ALBANY — Glenda Tyson, a retired captain and New York Air National Guard nurse, didn’t go far from the military after her active duty was done. She took a nursing job at the Department of Veterans Affairs, treating other former service members.
Then, eight years ago, Tyson became a patient herself. Diagnosed with multiple sclerosis, or MS, she tried many treatments to slow the progress of the autoimmune disease attacking her central nervous system, and said her body “could not tolerate” the slew of drugs. That’s when she learned that her best friend’s mother, who also has MS, used cannabis to control her symptoms.
“I’m a very active woman. So as I started to get sicker, I was looking for ways to maintain my quality of life,” the 45-year-old Tyson said. “But I was at the VA, and also still in the military. I couldn’t even think about trying medical marijuana, because I worked for the federal government,” she said, referring to the fact New York’s legalization of cannabis for medical use does not apply to federal employees or services, including veteran medical facilities.
Tyson is frustrated with the double standard and she is not alone. Many veterans have sought medical cannabis as a treatment option for common wounds of war like post-traumatic stress disorder (PTSD). Both PTSD and MS are eligible conditions under New York’s medical cannabis program.
In an ongoing federal case, three veterans and a doctor who has researched the use of cannabinoids in PTSD treatment – Dr. Suzanne Sisley – are arguing that the U.S. Drug Enforcement Administration should be ordered to reconsider its classification of cannabis as a Schedule I drug, a category reserved for substances with “no currently accepted medical use and a high potential for abuse.”
“The marijuana issue has already offered some complications, because people say, ‘well, in New York it’s legal,’” said Peter Potter, a spokesman for the Albany Stratton VA Medical Center, which serves veterans at low or no cost. He said that if VA employees were drug tested they would be subjected to the federal law prohibiting the drug outright.
“This is also true for veterans,” Potter said. “While veterans may want to pursue health benefits of marijuana, we cannot prescribe it, we won’t prescribe it, just because of the federal law.”
Tyson’s structured life has long revolved around the federal government. After her teenage years in the South Bronx, when she was a “bit of a rebel,” she landed in a boot-camp program and joined the military at 19. Since then, she has had an active career: 20 years in the military, 17 of those as a registered nurse. She also kept busy as a single mother to her two children. Due to the progression of her MS, she had to leave the military five years ago, but she continued nursing for as long as she could.
“When I retired from the military in 2016, I decided to go ahead and start taking medical marijuana, even though I still worked as a nurse for the VA,” Tyson said. “And if I was tested, I would deal with it then, because I realized how much it was helping me and my neurological functions, and even my pain.”
Tyson said that her parents, both Black Caribbean migrants from Honduras, were supportive of her medical cannabis use in part because of their knowledge of herbal medicine from before they came to the U.S. But until her MS symptoms – including loss of vision in one eye – forced her to retire from the VA as well, she had to be tight-lipped about her treatment.
“Luckily, I wasn’t caught, because it could have messed with my pension. It could have went left all the way,” she said. “But as a nurse, my quality of life is the most important thing to me. I always was an advocate for my patients, so I’m a big advocate for myself.”
Two bipartisan bills currently in Congress would, if passed, carve out specific exceptions meant to facilitate veterans’ access to medical cannabis through the VA health care system, when appropriate for their treatment.
The first, known as the Veterans Medical Marijuana Safe Harbor Act, would create a five-year cushion during which time veterans who use cannabis and their prescribing doctors would be shielded from repercussions — allowing VA doctors in states which already permit medical cannabis to consider the drug in their treatment plans. The second, called the VA Medical Cannabis Research Act of 2021, would specifically require the VA to launch a series of clinical trials on cannabis’ potential use in treating chronic pain and service-related injuries.
One of the issues often cited by both proponents and detractors of medical cannabis is the sparse research on its effectiveness, especially in rigorous clinical trials.
Some preliminary research into cannabis use in PTSD treatment has looked promising, including a 2020 paper that found that PTSD sufferers using dispensary-obtained cannabis were over two and a half times more likely than their peers to no longer meet criteria for PTSD after a year. Other research, including the first controlled trial with a placebo group, raised no safety concerns but failed to identify a significant impact of the drug in PTSD treatment – a difference co-author Rick Doblin suggested may be attributable to “the quality of the marijuana” used in the trial.
Researchers in San Diego are currently recruiting veterans for a VA-sponsored study of the use of cannabidiol (CBD) in combination with prolonged exposure therapy to treat PTSD. But the study will use a lab-created version of CBD with no tetrahydrocannabinol (THC) or other naturally occurring cannabinoids.
“The anti-cannabis crusaders and the pro-cannabis crusaders can really have these hard stances, like THC is all good, or THC is all bad,” said Eloise Theisen, president of the American Cannabis Nurses Association. “We need the research to validate a lot of what we see in practice, we really need that data to either debunk it or support it.”
Theisen came across cannabis as a treatment for trauma when she was working in oncology in California. She has seen its effects among her own patients, but feels that thorough research is “stymied” because of federal regulations, as well as fear and stigma around its use.
This past year, Theisen said, the use of cannabis in PTSD treatment plans became all the more pressing. During the pandemic, “post-traumatic stress was becoming more prevalent, even among health care professionals, because of those who were on the front lines taking care of COVID patients,” she said.
Preliminary research supports the notion that the general population of the U.S. has seen “a rise in the incidence of PTSD in a short time” during the COVID-19 pandemic. The pandemic may have also exacerbated the difficulties of those previously suffering with the condition, including veterans. A recent white paper by the Wounded Warrior Project reported that veterans experiencing PTSD symptoms during the pandemic were over three times more likely to have suffered a deterioration in their quality of life than those who did not.
Dr. Michael Kullman, a veteran who now certifies patients for New York’s medical cannabis program, says “it’s incredibly effective for PTSD” among veterans. He has also seen a number of patients who have developed PTSD from the COVID-19 pandemic, which he says is a “legitimate” pattern and one he expects will continue for a while.
While some veterans can seek medical cannabis for PTSD treatment or other service-related injuries outside of their normal VA care providers, Glenda Tyson knows from experience that that’s not always easy. It’s expensive, for one, since it is not covered like other drugs.
Tyson’s 24-year-old stepson, who has just gotten out of the military, has a history of PTSD. But she said he’s had a hard time finding someone outside of the VA to prescribe him cannabis as a treatment option.
“You still have some doctors that are scared, or are old school, or are thinking that people are drug seeking,” she said. “So you have a big population right there that can’t get help.”