When the Colorado Board of Health voted against adding Post-Traumatic Stress Disorder to the list of qualifying conditions for medical marijuana last month, a core group of advocates immediately gathered in the lobby to start plotting their next move. They had tried legislation. That failed. Then they turned to the executive branch. And that failed too. So the next step was obvious: Go to court.
Last week, five PTSD patients represented by attorneys Bob Hoban and Adam Foster sued, asking Denver District Court to reverse the state health board’s decision.
For plaintiff Matthew Kahl, access to cannabis isn’t about getting stoned. It’s about saving lives.
Kahl came back from his second deployment in Afghanistan this year with a traumatic brain injury, severe spine damage and a heavy psychological burden. Back home in North Carolina, he could barely reintegrate with his family, let alone the rest of society. A Veterans Affairs doctor prescribed Kahl a cocktail of 15-20 pills a day, but Kahl was still miserable. His liver shut down, his kidneys started to fail, and he lost the will to live.
“I was literally dying before everyone’s eyes.”
Picking at his fingernails at the Holban and Feola, LLC office in downtown Denver, Kahl told The Colorado Independent his motivation for joining the lawsuit comes from remembering what it was like to lie in a hospital bed after a suicide attempt and feel his three year old son’s hand in his.
“He’s been through too much. So I’m doing this for him and all the other kids whose parents can’t function.”
[pullquote]“22 veterans kill themselves every day. They need their medicine today.”[/pullquote]
Kahl said cannabis was a revelation for him. He had tried it once or twice as a teenager, but never considered it as a medicine. Now, he said, he wouldn’t be here without it.
“I would’ve been dead and buried a long time ago.”
Attorney Adam Foster said that after hearing stories like Kahl’s the choice to take this case on pro bono was simple. He emphasized that the health board’s July 15 decision bucked the medical community and ignored readily available scientific evidence.
Both Colorado Department of Health chief medical officer Larry Wolk and the Medical Marijuana Scientific Advisory Council recommended the board add PTSD to the list of qualifying conditions. And those recommendations were based on a growing body of research showing cannabis treats PTSD without harmful side effects pharmaceuticals often carry.
At that July 15 meeting, leading marijuana researcher Sue Sisley testified about some of the peer reviewed, published studies already out there. One found a 75 percent reduction in CAPS scores — the gold standard for measuring PTSD severity — among patients using cannabis. But board members found that existing research isn’t rigorous enough. Only a randomized control trial using marijuana supplied by the federal government would do the trick. And without that kind of study, the board felt like proper scientific backing was lacking.
Dr. Sisley is working on precisely that kind of study. She was funded more than $2 million by this very board, but has been stonewalled at every turn. Because the study has an experimental design, rigorous, by health board standards, Sisley must use marijuana grown by the National Institute on Drug Abuse. Right now, that’s her biggest obstacle.
Sisley wants to investigate the treatment potential of marijuana rich in cannabidiol. CBD is a non psychoactive compound that’s been shown to have anti-inflammatory and relaxing properties. CBD-rich cannabis is the drug that brought hundreds of families with seizure-prone children flocking to Colorado.
NIDA staff told her they’re growing a CBD-rich strain for her study, but not at the potency she requested. And she has no clue when that sub-par strain will even be available. She estimates it’ll be at least four years before she’ll have the kind of results the state health board said it needs.
“We just can’t wait that long,” she said. “22 veterans kill themselves every day. They need their medicine today.”
This lawsuit claims the state board of health established an unattainable standard by saying it needs Sisley’s results before PTSD can get added to the list of conditions that qualify a patient for medical marijuana.
“It’s as if they said, ‘You have to go to Mars to conduct this study,” said attorney Bob Hoban. It’s just not gonna happen.”
Hoban acknowledged that many PTSD patients do currently self-medicate. But they’re getting the CBD-rich strains either from the recreational market or by lying to get a medical card for some other condition. And both of those options, he said, are insufficient.
Cannabis products for the typical PTSD treatment regimen are nearly twice as expensive in the recreational market, and most dispensaries don’t even stock the CBD-rich strains that patients need. “The fact is, the rec market is made up of tourists coming to Colorado to get high just like anyone who goes to Amsterdam,” Hoban said. And they want the high potency strains with lots of THC. So that’s what’s on the shelves.”
Not only is it pricier to medicate with recreational products, it’s irresponsible.
“Patients need to be able to have open and honest conversations with their physicians. Expecting people to lie — especially people with anxiety — makes a sham of the system.”
Plaintiff Larisa Bolivar hopes that giving PTSD patients legitimate access to this kind of medicine will reduce stigma around both cannabis and trauma. She’s proud that society is more aware than ever before that soldiers suffer psychological wounds during war that need healing long after they’ve returned home. But Bolivar wants to call attention to another kind of trauma that all too often gets swept under the rug — domestic abuse.
“Women are the silent majority of PTSD sufferers,” she said. “And we need to recognize that.”
Molested as a child, Bolivar was the victim of abuse throughout her teenage and young adult life. It wasn’t until she moved to Colorado and started seeing a psychiatrist about her panic attacks that she was diagnosed with PTSD. At that point she weighed 89 lbs. When Bolivar went off all her prescription drugs and tried medicating with cannabis, her anxiety decreased and her appetite returned.
Then in her late-20s, Bolivar survived another harrowing trauma. She was held hostage by an abuser for seven months. After that, she took her advocacy to the next level, founding the nonprofit Cannabis Consumers Coalition that pushes for drug policy reform and consumers rights.
“Just to put it bluntly, cannabis saved my life,” she said. “And now my life is fighting to save others.”
The state health board has until September 10 to file a response to the complaint.
CDPHE spokesman Mark Salley said he can’t comment on pending litigation, and the Attorney General’s office didn’t respond to multiple inquiries about how the state will proceed.
Dr. Sue Sisley thinks the board’s decision was more political than it was scientific.
“Why is it that I can prescribe all these off-label drugs for PTSD, but not this natural treatment?”
There are two medications the FDA approves for PTSD treatment, Paxil and Zoloft, but they’re no more effective than placebos. So it’s common practice to prescribe a “combat cocktail” of other drugs, Sisley explained, rattling off a long list of SSRI’s, benzodiazephines and other anti-psychotics and anti-depressants. Recognizable among them are Prozac, Lithium, Klonopin and Xanax.
She’s concerned that policymakers won’t even consider alternatives to these drugs with the pharmaceutical industry as enshrined as it is.
“It reeks of political motivations,” Hoban agreed.
“From day one, the CDPHE has been like, ‘our hands are tied.’ And it’s like, ‘wah wah, boo hoo, you have to make tough decisions.’ Well that’s why you were put there.”
And this shouldn’t even be a tough decision, Hoban said. “They violate federal law every single day by regulating a federally illegal substance. And we’re talking about giving veterans access to medicine. What’s risky about that?”
If this lawsuit is successful, Colorado will be the twelfth state to let PTSD patients medicate with cannabis.