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Five Questions: Can marijuana help military veterans with PTSD?
U.S. military members exposed to war or combat are at high risk of developing post-traumatic stress disorder, a condition that affects almost 8 million American adults. At Veterans Affairs hospitals across the nation, the number of prescriptions written to treat PTSD has been on the rise since 2001. However, these medications can have severe side effects and often fail to offer relief. Many veterans have found their only respite comes from a drug that is illegal in Texas: marijuana.
William Martin, director of the Baker Institute’s Drug Policy Program, wrote about the problem in "War Without End," published in the June 2014 issue of Texas Monthly. Below, he offers his insights on how marijuana can help veterans with PTSD:
How prevalent is PTSD among U.S. military veterans?
Estimates vary widely. The most common figure for some time has been 20 percent of combat veterans. The Department of Veterans Affairs estimates that 11-20 percent of veterans of the Iraq and Afghanistan wars and 30 percent of Vietnam veterans experience PTSD. The higher estimate for Vietnam vets may well reflect a longer time period for symptoms to develop and be diagnosed. A recent poll by The Washington Post and the Kaiser Family Foundation found that more than 40 percent of Iraq and Afghanistan veterans display signs of mental and emotional health problems characteristic of PTSD.
What are the effects of PTSD among veterans?
Common symptoms include re-experiencing traumatic events or circumstances through flashbacks or nightmares, insomnia, depression, fear, hyper-vigilance, anger, aggression, irritability, estrangement and isolation from family and friends, reckless or self-destructive behavior, and, tragically, suicide.
What are the benefits of using marijuana instead of prescription drugs to treat PTSD?
VA doctors have typically treated patients who presented symptoms of PTSD with powerful opioid pain-killers such as Vicodin and Percocet, anti-depressants such as Paxil and Zoloft, anti-anxiety and muscle-relaxant benzodiazepines such as Xanax and Valium, and sleeping pills such as Ambien. One of the veterans I interviewed for my recent Texas Monthly article said, “They would hand out prescription medicine like Skittles. The amount of medications you would get was just unbelievable.” Repeatedly, veterans I interviewed said these medicines left them feeling like “pilled-up zombies.” And when used in combination with alcohol or each other, they can be deadly.
Cannabis — marijuana — is an exceedingly complex plant, containing more than 100 “cannabinoids,” chemicals unique to the cannabis plant. Tetrahydrocannabinol (THC), the ingredient in marijuana that produces the “high,” is the best known of these, but another major chemical, cannabidiol (CBD), can reduce inflammation, pain and anxiety, and help mitigate painful memories. Dr. Raphael Machoulam, the Israeli chemist who identified THC and who continues to study the myriad components of the plant and their effects on the brain, believes smoking, eating or otherwise ingesting all the plant’s natural cannabinoids is more effective than trying to isolate one or two components and turn those into medicines. He calls this the “entourage effect.” The components of the cannabis plant work better together than in isolation. In contrast to the common assertion that marijuana is a “gateway” to using harder drugs, many veterans describe it as an exit drug that enabled them to conquer their harmful use of alcohol and prescription drugs.
Does using marijuana to treat PTSD qualify it as medical marijuana?
Not everywhere. At present, 22 states and the District of Columbia have some system of medical marijuana. Eleven states currently recognize PTSD as a qualifying condition. It is quite likely that both of these numbers will increase in the near future, even in 2014.
Although a majority of Texans support legalizing medical marijuana, what are the political hurdles to making it law? How have Texas politicians, especially those running in the 2014 elections, responded to the issue of medical marijuana?
Washington state and Colorado both allow citizens to gather enough signatures to place initiatives or referenda on the ballot, and then let voters decide directly. Seven other states, including California and Oregon, also have ballot initiatives underway. But Texas has no initiative or referendum process, so legislation must go through the legislature, where marijuana is a much tougher sell. Good legislation can be — and frequently is — blocked at various points along the way, from a committee chair refusing to give a bill even a preliminary hearing to having a bill that has made it nearly all the way through the maze die when the session ends before the bill could come to a final vote.
Legalization of marijuana even enjoys considerable support in the conservative quarter. The Koch brothers, the Cato Institute, the Hoover Institution, George Shultz, Grover Norquist, Newt Gingrich, The Economist, the Wall Street Journal and a sizable contingent of tea party libertarians have all called repeatedly for some form of legalization.
In Texas, Gov. Rick Perry favors some form of decriminalization and claims to have no objection to other states’ deciding to fully legalize its use, but among other prominent Texas politicians, attitudes fall along predictable lines. Democratic candidate for governor Wendy Davis told the Dallas Morning News that she also favors lowering the penalties for possession of small amounts and believes medical marijuana should be allowed. But her Republican opponent, Attorney General Greg Abbott, says he “supports Texas’ current drug laws,” and state Sen. Dan Patrick, the Republican candidate for lieutenant governor, called changing Texas’ drug laws “a nonstarter.” His opponent, Democratic state Sen. Leticia Van de Putte, is “open to the idea of reducing charges brought against individuals arrested with small quantities of marijuana” and “to discussing potential ways in which marijuana can provide medical benefits.”
No one realistically expects the Texas Legislature to legalize medical marijuana in its 2015 session, but bills will be brought and are likely to get much wider and open attention than in any previous session. It may take two or three more sessions before veterans and other people will be able to benefit legally from this helpful and, in some cases, life-saving plant.
