Summary: Tuscon Weekly speaks with combat veterans and MAPS-sponsored researcher Sue Sisley, M.D., about marijuana as a treatment for posttraumatic stress disorder (PTSD). Sisley is working with MAPS to address the national posttraumatic stress disorder (PTSD) epidemic through a clinical trial of medical marijuana for PTSD in 76 U.S. veterans. “I do not have any preconceived notions about how this plant works,” Sisley said. “In my role as a physician, I hear from patients that cannabis is a drug like any other drug: it has side effects, and it has benefits. The question is, do the benefits of cannabis outweigh the side effects?”
Originally appearing here.
Pedro Hernandez joined the military at the age of 19. Motivated by a drive to pay for school and provide for his family, he intended to join the Air Force. The recruiters told him it would be a six-month wait and offered him $5,000 if he joined the Army instead, so he did.
“This is war time; money talks,” Hernandez said. “I knew I was signing my life away, and I thought the more money, the more bullets I have to dodge. I’m not stupid. There comes a price for everything and that’s a bullet for every damn dollar … and did I see my five-grand’s worth.”
He went on one deployment to Forward Operating Base Loyalty in Iraq. Situated in the middle of Baghdad, he often pulled tower duty, a station that he said is reserved for enemy target practice. When he returned from deployment, Hernandez was diagnosed with post-traumatic stress disorder.
“It used to be in my dreams,” he said, “but weed stopped it.”
Between 11 and 20 percent of veterans of Operation Iraqi Freedom have PTSD, according to the Department of Veterans Affairs. Currently, the FDA has approved two medicines for PTSD treatment: Zoloft and Paxil. Both have labels warning of increases in suicidal thoughts.
Sue Sisley has seen these effects in her patients firsthand. She has been fighting to conduct research in treating PTSD with marijuana in Arizona.
“For 20 years now I’ve taken care of military vets, policemen, firemen and also tribe members,” Sisley said. “The conventional meds have a variety of some very disabling side effects from increased suicidal thinking to nausea to sexual dysfunction to weight gain.”
After his deployment, Hernandez spent his 22nd birthday in a mental institution after calling a VA hotline, threatening self-harm.
Two years earlier, Hernandez left for Baghdad on Oct. 6, 2006. His first stop was Kuwait, where they prepared troops for deployment. He met Navy SEALs and joked with British soldiers about the French. Soldiers had the opportunity to practice with their weapons, firing at the sand dunes.
“It was just a big pump-you-up,” he said. “I wasn’t pumped to go. I understand it. You’re going to war. This is mandatory.”
FOB Loyalty was a “recycled” base in Eastern Baghdad, formerly used as Saddam Hussein’s Directorate of Internal Security. The soldiers lived in tall buildings that Hernandez said resembled hotels. He said drive-bys were common and a lot of soldiers received Purple Hearts from injuries sustained within the barracks.
“Mortar time was okay,” he said. “You have a couple of stories of concrete above you. Everything else: love you, good luck.”
The environment took its toll, but the treatment from his fellow soldiers made deployment difficult for Hernandez. They would pick on him, and those who outranked him would try to make him do push-ups, an order soldiers can refuse in combat zones.
This kind of treatment follows from military hierarchy. Hernandez wasn’t a “grunt,” a soldier who leaves base to go on patrols. He was an engineer who did construction on base.
“They were the grunts,” he said. “I wasn’t a grunt because I did construction. You’re lower than low. I wasn’t a soldier because I didn’t carry a weapon. Of course, that pushed down the self-esteem.”
That’s how Hernandez felt during most of his deployment: isolated from the other soldiers in his battalion.
He had few friends on deployment. His best friend was another private first class he met at Fort Carson, Colorado, prior to deployment. His name was PFC Clinton Tyler McCormick, a combat engineer nicknamed “Peanut.”
Hernandez remembers a night walking to the corner store at Fort Carson and singing to Peanut’s girlfriend, Courtney, over the phone. It was her birthday. Another time, in Kuwait, Peanut fired a weapon too close to his face at the behest of senior soldiers and gave himself a bloody nose.
Peanut was killed by a roadside bomb in Iraq, two days after Christmas.
“When I found out my friend died, I couldn’t breathe,” he said. “I didn’t want to believe it.”
Now, Hernandez finds friends at the 420 Social Club on Fourth Avenue. The club provides a safe place where medical marijuana patients can medicate safely, many of them veterans with PTSD.
“It’s just a great opportunity to be a collective of people with the common goal, which is life, love and happiness, and that’s ultimately what the 420 Social Club agenda is,” said Fernando Ochoa, one of the club’s members.
Mark Brown is one of three veterans who founded the club. He strongly believes in using marijuana to treat PTSD.
“Not only does marijuana help with PTSD, but just growing the marijuana is therapeutic,” he said. “It gives them something to live for.”
Hernandez attributes his recovery to more than marijuana. He enjoys the biographies of other veterans, which provide validation for his experience. Therapy, unwavering faith and his four- year-old daughter have given him the strength to face his battles head-on.
While in the tower, Hernandez remembers a little girl with brunette hair, who would wave to him every time she walked by. He wasn’t allowed to wave back, so he would lift his fingers from his weapon in a signature wave, instead. That’s when he knew he wanted a daughter.
Hernandez’s daughter, Hazel Marie, or Hazelnut, is named after Peanut.
“I wasn’t meant to be a soldier,” he said. “I wanted to be an airman, not a grunt.”
One day in the tower, Hernandez was stationed with a sergeant who was shot by a sniper. The sniper killed the sergeant with a single shot through a 6-inch opening in the tower window and hit a gap in his armor the width of a dime near his left shoulder blade. The bullet went straight through his heart.
