Colorado denies veterans medical marijuana for post-traumatic stress disorder

Cannabis was hailed as a lifesaver by many veterans who spoke at the Colorado Board of Health’s meeting this Wednesday, though perhaps none more explicitly than 33-year-old Iraq war veteran Steve Otero.

“Without cannabis, I’d be dead.”

Otero told his story to encourage the board to add post-traumatic stress disorder to the list of debilitating conditions that qualify a patient for medical marijuana.

At the hearing, Otero kept his fidgety three-year-old twins by his side while telling the board about the hardest day of his life. He was an Air Force staff sergeant in Germany at the time, standing on a stool in a garage with a noose around his neck. A civilian friend walked into the garage and offered him a joint. “I said, ‘You know what? I’m going to die anyway, so I might as well go ahead and consume this tonight and maybe I’ll get some friggin’ sleep!”

So that’s what he did.

Later, THC would come up in Otero’s urine sample, landing him in front of an army review board. He spoke honestly about self-medicating for his PTSD, and the board ended up letting him go with honor. He’s the only combat veteran in U.S. military history to be honorably discharged for openly consuming cannabis while on active duty.

After leaving Afghanistan, Otero spent three-and-a-half months in the psychiatric unit of Walter Reed Medical Center where he was prescribed a cocktail of 14 pills a day to treat his PTSD. The pharmaceuticals only made symptoms worse, he said, but after an honest conversation with his doctor about his experience self-medicating, Otero landed an extremely rare prescription in the world of veteran health care — Marinol, the only FDA-approved synthetic cannabinoid.

Since then, Otero found a treatment plan that works for him: sports, a healthy diet and regular consumption of vaporized cannabis.

He argued that medical marijuana is safer than prescription drugs for someone struggling with suicidal thoughts. “If I wanted to, I could probably go to the VA  right now and get a big bottle full of Xanax or Klonopin and kill myself with it. You can’t do that with cannabis. Now, thankfully, five years later, I don’t have the desire to take my own life.”

Otero’s story was one of many that elicited gasps and tears throughout the room, but the board insisted that anecdotal evidence isn’t enough — no matter how moving.

In the end, the State Board of Health told a room packed with people something they didn’t want to hear: Post Traumatic Stress Disorder will not be added to the list of debilitating conditions that qualify a patient for medical marijuana in Colorado.

Six board members voted against the petition, primarily citing a lack of concrete, scientific evidence to back medical claims about the efficacy of cannabis in treating PTSD.

“Their blood is on your hands!” a man yelled as he stormed out of the meeting room.

Their vote defied the wishes of both the state Medical Marijuana Scientific Advisory Council and nearly everyone in attendance. More than twenty veterans, victims of abuse and their family members gave gut-wrenching testimony.

Colorado Chief Medical Officer Larry Wolk explained the board’s decision not to add PTSD to the state’s medical-marijuana registry. “It comes down to […] whether the evidence is there to support this technically speaking. And I don’t think the evidence is there, and that’s the way the board voted.”

Wolk sits on the Medical Marijuana Scientific Advisory Council that advised the board to approve PTSD this past spring. He thinks the issue is sure to come before the board and the legislature again.

“The humanity presented today isn’t what we’re ignoring. The presentations were very convincing, very intriguing,” board member Dr. Tony Cappello said before the vote. “It’s further justification for the research that we need.”

Scientific research to support claims of the plant’s efficacy in treating PTSD is indeed lacking.

Clinical psychiatrist Sue Sisley has been working for five years to change that, but her study looking at combat veterans with severe PTSD won’t be completed for another five.

She expressed frustration with limited access to the very plant she’s meant to research. “A study looking at vets with PTSD seems like it would be expedited by the government instead of stonewalled at every turn,” she said.

Part of the holdup was that the U.S. Department of Health and Human Services required research proposals to pass a Public Health Service review in addition to the one already done by the Food and Drug Administration, she said. It was a bureaucratic redundancy not required of cocaine or heroin.

Obama got high praise from marijuana advocates for nixing the PHS review last month. But Sisley finds the praise baffling because another major obstacle remains — the National Institute for Drug Abuse (NIDA), which is the only legal supplier of cannabis for medical research like Sisley’s. She expects it’ll be another year until NIDA gives her study anything to research.

Getting NIDA marijuana is hard enough as it is, she said, let alone the particular strains she needs. NIDA contracts with the University of Mississippi, which doesn’t grow the type of cannabidiol rich cannabis she needs for the study to go forward. Cannabidiol (CBD) is the compound in marijuana that brought families of children with chronic seizures flocking to Colorado.

But she wagers her study is tied up for political reasons. “Now if we were studying harmful side effects of marijuana […] we would’ve been green lighted immediately […] But because we dared to study the effectiveness of marijuana, that puts us in this permanent limbo.”

But NIDA’s monopoly on legal cannabis for research hasn’t stopped other states from moving forward, Sisley pointed out. Washington is expected to become the twelfth state to add PTSD to its medical marijuana registry next week. So Colorado is hardly blazing the trail. “It doesn’t take a big backbone to be on the side of science. Why does that require so much courage?”

Sisley’s research got a $2 million grant from the Colorado Board of Health last year — the same board now lamenting the lack of research. She wishes that Gov. Hickenlooper would do more to challenge federal barriers. Because stalled research is one thing in bureaucratic time, but it’s another for someone trying to survive day to day.

An estimated 22 veterans commit suicide every day. By that measure, some 32,000 veterans will be lost to PTSD by the time Sisley’s research is completed in four years.

“Could marijuana help these vets?” she asked. “That’s what we want to know.”

 Correction: July 24, 2015: this article has been updated to reflect the fact that Steve Otero was treated at Walter Medical Center after a tour in Afghanistan, not Iraq.

“How High” by Alexodus, Creative Commons, via Flickr. Army salute, public domain, via Pixabay. Composite by Nat Stein.