Clinicians are restricted by the federal law as they are working under the federal government directly. An outside doctor who is not part of the VA is not restricted by federal law and can thus recommend, prescribe, and endorse marijuana use.
The harmful effects of opioids are apparent among those veterans who follow the VA’s recommendation. Veterans have been disproportionately affected by opioid overdose and are twice as likely to die from accidental overdose than civilians. The side effects themselves are much more severe than marijuana. Short-term side effects of opioids include:
- Slowed breathing
Meanwhile, once physical dependency has been established, the withdrawal symptoms can be disastrous. Night sweats, fevers, severe pain, insomnia, and more are common and may induce more negative effects than what they are meant to be treating. Veterans who are thinking about taking opioids or their derivatives should do their research before starting them. Many veterans have turned towards marijuana as a fix for their symptoms as it is non-addictive with minimal long-term effects.
If you are seeking a marijuana license or want a second option outside of the VA’s recommended prescription, make sure to find a recommending physician and follow the proper channels to receive your license.
Current Legality of Marijuana Across the United States
As of right now, 38 states have legalized marijuana for medical use and 23 for recreational use. If caught in a non-recreational or non-medical use state you could be charged with a felony depending on the amount and type of marijuana on hand. Around one ounce is often considered intent to distribute in law, which poses more serious criminal charges. Even some recreational and medically legal states will enforce a maximum limit that can be on your person at one time before being classified as unlawful. Certain states have additional restrictions, such as Texas, which considers cannabis vapes as a felony, while anything up to two ounces is a Class B misdemeanor. It should also be noted that if you are a holder of a medical marijuana license and cross state lines with marijuana, your license is not valid for that state and you can be prosecuted.
Is Medical Marijuana Right for Me?
If you are looking for pain or stress relief, marijuana may be for you. If you are interested in exploring the effects of marijuana and think it will help you, get started by filling out our Medical Card Assistance form. We're here to support you on your journey to wellness with cannabis
At MÜV Florida, our extensive line of quality medical marijuana products is tailored to potentially relieve chronic pain or disorders and comes in many variations. With more than 80 percent of veterans supporting marijuana legalization—you are not alone in trying to find an effective pain reliever. We are proud to give back in a small way by offering discounts to veterans who have served this country to help ensure plant-based alternative medicines for our heroes.
*This post was originally published on November 10, 2020 and was updated on June 18, 2021, and again on November 8, 2023, to include new statistics.
Content Manager for MÜV Florida and Contributor for Zen Leaf Dispensaries. A cannabis connoisseur with a passion for explaining the miraculous possibility of the plant, Swan began her journey with cannabis as a recreational user and quickly realized its positive impact on her depression and severe anxiety. She joined the cannabis industry as Receptionist and MedTender and witnessed first-hand the immense potential of the plant for a wide variety of ailments, deepening her passion for alternative medicine. Swan is dedicated to self-education on the plant and sharing its potential with all. She holds a Journalism degree from the University of Iowa.