To learn more about using marijuana to treat PTSD, read Martin’s Texas Monthly article “War Without End” or register to attend “Texas Monthly Talks: Can Marijuana Help Veterans With PTSD?,” to be held at the Baker Institute on June 18.
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Bakers endow new Djerejian fellow
The Honorable James A. Baker, III, 61st U.S. Secretary of State, and Susan G. Baker have generously established an endowed fellowship to honor the work of Edward Djerejian, the founding director of Rice University's Baker Institute for Public Policy, and his wife, Françoise.
Recognizing the importance of the Baker Institute's Mexico Center, the Djerejians directed the endowment to Tony Payan, director of the Baker Institute Mexico Center, as the first Françoise and Edward Djerejian Baker Institute Fellow.
“When Susan and I proposed to Ambassador Djerejian and Françoise to consider coming to Houston to lead the Baker Institute for Public Policy, none of us could have then foreseen its meteoric rise to become one of the top public policy think tanks globally,” Baker said. “Ed and Françoise's long and distinguished foreign service career and their experience, level of dedication, vision, commitment and team effort have contributed in large part to our unparalleled success, and Susan and I could not be prouder to honor their work.”
Payan will lead a policy study group composed of fellows and scholars from the Baker Institute and from leading institutions in Mexico. He will focus the Mexico Center's crucial research on policy issues facing the U.S.-Mexico relationship, including border, trade, energy, infrastructure, telecommunications, migration, education, health, security and rule of law issues.
“Our endowed fellowship cements U.S.-Mexico policy expertise at the Baker Institute for Public Policy,” Djerejian said. “Our proximity to Mexico affords us a privileged position to achieve the ambitious goal we have set for ourselves — namely, to establish the Baker Institute for Public Policy's Mexico Center as the pre-eminent source of findings on the study of U.S.-Mexico relations. In keeping with the Baker Institute's commitment with respect to all of its activities, we intend to influence the highest level of policymaking of both the United States and Mexico governments.”
“I’m deeply grateful to Secretary and Mrs. Baker for endowing the Françoise and Edward Djerejian Baker Institute Fellow, and to Ambassador and Mrs. Djerejian for providing me with the opportunity to conduct important and meaningful research at the Baker Institute for Public Policy,” Payan said. “Both are incredible honors.”
Payan received his doctoral degree in international relations from Georgetown University in 2001. His work theorizes on various topics regarding international borders, including border governability, foreign policy attitudes on the border and the manifestation of U.S. foreign policy at its borders. He has authored two books, “Cops, Soldiers and Diplomats: Understanding Agency Behavior in the War on Drugs” and “The Three U.S.-Mexico Border Wars: Drugs, Immigration and Homeland Security,” in addition to numerous book chapters and academic articles. He joined the Baker Institute staff in 2012.
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For a complete list of upcoming events, visit our events page.
Research and News
For a complete list, visit our research library.
- How Should the National Football League Tackle Unproven Stem Cell Treatments?, by Kirstin R.W. Matthews, fellow in science and technology policy, and Maude Rowland Cuchiara, Baker Institute scholar for science and technology policy. June 5
- The rise was stunning, but Qatar has plenty of other worries besides football, by Kristian Coates Ulrichsen, fellow for Kuwait. June 5
- Health Policy Research Newsletter — June 2014, by Laura Petersen, director, Center for Innovations in Quality, Effectiveness and Safety, and associate chief of staff for research, Michael E. DeBakey VA Medical Center. June 2014
- Energy subsidies: easy to enact, difficult to retract, by Jim Krane, Wallace S. Wilson Fellow in Energy Studies. May 31
- An unhealthy system, by Hagop Kantarjian, Baker Institute scholar in health policy. May 30
- Travis County not an ideal venue for Perry, by Mark Jones, fellow in political science. May 27
- Can Marijuana Help Vets With PTSD?, by William Martin, Harry and Hazel Chavanne Senior Fellow in Religion and Public Policy and director of the Drug Policy Program. May 22
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Baker Institute Blog
- President Obama takes positive action on climate change, by Ron Sass, fellow in global climate change. June 10
- Parallels between the Affordable Care Act and the Civil Rights Act of 1964, by Hagop Kantarjian, Baker Institute scholar in health policy. June 9
- Texas voters will push for marijuana legalization by 2019, by Zoe Russell, assistant executive director of Republicans Against Marijuana Prohibition. June 6
- When will marijuana be legal in Texas? Maybe not till 2023, by Jerry Epstein, co-founder and president of the Drug Policy Forum of Texas. June 5
- Marijuana won’t be legal in Texas anytime soon, by Mark Jones, fellow in political science. June 4
- Texas will legalize medical marijuana in 2015 and regulate marijuana similarly to alcohol in 2017, by Steve Nolin, executive director of the Houston chapter of the National Organization for the Reform of Marijuana Laws. June 3
- Texas will legalize marijuana in 2019, by Rob Kampia, co-founder and executive director of the Marijuana Policy Project in Washington, D.C. June 2
- Five questions: Why the world is watching India’s new PM, by Russell Green, Will Clayton Fellow in International Economics. May 28
For a complete list, visit the Baker Institute Blog.
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Rice University's Baker Institute for Public Policy is a nonpartisan public policy think tank located in Houston, Texas. The institute's distinguished fellows and scholars conduct research and collaborate with experts from academia, government, the media, business and private organizations on domestic and foreign policy issues with the goal of bridging the gap between the theory and practice of public policy.
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