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The War on PTSD

The research on cannabis is inching along, but some veterans aren’t waiting

Sarah Stenuf isn’t waiting for the scientists—let alone the U.S. Department of Veterans Affairs—to tell her how to treat the post-traumatic stress disorder that nearly destroyed her life.

“With cannabis, I see clearly,” says the retired U.S. Army Apache helicopter crew chief.

Last summer, veteran and cannabis communities anxiously awaited the results of a groundbreaking clinical study on using medical cannabis to treat PTSD in U.S. veterans. The federally-approved study was run by psychiatrist Sue Sisley, of the nonprofit psychedelic research and educational group Multidisciplinary Association for Psychedelic Studies (MAPS) and funded by a $2.156 million grant from the Colorado Department of Public Health and Environment. Despite the plant’s Schedule I status, the study earned the approval of the Drug Enforcement Administration, Food and Drug Administration and the National Institute on Drug Abuse. To earn those approvals, however, Sisley’s study was forced to use low-grade cannabis grown at the University of Mississippi, the only facility licensed by the federal government to grow the plant. Sisley’s findings are a decade in the making: In addition to regulatory roadblocks and schwag cannabis, Sisley and MAPS plods along with no support from the VA.

“All eyes are on (Sisley),” said David White, communications director at Veterans Cannabis Project, a nonprofit, veteran-run lobbying effort advocating for medical cannabis reform at the federal level.

For veterans to access medical marijuana through a VA doctor’s recommendation, Congress must move cannabis off the Schedule I listing that says the plant has no medical value, says White. But to show medical value, research is required. “Sisley’s breakthrough in even getting this study approved is a critical step in both expanding research and descheduling cannabis.”

“With cannabis, I see clearly…”

Eighteen years after the U.S. launched Operation Enduring Freedom in Afghanistan and 16 years after the start of Operation Iraqi Freedom, America is in dire need of effective treatments for PTSD, the anxiety disorder that can develop from exposure to traumatic life events such as violent crime, abuse, sexual assault or military combat. The prevalence of PTSD in the general population is about 8% according to the National Center for PTSD run by the VA; the prevalence of PTSD in U.S. military veterans that served in Iraq and Afghanistan is as high as 20%; many veterans advocates say the rate could be higher because vets are afraid to report their conditions to the VA.


Relief Won’t Wait for the Data

While veterans groups and scientists wait for Sisley’s placebo-controlled, triple-blind study to be published, Stenuf, who served a tour of duty in Afghanistan, plowed forward with her plans to open Veteran’s Ananda, a nonprofit retreat that will combine holistic treatments, some that include cannabis, and an individualized approach to the rehabilitation and support of her fellow veterans suffering from PTSD.

It will be located by her two-year-old hemp farm, Ananda Farms, LLC. Set on the bucolic banks of the Oswego River between the Finger Lakes and Lake Ontario in upstate New York, the 22-acre plot, with its private pond and six hydroponic greenhouses, is a “dream come true,” Stenuf says. The region’s rich glacier-ground soils have long supported agriculture, she says, and she purchased the property from a Mennonite family that farmed the land to USDA organic standards, which she’s upholding as she works towards certification herself.

As recently as five years ago, Stenuf, 30, couldn’t have imagined she’d be a farmer and medical cannabis advocate with a wife and kid. She didn’t think she was going to be alive. She’d been stationed at Forward Operating Base Salerno in the southeast Afghanistan province of Khost. It was dubbed “Rocket City,” for the frequent attacks it sustained, and in 2010 a mortar blew up the barracks next to where she and a colleague were taking a break.

“I had just gotten off, and was going to hit the showers,” she recalls. “But a friend asked if I wanted to join him for a smoke. If I had been in those showers, I’d have been blown up.”

Following her May 31, 2013 discharge, she descended into addiction and anxiety, medicating chronic pain, PTSD, epilepsy and the traumatic brain injury suffered during the attack with cocaine, alcohol and all the pills the VA could prescribe. In a three-year period, she attempted suicide twice.

But beginning in 2014, she turned her life around, met her future wife and sought treatment with the VA. It was in the woods behind the Canandaigua clinic outside Rochester, New York, where she discovered medical cannabis from a World War II veteran who was an amputee. One day, he asked her if she’d like to try it, she recalls. Soon, the duo was regularly sneaking off into the woods behind the clinic to smoke, Stenuf often hitching a ride on the back of his motorized wheelchair. During those first few illicit sessions, Stenuf remembers feeling joy.

“I was a zombie—I had no feelings, just hatred and depression,” she says. “And now I was feeling emotions, and I had to relearn everything from sex to socialization.”

She also discovered her endocannabinoid system, independently researching how it responds to photocannabinoids and terpenes, while also taking the time to study what really happens when we induce trauma on our brains. In addition to medical cannabis, she integrated hemp into her diet, and with the support of her wife and under the guidance of doctors outside the VA, she gradually weaned herself almost entirely off of prescriptions.

