In Colorado, a Post Traumatic Stress Disorder diagnosis will not get you a red card. At the outset, Amendment 20, the state constitutional provision legalizing medical marijuana, listed eight qualifying conditions and included a provision for adding more through petitioning the Colorado Board of Health.
Last summer, the board chose not to add PTSD, saying there's not enough scientific evidence to support the efficacy of medical marijuana as a treatment.
Ironically, a study that could produce sufficient results was approved by the board and funded by the Colorado Department of Public Health and Environment just a year earlier. Principal investigator Dr. Sue Sisley — booted from the University of Arizona for her risky interests in 2014 — was awarded $2 million for her study on cannabis in treating combat vets diagnosed with PTSD. Sisley's first-of-its-kind, randomized, controlled trial would add to the existing body of research already suggesting that medical marijuana works against PTSD.
But, with hurdle after hurdle in her way, those results are years from publishing.
One hurdle, strangely enough, is access to cannabis. Sisley must source the plants for her study from the National Institute on Drug Abuse, which, at its one grow at the University of Mississippi, can't produce the kind of cannabidiol-rich strains she needs.
"I could walk into any dispensary in Colorado and get this stuff," she said in an interview in July. "Now if we were studying harmful side effects of marijuana ... we would've been green-lighted immediately. But because we dared to study the effectiveness of marijuana, that puts us in this permanent limbo."
Not content with waiting around, five PTSD patients (four of them vets) sued the state health board to get that July vote overturned. That case is still pending in Denver district court, with a decision expected in the next six weeks.
The plaintiffs' argument is that the board made an "arbitrary and capricious decision" when it ignored significant scientific and medical support in favor of an unattainable standard of rigor — at the expense of people who urgently need medicine.
"When someone is truly at the end of their rope, looking for anything that would give them relief, they're not thinking about possible side-effects," says attorney Adam Foster of the Denver-based firm Hoban & Feola, trying to verbalize the absurdity of denying a desperate person access to a natural plant that's far more benign than regularly prescribed, highly addictive and potentially lethal opioids.
The Food and Drug Administration approves two medications for PTSD, Paxil and Zoloft, neither more effective than a placebo, according to research published in the Journal of the American Medical Association. Doctors regularly prescribe a "combat cocktail" — a slew of SSRIs (selective serotonin re-uptake inhibitors), benzodiazepines and antipsychotics and other antidepressants — with documented potential for abuse and other undesired side-effects.
From a legal perspective, Foster points out that in Amendment 20, Colorado voters allowed the Board of Health to add conditions. Yet no petition has ever been approved. "I don't believe in conspiracy theories, I think they're trying to be good," Foster says of the appointed board. "But it really begs the question, is [adding a condition] really possible in practice?"
Legislation to add PTSD failed in 2014 but could resurface should this lawsuit fail. Rescheduling marijuana under the federal Controlled Substances Act (which the DEA recently hinted it might do soon) also would help Sisley proceed with her study.
Colorado would in no way be a trailblazer on this issue. Eleven other states already allow PTSD patients access to medical marijuana.
Sisley, outside the board room after that now-infamous vote, expressed frustration:
"It doesn't take a big backbone to be on the side of science. Why does that require so much courage?"