It was 2007 and less than three months into U.S. Army Captain Ryan Miller’s tour of Iraq when an explosively formed penetrator, an especially nasty type of IED, barreled into his armored car while he was on patrol in southern Baghdad. The EFP is designed to pierce through just about any surface, and it did. A soldier in Miller’s car died, and Miller should have died too. Instead, the bomb annihilated his left leg and shattered his tibia, leaving him with a “knee full of holes.” Shrapnel also ripped through his back, traveled up his body and tore through his liver, bladder and intestines, causing extensive soft tissue damage to his abdomen. Thanks to improvements in treatment, including the experiential learning of trauma surgeons and the increased use of tourniquets on the battlefield, Miller survived the injuries. “Any other war, maybe even a year earlier than this war, I would have been dead,” says the 34-year-old today.
After his first 100 days as a hospital inpatient, Miller rotated in and out of medical facilities for more than three years, undergoing approximately 15 surgeries and ultimately receiving a high-tech prosthetic leg. Miller’s surgeries occurred at a time of “peak opiate [prescription]” in the military, he says. At the time of his treatment, he was being seen by a combination of Army doctors, civilian specialists and health care professionals from the U.S. Department of Veterans Affairs. At one point, doctors had prescribed him more than a dozen drugs, including Fentanyl, Dilaudid, Morphine pills, Vicodin and Percocet.
According to the Center for Investigative Reporting, prescriptions for the primary opiates—hydrocodone, oxycodone, methadone and morphine—administered by the VA spiked by 270 percent from 2001 to 2013. In January 2008, Miller was prescribed high doses of methadone, a painkiller commonly used to wean addicts off heroin. The methadone pills were supposed to help manage the nerve pain that rattled through the remains of Miller’s leg. He took the opiate for two and a half years, after which he tossed a mostly full bottle into a medicine drop-off bin, severing ties with the heavy-hitting drug in what he now describes as “a proud moment.” Although Miller was spared the debilitating side effects wrought by many opiates, such as liver damange, brain damage, nausea and vomiting, methadone did impact him in one major way: memory loss. “It really, really, really, causes havoc with memory,” says Miller, who was in a relationship throughout his treatment. “I don’t remember half the things we did together.”
If Miller had been offered medical cannabis, he says he would have opted for it “in a heartbeat” instead of the “opiates, benzodiazepines, Lyrica and other pharmaceuticals thrown at me.” Memory loss withstanding, Miller is one of the lucky ones. Veterans are twice as likely to die from an accidental opiate overdose than the general population, according to the VA.
Veterans are fighting the Drug Enforcement Administration’s war on weed on the frontlines—a battle that has been emboldened as of late by Attorney General Jeff Sessions.
The federal agency has been widely recognized for prescribing dangerous painkillers with abandon. Over-prescribing opiates can lead to addiction, life-changing side effects and even death by accidental overdose. Over the course of two years, the VA had issued, on average, more than one opiate prescription per patient, according to a 2013 report from the Center for Investigative Reporting. That same year, the VA and Veterans Health Administration, citing a “mounting body of research detailing the lack of benefit and potentially severe harm of long-term opioid therapy,” launched its Opioid Safety Initiative to better monitor the dispensing of the powerful drugs and push alternative therapies, such as acupuncture. The department is now trying to correct its systems that have unintentionally helped shape America’s modern-day opiate epidemic, which affects more than 10 million people a year. In August, a White House commission created by President Donald Trump and headed by New Jersey governor Chris Christie advised the president to declare the opioid epidemic a national public health emergency. According to a report by PBS, “Since 2012, the height of the VA’s opioid prescribing, the department has reduced the number of veterans receiving opioids by 20 percent, and cut the overall opioid dosages for about 17,000 patients.”
Having seen the destruction wreaked on their brethren, and in the face of increasing public support, Miller and a growing number of military veterans are now becoming ambassadors of medical marijuana, fighting the Drug Enforcement Administration’s war on weed on the frontlines—a battle that has been emboldened as of late by Attorney General Jeff Sessions. Today, marijuana is Miller’s primary therapy, from treating ailments to replacing alcohol in social circumstances. What’s more, his advocacy is a direct protest of Congress’s inaction and the policies of the Veterans Health Administration (VHA). That inaction most recently took form in the failed efforts to pass the Veterans Equal Access amendment. Introduced by Democrat Representative Earl Blumenauer of Oregon in March as part of the VA’s 2018 funding bill, the amendment moved to “authorize VA health care providers to provide veterans with recommendations and opinions regarding participation in their state’s marijuana programs.” The House Rules Committee stripped the amendment from the funding bill, however, in late July, effectively blocking a vote to allow VA doctors to advise patients on medical marijuana use. A similar Blumenauer-sponsored amendment failed to pass in 2016, despite bipartisan support, after it disappeared from the final appropriations bill in which it was originally included.