Research is critical for veterans and hundreds of thousands of Americans who know experientially how cannabis can improve mental health, she says. “Someday, we’ll have a specific cannabinoid we can take to affect our mental health in certain ways.”

But when she thinks about her family, advocacy and vision for Veteran’s Ananda, she must soldier forward on this frontier with or without data.

“I don’t see a choice,” she says.

The American Legion Goes AWOL

Neither does Army veteran Sean Kiernan, president of the California-based Weed for Warriors Project, a nonprofit with 12 chapters across the country helping veterans access medical cannabis. The battle is at a critical stage, he says, because recreational legalization has priced patients out of the legal market at the same time the nation’s most powerful veteran’s organization has backed off its push for research into the efficacy of medical cannabis.

The danger for veterans who need cannabis is acute in California where the state is cracking down on a black market that supplies many of the state’s vets with low-price medicine, he said.

In the first six months of 2019, the state’s Bureau of Cannabis Control tripled the number of raids on unlicensed sellers compared to 2018, seizing nearly $17 million in marijuana, according to the Los Angeles Times. Last July, Gov. Gavin Newsom authorized fines of up to $30,000 per day against unlicensed growers, distributors and sellers.

“When Gov. Gavin Newsome wages a war on the so-called black market, he wages a war on veterans,” Kiernan says. While the state’s recreational market “caters to Beverly Hills,” many rural communities have banned cannabis cultivation and sale outright—a right provided by Proposition 64, which codified California’s cannabis legalization—creating massive cannabis deserts between coastal communities and Nevada.

When it comes to the prospect of clinical research, liberating the plant for veterans, Kiernan is pessimistic, as support for such efforts fall by the wayside. In 2016, the American Legion, the nation’s largest veterans organization, took up the cause of medical cannabis at the behest of its members, passing a resolution calling on the DEA to license privately-funded medical marijuana production and urging Congress to recognize cannabis as a drug with potential medical value with the aim of stimulating research on the plant’s medical efficacy. The group also called on the VA to clear roadblocks threatening the completion of Sisley’s study and released a survey showing overwhelming support in the veteran community for medical research and federal legalization of cannabis.

But since early 2018, the Legion has toned down its advocacy efforts. A spokesperson for the American Legion replied to Kitchen Toke’s request for an interview on medical cannabis by emailing a link to the 2016 resolution and providing a statement that “there was nothing to report or add about it.”

“The Legion is gagged,” Kiernan says.


A K-Hole

In the last year, legislation the Legion might have supported stalled in Congress after the VA voiced its displeasure. At the beginning of May, three bills to provide access to medical cannabis for veterans were killed by the U.S. House Committee on Veterans Affairs at the VA’s behest: the VA Medical Cannabis Research Act of 2018, the Veterans Equal Access Act and the Veterans Cannabis Use for Safe Healing Act.

The federal government’s incongruity peaked at the end of June, Kiernan says, when the VA approved a pharmaceutical version of the psychedelic drug ketamine to treat PTSD dubbed “Spravato” by Johnson & Johnson. It’s “crazy” that the VA would allow vets to use ketamine, which is psychologically addictive, but not cannabis, which is far less psychoactive and not addictive, he says.

Kiernan would know: “Ketamine saved my life,” he says.

From 1989 to 1993 he served in the Army airborne infantry in Latin America—largely fighting America’s war on drugs. He received an honorable discharge, graduated from the University of California at Berkeley and worked as a hedge fund manager on Wall Street until the mental trauma of his combat experiences caught up with him in 2006. He began a downward spiral into drugs, alcohol and pills, bottoming out in 2011 when he attempted suicide.

Ketamine was the most effective drug for suicidal urges, but it’s not a long-term treatment, Kiernan says. He became addicted, it also destroyed his urinary tract and gallbladder and it rendered him completely dysfunctional: “On a mind altering scale of 1 to 100, it’s a space ride.” Cannabis, on the other hand, helped him control his PTSD symptoms and remain engaged in everyday life, he says.

Kiernan hopes Spravato helps vets. But its approval by the VA while cannabis remains illegal underscores his experience that waiting for science to pass judgement on the plant is deadly in an era where the VA’s own data showed the suicide death rate for retired and active-duty military personal at 20.6 per day in 2015. He speaks highly of Sisley’s dedication to the PTSD study over the last decade and even participated in research, but his experience with cannabis leaves him disinterested in data in favor of the positive outcomes he has witnessed. When it comes to suicide risk reduction, positive social impact and improved family health, he has seen the lives of thousands of veterans suffering from PTSD improve because of medical cannabis.

To continue to provide free cannabis medicine to California veterans, Weed for Warriors is focused on the passage of California Senate Bill 34, which would enable licensed cannabis companies to provide free cannabis to patients without being taxed.

