Eighteen states allow for the use of medical marijuana to treat symptoms of post-traumatic stress disorder, but Colorado is not one of them. According to state health leaders, there’s not enough research available to make the case. That hasn’t stopped veterans who rely on marijuana to treat their symptoms.

One of those veterans is Denver resident Curtis Bean.

Blonde, with the sides of his head shaved - the top left longer - and tattoos covering both arms to the wrist, Bean surrounds himself with art. The walls of his apartment are covered in large-scale abstract paintings he’s done. Leaning against a far wall are several framed screen prints - also his.

He’s been using marijuana - either vaping, smoking or consuming edibles - for the past four years. He says it calms his nerves when his anxiety acts up, and helps him sleep at night - something he’d struggled with ever since leaving the Army.

“I was programmed, I was programmed to do one thing. I was programmed to kill, and I was programmed to fight in war,” he says. “You know, when you get out of the military and you’re a civilian, you try to be an adult in society. You know, it’s hard.”

Bean says he knew he had PTSD before he even finished his second deployment in Iraq. “I was having problems sleeping. I was having anxiety. My medic gave me some Ambien to help me sleep,” he says. He was coming off of 15 months heading a team of snipers. “A lot of action. A lot of that stuff still stays with me for sure,” he adds.

After a lengthy process, the Department of Veterans Affairs finally granted Bean his PTSD diagnosis, which enabled him to access treatment resources. It was then that Bean began a process many returning veterans are too familiar with: the characteristic trial and error of PTSD treatment.

Current approved - or otherwise accepted - treatments for PTSD

The only two drugs that are cleared for PTSD treatment by the Food and Drug Administration are Zoloft and Paxil - a class of drugs called selective serotonin reuptake inhibitors, or SSRIs. However, a number of studies have found that SSRIs can increase suicidal thoughts, an existing struggle for many with PTSD.

This has led to many physicians trying drugs meant to treat other conditions, such as lithium, intended for treating severe bipolar disorder, and various antipsychotic drugs or antidepressants that don’t fall into the SSRI family of drugs.

While the side effects may not be as dire in some cases, many of these drugs have significant impacts on quality of life.

Bean was put on a few different drugs to treat his symptoms, one of which was Wellbutrin. Initially meant to treat depression, it’s one of many drugs prescribed off-label to veterans suffering from PTSD. Wellbutrin has a laundry list of side effects, among them a loss of interest in sex. Bean - who was in his early 20’s when he was last on the drug - says it made him feel like “a zombie.”

“That’s the whole point of Wellbutrin, is to bring your lows to a manageable point,” he says. He felt the medication made it hard to enjoy life. Curtis wasn’t alone in this; many who take Wellbutrin report feeling emotionally numb.

Opioids add another layer of complication to treatment.

Opioid painkillers are often prescribed to injured veterans. For veterans suffering from PTSD, those prescriptions may have deadly consequences. Many studies show that opioid use can intensify PTSD symptoms, and PTSD increases the likelihood of opioid dependence.

Nonetheless, VA doctors prescribe opioids to PTSD patients at significantly higher rates. The VA’s researchers even acknowledge that opiate overdose deaths are twice as likely among veterans than the general population.

If you ask Curtis Bean, the solution for many veterans is marijuana.

Before moving to Colorado, Bean had never smoked marijuana. Not even in a fit of teenage rebellion. He attributes it to his Midwestern upbringing.

“I had a Marine neighbor who introduced me to it and I started trying some and I [was like] ‘well, I feel great.’ And I started doing it more and more and more, mostly I’d just do it at night to help me sleep,” he says. “Sometimes I’ll do it when I’m having a stressful day and I need to relax.”

Ever since leaving behind the traditional treatment route, Bean looks to art, yoga, meditation and recreational therapy to help himself cope. Marijuana provides relief that prescription medications simply couldn’t - not without some level of sacrifice.

“Your highs are really high, but your lows are not as low,” he says, referring to Wellbutrin “With cannabis, I’m able to manage that effectively and not be a zombie. You know, be a functional person.”

But in Colorado, Bean’s medical reason to use marijuana isn’t enough to get him a medical marijuana card.

Adding medical conditions to the approved list

When Colorado voters chose to legalize medical marijuana in 2000, Amendment 20 included examples of conditions that “reasonably may be alleviated by the medical use of marijuana.” The examples eventually comprised the list of eight medical conditions approved for marijuana treatment.

In that same amendment, the Colorado Department of Public Health and Environment is given the authority to add new conditions through petitions from patients or physicians. But in the last 15 years that the medical marijuana registry has existed, the board of health has vetoed any additions to the list. The reason often cited is a lack of peer-reviewed research trials - the kind that any medication is subject to prior to FDA approval.

Colorado’s board of health has denied petitions to add PTSD under the same logic for several years. Last year, the petition was denied against the recommendation of Dr. Larry Wolk, Colorado’s chief medical officer.

Soon, that reasoning may no longer apply.

In 2014, CDPHE kicked in more than $2 million in grant money to fund the first ever FDA-approved research study to test marijuana’s effectiveness in treating PTSD symptoms. In the study - sponsored by the nonprofit Multidisciplinary Association For Psychedelic Studies - Dr. Sue Sisley and several of her colleagues will track the impact of regular marijuana consumption on 76 veterans over three years.

While Sisley believes Colorado’s funding is a positive sign, she says three years is simply too long to wait for some veterans.

“The problem that the state of Colorado has is that they’ve got sick, debilitated PTSD patients right now who need relief,” she says. “Even if we started enrolling patients tomorrow, we wouldn’t have published data for three years. And during those three years, how many more people are going to kill themselves, and suffer needlessly? I think that the existing body of literature on PTSD is already very compelling.”

Although Sisley lives and works in Scottsdale, Arizona, she appeared in Colorado to testify before the board of health last year, extolling the benefits of marijuana as a medicine.

Sisley has also voiced support for an amendment pushed by Rep. Earl Blumenauer, D-Ore., which would have allowed VA doctors to discuss marijuana as a treatment option in states where it’s legal.

“I have long felt that it was completely irrational that we did not allow the veterans doctors - who know their patients the best - to be able to consult with them about medical marijuana. Whether it’s right for them, the pros and cons,” Blumenauer says.

Although his amendment - tacked onto a defense appropriations bill - passed both the House and Senate, it was removed before hitting the president's desk.

“We’re gonna get it eventually. But it’s just sad that we had backroom maneuvering that overturned both the votes in the House and the Senate, and for something that is so important,” Blumenauer says.

In a state like Colorado - where marijuana is legal both medically and recreationally - that inability to speak with a doctor in the VA system is one thing veterans like Curtis Bean are missing.

“It’s just frustrating, veterans are dying every day because they don’t have the proper access to resources and this is one huge resource that they’re being denied - for no reason, really,” he says.

Other problems include a higher cost for recreational than medical marijuana - sometimes twice as much - and limits on much a person can keep and grow. That’s why Bean hasn’t stopped at simple advocacy.

In early 2016, he and other veterans sought to sue the state of Colorado for last year’s board of health decision to reject PTSD from the medical marijuana program. A judge ruled in May that the board of health acted appropriately. Bean and others are appealing the decision.

Regardless of the outcome, it seems as though the tides may turn. In September, a legislative panel voted 5-0 to allow for the use of marijuana to treat PTSD symptoms. While it’s not a binding vote, it’s a recommendation to lawmakers to take up the issue when the legislature convenes in January.