Despite growing support for medical marijuana—recent polls show upward of 90 percent of U.S. voters are in favor of the drug if prescribed by a doctor—the VA still can’t recommend its as treatment. That’s because as a federal agency, the VA, which provides health care services to nearly nine million people, defers to federal law. Of course, under federal jurisdiction, medical marijuana is illegal and still a Schedule I drug, defined as having “no currently accepted medical use” and lumped alongside LSD and heroin.
Earlier this year in May, Veterans Affairs Secretary David Shulkin responded to questions about medical marijuana and its capacity to treat veterans at a White House briefing. Although non-committal, Shulkin did state that everything that could possibly help veterans should be considered and debated, and that includes cannabis. “There may be some evidence that this is beginning to be helpful, and we’re interested in looking at that,” Shulkin said. But as Blumenauer says, “We know that states that actually have medical marijuana, prescribe fewer pills.”
The VA declined Playboy’s interview requests but did issue a statement via email confirming that the department “may not prescribe or facilitate access to medical marijuana.” In addition, according to standards listed on the VA’s website, doctors can’t fill prescriptions for cannabis, clinicians can’t fill out the paperwork needed to participate in 29 states’ legal medical marijuana programs and veterans are prohibited from using or possessing marijuana on VA property.
“While patients participating in state marijuana programs must not be denied VHA services, comprehensive care includes assessment for potential interactions with other prescribed treatments as well as providing information to reduce risk of usage,” the VA told Playboy via email. “Decisions to modify treatment plans need to be made by individual providers in partnership with their patients.”
Some veterans say this policy provides just enough grey areas such that those in more conservative states are hesitant to disclose their cannabis use to VA doctors out of fear they’ll lose their benefits. If veterans do decide to use medical cannabis, they must buy it out of pocket, which means either securing a recommendation from a private doctor or procuring it illegally.
In 2016, Miller left a corporate job at a large health care company to study at Oaksterdam University, the country’s first cannabis college, founded a decade ago in Oakland, California. He’s now in the process of launching a cannabis employment marketplace called Field that intends to fill the industry’s needs for temporary and short-term employment, hopefully with veterans. Much like the success Miller’s had using cannabis tinctures and edibles to help him sleep and for his overall health, many more veterans have reported success in using marijuana to manage chronic pain, calm post-traumatic stress disorder, ease anxiety and help improve wellness.
“They’ve made addicts out of us,” says 35-year-old U.S. Army veteran Colin Zaremba of the VA. According to Zaremba, veterans often go in for something as simple as acne and they walk out with a Vicodin prescription. When he left the military in 2005 with asthma, PTSD and chronic knee pain, he says the VA tried to “shove all these opiates down my throat.” He refused to take the pharmaceuticals and instead opted to start growing his own personal supply of pot.
After learning from a grower on the south side of Chicago, Zaremba uprooted himself and his family and relocated to Michigan in 2012, where medical marijuana is legal. (Illinois opened its first legal medical dispensary in 2015.) Three months later, Zaremba was arrested and charged with two felony counts of manufacturing and delivery of a controlled substance, even though he operated within a compassionate care state. He fought the charges for more than a year and after being treated “like a criminal,” subject to twice-weekly drug tests and a 7 p.m. curfew, Zaremba got his charges reduced to a misdemeanor and served no jail time.
They’ve made addicts out of us.
While this close call would be enough to scare off many from the industry, Zaremba channeled the spirit of the Army. “Failure’s not an option,” he says. “I used the military mindset.” Zaremba returned to the weed biz at the behest of a desperate friend whose mother was dying from Stage 4 cancer. Zaremba tried his hand at extraction to make cannabis oil for the woman; upon consumption, Zaremba says, her condition began to improve rapidly. For the first time, he saw cannabis’ capacity to not just manage symptoms, but treat cancer. “What I’m trying to do with my life, what I want to do in this industry changed forever,” he says. “We shifted our whole entire business toward curing patients.”
In January, Zaremba moved to Oregon to work for cannabis cultivator Savant Plant Technologies. He’s now an activist for the therapeutic properties of marijuana in veterans and is in the process of opening PTSD Farm 4 Vets, a retreat for veterans and first responders where they can consume cannabis and learn how to grow it, cook with it and use it to improve their health and well being.
Seven hundred miles down the coast, 45-year-old U.S. Marine Corps veteran Scott Breitenstein has settled into life with his wife and two kids in Venice, California. Breitenstein served in the military from 1990 to 1995; he was deployed in the Gulf War, served in Somalia and Mogadishu and left the service with PTSD, anxiety and Traumatic Brain Injury. Booze became his drug of choice; while effective in curbing anxiety, for veterans with PTSD it just “throws fuel on the fire,” he says.