“On top of everything else, cannabis donations for those in need of medicine are another casualty of legalization and regulation,” he says.


Oh, Canada

It doesn’t have to be this way—just look to Canada. The country’s Veterans Affairs department doesn’t just permit medical cannabis for veterans of their armed forces—it pays for it for qualifying vets. While there’s no data on medical cannabis use for PTSD available in Canada, data released last April by Veterans Affairs Canada showed that its vets were choosing medical cannabis over pills: 10,000 veterans used medical cannabis in 2019 compared to 1,700 in 2015. Likewise, in the last five years, payouts for veterans’ opioid prescriptions for fentanyl have dropped 85%, while payouts for oxycodone have dropped by 75%, according to the agency.

Medical cannabis is saving lives across Canada, says Riad Byne, CEO of Spartan Wellness. The two-year-old Toronto-based company functions as a health navigator, helping veterans use their benefits to access medical cannabis and other holistic treatments for ailments including PTSD. Byne counts himself as a cannabis success story and says the group has helped more than 2,000 veterans and first responders access medical cannabis.

“Cannabis puts me in a state of mind where I’m relaxed and can engage with my injuries.”

After 23 years of military service, including tours in Kosovo and Afghanistan, Byne was medically retired in May 2014. His myriad mental and physical injuries, including chronic pain and PTSD, had caught up with him, he said, and he soon found himself on a cocktail of pills.

“My anxiety was crippling,” he says. “I didn’t leave the house, I was overweight, I was distant from my family—I was suicidal.”

A fellow vet introduced him to medical cannabis, he recalls, and after six months of experimentation he found a balance of edibles, topicals and pills that mitigated his symptoms and helped him advance in therapy.

“I felt empowered with my recovery,” says Byne. “Cannabis puts me in a state of mind where I’m relaxed and can engage with my injuries.”

While providing safe, reliable access to medical cannabis, Spartan Wellness focuses on educating vets to find balance with cannabis through delivery methods other than smoking or vaping, says Byne. To help vets understand edibles, they’ve teamed up with British Columbia-based chef Cody Lindsay, aka The Wellness Soldier, on educational videos and seminars.

When Lindsay, who served in the Royal Canadian Navy as a cook, launched The Wellness Soldier in 2014, he heard an outcry from veterans who wanted relief from cannabis without smoking or vaping. Other veterans reached out because they liked the way the medicine made them feel, but they didn’t know how to make their own infused foods—a necessity in Canada which has been progressive on access to medical cannabis and nationwide legalization, but more conservative on rolling out a regulated edibles market.

“Every person’s relationship with the medicine is different,” he says. “I’m providing them tools to include cannabis in a healthy diet, which is key to finding healing, health and happiness for vets and first responders suffering from PTSD and other mental health issues.”

Safe, reliable access to medical cannabis has allowed Spartan Wellness to extend its focus beyond obtaining the medicine to crushing the stigma of PTSD among Canada’s bravest. For starters, Spartan Wellness refers to the condition as, PTSI, subbing “injury” for “disorder.”

“The word disorder implies infinite—you’re stuck with it,” says Byne. “But when we look at an injury we think, ‘recover.’ And everybody recovers differently.”

 

Power Muffin recipe
See the recipe for The Wellness Soldier’s Morning Power Muffin

 

It’s an important point to Lindsay, who was diagnosed with PTSD following his service as a cook in Kandahar, Afghanistan, during Operation Apollo, which supported U.S. military operations in that country following the Sept. 11 terrorist attacks. While he didn’t see combat, war was all around him. He was dropped in the war zone with no training beyond his cooking skills and no gear. Alone, scared and tasked with cooking for 300-plus soldiers, his mind began racing day and night with “what if” scenarios, and it didn’t stop when he returned home to Victoria, British Columbia. After leaving the military in 2006, he started medicating himself with cannabis and his mind “slowed down so I could see how messed up I was and see how PTSD was causing me to do destructive things,” he says.

Weed for Warriors’ Kiernan shared the experience that community advances healing. “We’re coming together to help each other because the system is failing us,” he says. The limbo in which medical cannabis exists in America “is emblematic of a system for everybody but the patient.”

“We’re only about the patient.”

Meanwhile, across the country on her upstate New York hemp farm, Stenuf is also committed to a patient-first focus. The Veteran’s Ananda approach to healing aims to include medical cannabis, yoga, meditation, therapy, lots of farming—maybe even auto repair.

“A lot of guys find it meditative,” she says. She’s focused on “adding value to my community,” and the farm strives to employ veterans and supplies hemp products to the local Community Supported Agriculture program. Most of all, though, she says she’s excited to share the serenity she found here.

“I also think (personalized care) creates a model of healing that is replicable,” she said. “We have to find successful models and replicate them to help veterans now. We can’t delay our healing any longer.”

By Alex Pasquariello
Illustration by Chema Mendez