“The enemy sniper killed that sergeant that was beside me in this impossible shot, and he was doing it constantly,” Hernandez said.
Hernandez spent 15 months in Iraq. His deployment was extended halfway through. When he came home, he didn’t want to go back.
“You have to relive your worst day over and over,” he said. “It just turns into a boring movie after that. It’s like Groundhog Day.”
Using marijuana doesn’t rid him of the pain, but it allows him to manage it.
“When I’m high, it feels like when I wake up from a good nap,” he said. “There’s pain, but I don’t fear. It’s not going to hurt me.”
Hernandez’s struggle parallels that of many of the members at the 420 Social Club. While many members are veterans, not all have PTSD related to combat. Some non-veterans have PTSD, as well, and the club provides a place where they belong.
“A lot of people, wrongly, felt opposed to the law because of a plant,” Ochoa said. “Nowadays it’s not like that. Everyone here has heart, has vision, has purpose, has motivation, and we come together and collaborate. For me, it’s a home away from home.
Brown has gathered several veterans who use medical marijuana at weekly veterans meetings. A large part of the meetings’ purpose is to help publicize marijuana as an alternative to what they consider more-dangerous drugs provided by the VA for PTSD.
“The problem with our guys with PTSD is they’re going to the VA, taking the drugs that they give them, mixing it with alcohol, and they’re ending their lives,” Brown said.
Dave Croteau helps run the veterans meetings at the social club. He hopes that medical marijuana could provide an alternative to the treatment the VA provides for PTSD, which doesn’t include prescriptions for marijuana.
“I see the need for us to organize to help each other,” he said. “There’s so many things ending the war on marijuana would relieve. At the peak of it is this issue with regards to veterans’ health.”
Gabriel Guerra attended the veterans meeting for the first time on Saturday. He was in the Marines and deployed to Iraq in 2007. He was diagnosed with PTSD in 2009 after being discharged.
“They had me on 100 mg of Zoloft, and I didn’t like that feeling,” he said. “I didn’t like what it was doing to me.”
Guerra said it made him numb. He would throw up and have panic attacks. Since he started medicating with marijuana, he doesn’t feel like that.
Sisley hopes her research can provide an alternative to the VA’s treatment of PTSD, but acknowledges marijuana requires additional research to determine its efficacy.
Inspired to start studying the beneficial effects of marijuana, Sisley formed a partnership with the Multidisciplinary Association for Psychedelic Studies in 2009.
She had intended to conduct the study at the University of Arizona, but was fired in June 2014 for what she believes were political reasons in relation to her lobbying the state legislature for funding.
To conduct the study, MAPS had to get approval from the FDA, National Institute on Drug Abuse, Department of Health and Human Services and the Public Health Service, a branch of the HHS. The process has taken more than six years to complete.
“It can take months to respond, years if they want,” Sisley said. “Law enforcement agencies appear to be systematically impeding this process.”
After Sisley was fired from UA, the study lacked funding until the Colorado Department of Public Health and Environment gave $2.16 million to MAPS to conduct the study.
The problem then was receiving the marijuana for the study from NIDA. NIDA holds the only license from the DEA to provide marijuana for scientific study, resulting in a monopoly on growing. Under the Controlled Substances Act, NIDA is required to provide an adequate, uninterrupted supply of marijuana for research.
Sisley argues NIDA has never produced an adequate or uninterrupted supply of marijuana, hindering the scientific study of marijuana as a treatment for diseases such as PTSD.
Rick Doblin, MAPS founder and executive director first realized the issues surrounding the NIDA monopoly in 1999 and has been fighting to end it ever since.
The efforts of MAPS lobbying helped lead to the dissolvement of the PHS in August 2015. Two months later, one of MAPS’s partners, Lyle Craker of the University of Massachusetts-Amherst, won a 15-year battle with the DEA for permission to grow marijuana for medical research.
Sisley’s study involves randomly assigning test subjects to four different groups with varying levels of tetrahydrocannabinol, the main psychoactive ingredient in marijuana; cannabidiol, the pain-reduction chemical in marijuana; and a placebo.
NIDA provided most of the strains, except for the one with equal amounts of both THC and CBD. Sisley requested a strain with 12 percent THC/CBD, but received only 9 percent THC/CBD.
“As a rule, monopolies are terrible, and here’s a perfect example,” Sisley said. “They don’t have anyone to compete with, so why would they make any effort to be responsive to the public? They’re not.”
According to Sisley, NIDA doesn’t provide adequate information about the marijuana they produce, either. Most drugs for study contain a “drug master file.” NIDA has never provided a drug master file for its marijuana, leaving researchers to guess if the product contains mold, pesticides and other information about the marijuana.
“There are literally hundreds of expert growers around the country that can do what NIDA does and do it 100 times better,” Sisley said.
Canada, for example, has more than 30 licensed growers.
MAPS agreed to conduct the study with the 9 percent THC/CBD strain and settled on two locations for the study: John Hopkins University and Sisley’s site in Phoenix.
Sisley is screening patients now, hoping to begin the study soon and conduct Arizona’s only marijuana efficacy study.
“I do not have any preconceived notions about how this plant works,” Sisley said. “In my role as a physician, I hear from patients that cannabis is a drug like any other drug: it has side effects, and it has benefits. The question is, do the benefits of cannabis outweigh the side effects?”
She believes the answer is yes.
If Sisley’s research shows positive results, then it may help legitimize medical marijuana as treatment for veterans like Hernandez, Guerra and Brown, void of side effects like depression and suicide.
“The only thing standing in our way is the federal government,” Brown said. “If we can get them to step back and not force the pharmaceuticals on us, then we’ll be a lot better off. If you could have a safer option, then that is a better option. Marijuana has never killed anybody.”