Officially, Rick Fabian uses

to relieve severe pain from a litany of health problems. But more than pain, the 60-year-old Vietnam vet relies on the drug to blunt the debilitating symptoms of post-traumatic stress disorder.

"I was a crabby vegetable, my wife says," said Fabian, who lives in Corbett. "I am still a little bit high maintenance, but I do better. ... I am not saying I am cured, but I am kinder and gentler to people. I am happier."

Oregon medical marijuana advocates are laying the groundwork to add PTSD to the list of conditions that qualify patients to use medical marijuana. They say many with the disorder are already in the state program because they have other medical conditions that allow them to legally use the drug. But as more veterans return home and struggle to resume their lives, advocates say it's time to recognize PTSD as a stand-alone condition.

Medical Marijuana

As with virtually all marijuana-related matters in the United States, the debate over expanding Oregon's program to include PTSD is politically charged. The drug's outlaw status under federal law makes it a lightning rod for controversy. Two previous attempts to add PTSD to Oregon's program have failed, and Colorado and Arizona officials recently rejected efforts to add the condition to their medical marijuana programs.

Law enforcement in Oregon generally opposes the expansion of the program. Some drug treatment providers caution against treating PTSD sufferers with what they view as an addictive drug.

Oregon is home to an estimated 300,000 veterans, including more than 20,000 from the Iraq and Afghanistan conflicts, according to the Oregon Department of Veterans' Affairs. A 2008 Rand Corporation study found nearly 20 percent of Iraq and Afghanistan vets reported PTSD symptoms.

Jason Hansman, senior program manager for the Iraq and Afghanistan Veterans of America, said medical marijuana's potential to help sick veterans deserves serious examination.

"We treat it like any other new treatment technique: We want to see it studied. We want to see increased research to see if it's a viable solution," said Hansman, whose group represents 145,000 veterans.

But Darryl Inaba, director of clinical and behavioral health services at the Addictions Recovery Center in Medford, opposes expanding Oregon's medical marijuana program to include PTSD.

PTSD sufferers, he said, should be treated with medications that don't post the same addiction risk.

"People have to realize marijuana is very addicting," said Inaba. Although he emphasized that he sees some medicinal value in marijuana, Inaba said the drug "causes both physical and emotional addiction."

Growing the program



But some veterans say they rely on medical marijuana to function.

Program now

These are the conditions for which someone can obtain an Oregon medical marijuana card:

Cancer, glaucoma, agitation due to Alzheimer’s disease, HIV/AIDS, cachexia (a weight loss disease that can be caused by HIV or cancer), severe pain, severe nausea, seizures including but not limited to seizures caused by epilepsy, persistent muscle spasms, including but not limited to spasms caused by multiple sclerosis

Jared Townsend, a 27-year-old Iraq War veteran, depends on the drug to help him sleep and, as he puts it, "balance life out a little bit better."

The Hillsboro man qualifies for medical marijuana due to severe pain from a ruptured disc and injured shoulder, injuries from his 2007-08 combat tour. But the drug is a bigger help with his PTSD symptoms.

"If I get racing thoughts and real worked up, it can break a panic attack pretty quick," Townsend said.

Seventeen states and Washington, D.C., have medical marijuana laws, but only a few list PTSD as a qualifying condition.

In New Mexico, which legalized medical marijuana in 2007, the inclusion of PTSD on the list has been significant. The New Mexico Department of Health said 40 percent of medical marijuana patients list PTSD as their qualifying condition, far more than any other condition.

But expanding Oregon's medical marijuana program to cover more conditions isn't easy.

First, a person must submit a petition to add a health condition. The state then convenes a panel of experts to review it. The Oregon Health Authority selects who sits on the panel, which in the past has included people who advocates say opposed marijuana's medicinal use.

Since the program's implementation 14 years ago, only one new condition – agitation related to Alzheimer's disease – has been added to the list of conditions.

Brian Michaels, a Eugene attorney said he and other advocates are pushing for a new system for evaluating which health problems to add. They're hoping Attorney General Ellen Rosenblum, whose job includes advising the medical marijuana program, supports efforts to change the process.

Michaels said medical marijuana participants and supporters viewed Rosenblum's predecessor, John Kroger, a former federal prosecutor, as hostile to the program. Pro-marijuana groups gave Rosenblum $200,000 in her primary campaign, about a third of her total.

"We are not expecting Ellen to be a big medical marijuana supporter," Michaels said. "We just want her to advise the agency to advance its interest in administering the Oregon medical marijuana act."

What researchers say

States considering whether to add PTSD to their medical marijuana programs face a lack of research on the topic, and that's not likely to change anytime soon.

Dr. John H. Halpern, an assistant professor of psychiatry at Harvard Medical School and researcher at McLean Hospital outside Boston, one of the country's leading psychiatric hospitals, said there's an "overabundance of case reports" suggesting marijuana aids PTSD sufferers. In a recently published paper, Halpern presented a case study he helped conduct on a PTSD sufferer whose marijuana use dramatically eased his symptoms.

But the politics of marijuana bogs down any meaningful examination of its benefits, Halpern said.

Halpern is one of only a handful of U.S. researchers to conduct clinical research on humans using a so-called Schedule 1 drug. That category of drugs, which includes marijuana, heroin and ecstasy, is defined as substances that have a "high potential for abuse" and "no currently accepted medical use."

Halpern said when it comes to research proposals involving Schedule 1 drugs, only marijuana studies are required to undergo an additional review by the National Institute on Drug Abuse. The agency's research focus is on drug abuse and addiction.

"We are at this point because there are limited treatment options for people with PTSD," Halpern said.

Society ought to help people who are suffering, "whatever the public policy issues are," he said.

"Sometimes we have to tolerate a lot of things," Halpern said, "for someone to have an improved quality of life."

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