After the bottle came the pills, says Breitenstein, and mostly antidepressants and Vicodin. At peak use, he was swallowing 20 to 30 pills a day, mixing them with alcohol. His relationships deteriorated and he grew “sick of feeling and looking like shit.”
His medicine cabinet looks a lot different today. “The only thing I get from the VA is my asthma medication,” says Breitenstein. “I don’t use Motrin. I use CBD.” A “late bloomer” when it came to cannabis, Breitenstein says that after some experimentation, he’s found the right combination of marijuana strains and methods of consumption that allows him to “act human instead of [like] an insane zombie on alcohol.”
“I did not use cannabis until I was 25 years old and I didn’t use it properly until I was 30,” he says. “I rarely get high, but I absolutely need to medicate.” Now, Breitenstein is paying it forward, working with the American Legion in Hollywood to educate veterans about the benefits of cannabis to treat PTSD, depression and pharmaceutical dependency, to name a few. He’s also in the process of opening a cannabis treatment center in upstate New York, where he’s from, for veterans and civilians suffering PTSD and chronic pain.
While veterans continue to bootstrap their own network of cannabis growers, educators and health care providers, the VA remains frozen between politics and progress. The agency has publicly acknowledged that opiates can be dangerous and are often over-prescribed yet refrains from cannabis therapies. If you ask some veterans, Big Pharma’s financial chokehold on the VA drives the agency’s reluctance, but there’s another major logistical hurdle: the federal government’s reticence to reclassify the drug.
Comprehensive studies would help prove what conditions cannabis is a viable medical treatment for, which would help get it rescheduled, but Schedule 1 classification makes it highly difficult for researchers to get access and federal funds. Product cleared for federal testing comes from one DEA-sanctioned weed farm in the U.S., a 12-acre plot at the University of Mississippi that recently came under fire for growing weak, sometimes moldy, marijuana that’s nothing like the quality of product available to the masses. Scientists from the Multidisciplinary Association for Psychedelic Studies called attention to the government’s sub-par weed after requesting it for a study on cannabis’ effects on veterans with PTSD, PBS reported in March. Johns Hopkins University, slated to help conduct this study, pulled out of it at the last minute, in part because the government’s weed that contained too low of THC levels, according to Leafly.
While science struggles for footing, legislators go on attempting to enact change. In May, Congress denied Attorney General Jeff Sessions money for his quest to persecute states that have legalized medical or recreational weed. The month prior, Florida Representatives Matt Gaetz, a Republican, and Darren Soto, a Democrat, introduced a bipartisan bill that would reclassify marijuana as a Schedule III drug, making it more accessible for scientific research and categorizing it alongside drugs like steroids. But every previous legislative attempt to do the same has failed.
Congressman Earl Blumenauer of Oregon, whose Veterans Equal Access amendment was blocked in July, said that for veterans, the solution is even simpler than rescheduling. Medical marijuana doesn’t need to be re-classified, he says. We just need to get rid of the “stupid guidance” implemented by the VA and allow doctors to follow the practices of their individual states. “It’s not law—it’s just what the VA has taken upon itself,” he says.
A longtime medical marijuana advocate, Blumenauer, who was a member of the Oregon legislature in 1973 when the state became the first in the country to decriminalize weed, is now leading change on a range of cannabis-related issues, including that of access for U.S. military veterans. “Veterans should not have to pay extra out of their own pocket for a different doctor that doesn’t know them as well,” says Blumenauer. “Medical marijuana has proven to be very successful therapy for a wide variety of conditions, particularly those that affect our veterans.”
This summer, New Jersey Senator Cory Booker introduced the Marijuana Justice Act, which would remove marijuana from the DEA’s list of scheduled substances, effectively decriminalizing the plant at the federal level. The Democrat’s manifesto for introducing the bill focuses more on how the government’s decades-long War on Drugs has overwhelmingly hurt low-income communities and people of color. “Our country’s drug laws are badly broken and need to be fixed. They don’t make our communities any safer – instead they divert critical resources from fighting violent crimes, tear families apart, unfairly impact low-income communities and communities of color, and waste billions in taxpayer dollars each year,” Booker said in a statement. But while reframing marijuana criminalization as a class issue on a national stage is revolutionary, Booker’s bill is not expected to get any real legislative traction.
In the meantime, Blumenauer will continue to advocate for veteran access and plans to reintroduce the Equal Access amendment. The timing of that is yet to be determined, but Blumenauer says change is near. “The last five years have been remarkable,” he says, “and I think the next five years it’ll all come to a head.”
[*Editor’s Note: An earlier version of this article incorrectly described Ryan Miller’s previous employer. It was a health care company, not a Silicon Valley startup.]