Enlisting Marijuana and MDMA to Fight PTSD

October 31, 2017

Veterans turn to forbidden cures for relief from their nightmares.

After deploying to Iraq for a seven-month tour of duty in 2004, Nigel McCourry recalls, “I was engaged in a fight every day, whether it was gunshots or bombs blowing up next to me or land mines. It was the most intense experience of my life.”

That experience did not end when McCourry, a U.S. Marine, returned to the United States. “It didn’t matter if it was a year or four years or six years after coming back from Iraq,” he says. “There was no sense of separation of time. The experience was so fresh that I was constantly reliving it. I was alive in it.”

Separation was also elusive for Roberto Pickering, another Marine, who arrived in Iraq a year before McCourry and served nine months there. “We saw a lot of heavy combat during the initial invasion of Iraq,” he says, and “I lost a few very close friends who were in my unit.” After he got back to the U.S., he “lost another couple of friends in further deployments of the unit.”

Finding it impossible to achieve emotional distance from their experiences in Iraq, both men struggled to make new connections or renew old ones. Even getting a decent night’s sleep was a challenge.

“I ended up drinking a lot, basically as a way of forcing myself to pass out at night,” McCourry says. Pickering was “self-medicating heavily with alcohol and severely suffering a depression.”

Years of anxiety and alienation left McCourry despondent. “I had this war inside of me that would flare up without warning,” he says. “I couldn’t live with it anymore. I got to the point where the thought of living day in and day out like that for the rest of my life was so miserable I wanted absolutely nothing to do with it.”

Pickering could not hold a job. “I was incapacitated,” he says. “I was a zombie.”

For both men, the journey back to the land of the living began with illegal drugs.

McCourry enrolled in a study of MDMA-assisted psychotherapy and was amazed by how quickly it made a difference. After years of insomnia and nightmares, he was suddenly able to sleep through the night. Within two years he felt like this “huge healing event had taken place,” because he finally “had this sense of separation from the experiences of Marine combat.”

Pickering used marijuana to replace alcohol and the “kamikaze cocktail” of prescription drugs—sleeping pills, anti-anxiety meds, mood stabilizers—that had previously left him foggy. “It got my head back on straight,” he says. “I still struggle sometimes, but I’m leaps and bounds beyond where I was.”

Psychiatrists call the problems Pickering and McCourry encountered after serving in Iraq post-traumatic stress disorder (PTSD). People who qualify for that diagnosis find themselves re-experiencing a traumatic event (through nightmares or flashbacks, for example); avoiding trauma-related thoughts, feelings, or reminders; and experiencing negative emotions that may include depression, isolation, and excessive guilt or blame. They are also prone to “fight or flight” symptoms such as hypervigilance, a heightened startle reaction, irritability, and difficulty sleeping or concentrating.

Research suggests about 30 percent of Vietnam War veterans experience PTSD at some point in their lives. In the late 1980s, the National Vietnam Veterans Readjustment Study found that 15 percent were at that point diagnosed with the disorder. Annual rates for veterans of the Gulf War and the wars in Iraq and Afghanistan seem to be in the same ballpark: somewhere between 11 percent and 20 percent, according to studies cited by the Department of Veterans Affairs (V.A.). By comparison, the annual incidence of PTSD among adults in the general population is about 3 percent. Nearly 1 million veterans are receiving compensation for disabilities that are at least partly due to PTSD, according to V.A. records.

The age-adjusted suicide rate is also higher among veterans than in the general population: about a fifth higher for men and more than twice as high for women. The upshot is that hundreds of thousands of veterans with PTSD, including at least some of the 20 or so who kill themselves every day, might be interested in trying the substances that Pickering and McCourry credit with helping them reclaim their lives.

The main obstacle they face is the federal government’s pharmacological taboos, which impede access to those drugs and scientific validation of their benefits. But thanks to the work of a plucky and persistent organization founded three decades ago, MDMA and marijuana could be available as doctor-prescribed medicines sooner than you might think.

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