Is Marijuana the Answer to Help PTSD Symptoms?

As a counselor I deal with many issues, self-medicating is a big one. Chad came into my office and asked me to explain what the term “Dual Diagnosis” meant. His clinician used the term and Chad did not ask what it meant feeling he should know. I explained to him how many veterans self-medicate by using drugs or alcohol to suppress Post Traumatic Stress Disorder (PTSD) symptoms. Dual Diagnoses is described by mental health professionals as a practice that treats people who suffer from both an addiction (in Chads case Marijuana) and a psychiatric disorder (PTSD). Chad is not alone; a lot of veterans use cannabis to suppress their PTSD symptoms. In the mental health community, we see a lot of this with our veterans, some veterans refuse to use the VA because of the fear from losing benefits because of his self-medicating.

Chad struggles with PTSD and is like so many other veterans he uses the marijuana to help him sleep. The VA has said that they will not take away a veteran’s benefits for marijuana use, but so many veterans don’t believe the VA because of their past experiences, and what other veterans have been through. I have several clients who use marijuana to help them with their PTSD, they tell me but not the VA. Some veterans are scared they will lose their VA benefits, and others don’t want to be preached to about their cannabis use. According to the VA website the VA believes the use of marijuana for PTSD is a growing concern, and notes the use of marijuana by veterans has steadily increased throughout the years. In 2002 the known cases of veterans using cannabis for PTSD was 13%, that number has jumped to 22.7% in 2014. It is possible fewer veterans disclosed their usage of marijuana in 2002 than 2014 for fear of losing their VA benefits. It could also be, so many veterans have multiple deployment increasing their possibility to get combat PTSD. It is also possible the numbers are bigger because there are so many veterans like Chad who do not trust the VA.

Marijuana is not new to the military or veteran communities. Vietnam Veterans were raised in a time when the use of marijuana was normal in civilian and military communities. In Vietnam marijuana was the preferred drug for Veterans getting away from the reality of war. During Vietnam marijuana was tolerated by the higher ups even though it was illegal. It took the media in 1968 to disclosed the popularity of marijuana in Vietnam for the higher ups to cracked down on its use. Many Vietnam veterans continued to use marijuana when they returned home to survive their PTSD, and some continue over 40 years later.  

While researching this subject I found the VA to be ambivalent in their reasoning for not studying the positive effects of Marijuana for PTSD.  On the VA’s website they claim “research suggest that marijuana can be harmful to individuals with PTSD”, but also claims that little controlled research has been conducted on the use of marijuana for PTSD. In the past the VA has refused to look at marijuana as a possible treatment for PTSD. The VA recently disclosed a plan to study the effects of marijuana on PTSD patience at Phoenix, AZ and Baltimore, MD VA hospitals. We will see where the study will lead but many veterans are skeptical of the study.

It is understood that today’s marijuana is different than that of 40 years ago. The potency of tetrahydrocannabinol or (THC) has increased 10 fold and could increase the risk of adverse effects. After talking to a licensed psychologist I can see where the use of marijuana could be a problem. She suggests that marijuana decreases motivation and causes paranoia leading to other problems. If used incorrectly the usage of marijuana can also cause sexual dysfunction in chronic users. The psychologist noted the important part of the success of the study or usage of marijuana for PTSD would be educating physicians on marijuana. Prescribing the correct dosage including the level of THC, which can be controlled, is the key to a successful study.  

Chad is just one of the veterans I know that use marijuana for his PTSD. It is troublesome that so many veterans use marijuana for their PTSD and the VA is starting to look at it after 40 years. Many veterans like Chad will continue to use marijuana against the wishes of the VA. Until it is proven that the use of marijuana is or is not helpful in the treatment of PTSD many veterans will continue to use it for medicinal purposes. It’s about time the VA starts to study what so many veterans feel is helpful to them.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Psychological Medication Still a Problem at the VA

Mitch is a homeless 45 year old veteran I met in the high desert. He has a heartbreaking story that has affected his life. He was betrayed by his parents who traded him for drugs, during that time he was sexually molested from ages 5-8 before being placed in the foster care system. He has struggled his whole life because of it. When he aged out he went in the Army hoping to gain a better life. Like many veterans he joined the military to escape the situation he was in, the problem is his past followed him. He was sexually assaulted in the Army too but like many did not report it to his command. During his life he continued to excessively drink alcohol to numb his pain so he could deal with the shame of being molested and raped. Many people don't realize that in 2012 an estimated 13,900 men were sexually assaulted in the military. Men are less likely to report the sexual assault, therefore this is probably a low number. Imagine what it was like over 25 years ago. Mitch received an honorable discharge from the Army, but it was "highly suggested" he not attempt to re-enlist by his Commanding Officer due to his substance abuse.

One of the biggest problem clinicians are struggling with concerning veterans is duel diagnosis. Duel diagnosis is a combination of a diagnosable psychological disorder and comorbid substance abuse. Mitch has a duel diagnosis. He has Post Traumatic Stress Disorder (PTSD) from his molestation and sexual abuse and alcohol abuse because he was trying to deal with his PTSD. In a report published in 2009 an estimated 29% of veterans with mental health problems were diagnosed with duel diagnosis and 33% of those were diagnosed with 3 or more diagnosable disorders. I have worked with several clients that have duel diagnosis and it is troublesome to say the least.

The more I work with veterans on their mental health issue the more I see them refusing to work with the Veterans Administration’s (VA) mental health system. Mitch didn’t file a claim because of the shame. He tried to get services but he struggled to make his appointments. Most veterans who don’t trust the VA don’t file a claim and continue to self-medicate to deal with their pain, creating and maintaining their duel diagnosis. Some veterans are scared to get help or file a claim because of the VA’s reputation of giving them psychiatric drugs and sending them out the door. Some fear being forced to take medication or be denied their claim. I have talked to several veterans who have refused to get mental health assistance through the VA because of their reputation of drugging them instead of helping them with counseling. Some have been to the VA and been given medication, but stopped taking it because it made them feel worse. There are several reasons some veterans don’t seek mental health help, the fear of being catatonically medicated is one of them. The VA doesn’t feel there is a drug problem, but some veterans I talk to disagree. Whether it is the truth or not, veterans are scared to seek help due to their perception, what they read, and what they hear from other veterans.

In some VA locations a medication approach is being taken because they are overwhelmed. Between 2007 and 2013 there was a 40% increase in the number of veterans seeking mental health care in west LA alone. Where this is a huge increase in clients the number if psychologist and psychiatrists only increased by 12%. A RAND Corporation study anticipates a 30% of all Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) will meet the full criteria for PTSD, depression, substance abuse, or anxiety disorders. That is about 810,000 Soldiers, Sailors, Airmen, and Marines. There is a real problem within the VA concerning mental health issues that is not being addressed properly. The information in the media about the VA fuels veteran’s fears and feeds into their paranoia that the VA just wants to drug them and send them on their way. Many are scared to go to the VA for obvious reasons.

Fortunately, local community organizations have taken up the slack in some areas. Some states like California have mental health programs for veterans. These programs have been put into place because the VA is overwhelmed or ill prepared for today’s veterans. Also, these programs are in place to catch those who don’t trust the VA or meet their criteria for VA services. Often these services include the families of the veteran in the mental health treatment process. Also, there are multiple non-profit agencies available for services. Look at your local community for help if you do not trust or are not near a VA facility.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.