Big Pharma Round-Up V (#Cannabis edition)


Large Indoor Marijuana Commercial Growing Operation With Fans, Greenhouse, Equipment For Growing High Quality Herb. Cannabis Field Growing For Legal Recreational Use in Washington State

PTSD, Peacekeeping, and Politics by Adam Montgomery

(It’s an honour to have Dr Adam Montgomery share his thoughts on trauma, the military, and PTSD. You can read more of his work in a forthcoming book, The Invisible Injured: Psychological Trauma in the Canadian Military from the First World War to Afghanistan.)

PTSD, Peacekeeping, and Politics

In the twenty-first century, it seems that trauma is everywhere. From soldiers to emergency medical workers, there has been a growing awareness since the new millennium about the effects of psychological trauma on long-term mental health outcomes. We now routinely hear about post-traumatic stress disorder (PTSD) after natural disasters, car or train accidents, sexual assault, and even war journalism.

But while the Western world is now keenly attuned to trauma and PTSD, each nation has had its own unique historical experience with this complex and thorny disorder. In America, the PTSD concept first grew out of the Vietnam War and the social alienation felt by returning American soldiers. Working with anti-war psychiatrists in the late 1970s, Vietnam veterans were able to gain recognition (and in some cases, compensation) for both the traumatic events they witnessed and a social ostracism which stripped them of any ability to tie their service to a nationally supported cause. PTSD was, for better or worse, as much a political disorder as a medical one in 1980s America.

Stemming as it did from socio-political turmoil, PTSD was initially dismissed by other Western nations as a unique, American-specific phenomenon; that is until they, too, discovered PTSD symptoms in their own citizens. In Britain, the Falklands War and subsequent difficulties faced by British veterans spotlighted the reality of PTSD and slowly forced the British government, psychiatrists, and military brass to accept the reality of war trauma. By the late 1980s, trauma and PTSD were seen as a natural outcome of witnessing death and destruction.

In Canada, a nation that had not been at war since the Korean conflict of the 1950s, PTSD was also viewed as an American-specific phenomenon throughout the 1980s. Despite ample experience with shell shock and battle exhaustion in the First and Second World War, the Canadian military quite simply forgot about trauma from the 1950s until the end of the Cold War.

Then, everything changed overnight. With the fall of the Soviet Union in 1991, the United Nations and its allied countries were thrust into a plethora of peacekeeping missions; in several regions where there was little or no peace to keep. In Rwanda and the former Yugoslavia, for example, Canadian peacekeepers were faced with numerous traumatic events, such as ethnic cleansing and combat with belligerent forces. Unfortunately, they returned to a Canada that cared little for their service.

Caught up in a series of scandals such as the murder of a Somali teenager by Canadian paratroopers in Somalia in 1993, the Canadian military and Department of National Defence wished to suppress any unpalatable overseas experiences. Thus, they initially denied peacekeepers faced any post-tour issues. But by the late 1990s, with Lieutenant-General Roméo Dallaire’s public battle with PTSD following his time as Force Commander in Rwanda in 1993-94, and a growing chorus of traumatized rank-and-file peacekeepers, PTSD became a cause for national concern.

The Croatia Board of Inquiry, called in 1999 to investigate the possible exposure of Canadian peacekeepers to toxins in Croatia, found quite another cause for soldiers’ suffering. After dozens of testimonies from peacekeepers, many of whom told tales about cleaning up dead bodies, watching belligerents’ bodies being dragged through the streets, and having guns pointed at their heads by Croat and Serb soldiers, the board concluded that soldiers’ trauma and subsequent health difficulties were caused not by toxins, but intense psychological duress.

Canadians at first demurred. Peacekeeping had become Canada’s defining contribution to global politics in the 1950 to 1980s period; it was viewed as a relatively benign and adventurous experience for Canadian soldiers. How could ostensibly peaceful tours cause the same after-effects as war? By questioning peacekeeping, Canadians had to turn inward and question their own national identity. Naturally, this introspection took time, and to some degree the peacekeeping myth – a belief that peacekeeping involves simply patrolling a well-defined zone of separation between belligerents and handing out candy to local children – endures.

What has changed, though, is Canadians’ understanding that a percentage of soldiers exposed to traumatic events, whether on peacekeeping or war operations, will return with long-term mental health challenges – the most obvious being PTSD. My book, The Invisible Injured, explores all of the aforementioned themes and events, and argues that PTSD and its antecedents should be viewed not just as medical conditions, but also as profoundly shattering social experiences which are intimately linked to politics as well as Canada’s need to define itself as a middle power in world events. PTSD’s effects include not just nightmares and flashbacks; they also include possible release from the military, pension battles, and social ostracism. In the post-Afghanistan era, when the Canadian government is making plans to once again commit Canadian soldiers to peacekeeping missions in Africa, history can once again play a role in demonstrating not just where we have come from, but where we are going.


Adam Montgomery is the author of the forthcoming The Invisible Injured: Psychological Trauma in the Canadian Military from the First World War to Afghanistan (McGill-Queen’s University Press, 2017).


Clarify Pot Policy for Veterans

Today I wrote a short viewpoint for the Star Phoenix. The article is on medical cannabis for Canadian veterans.

Auditor General Michael Ferguson has raised important questions about the increasing use of medical marijuana by Canadian military veterans.

As authorities contemplate enforcement actions and zoning bylaws relevant to marijuana dispensaries, and the federal Liberal government prepares for legalization in 2017, Ferguson is urging the Department of Veterans Affairs to address the amount of medical cannabis being prescribed to veterans. He found the quantity prescribed was “poorly documented” and not always evidence-based.

Ferguson focused more broadly on how Veterans Affairs has been managing drug benefits for former servicemen and women, some of whom have complicated health issues and suffer from mental health conditions such as post-traumatic stress disorder. The AG made it plain that it’s time to cut through the haze and clarify marijuana policy for veterans.

The core problem rests with the amount of cannabis veterans are authorized to take. In 2014, Veterans Affairs doubled the amount to 10 grams per day for eligible veterans. Yet, for Health Canada this is twice the amount it considers safe. An internal Health Canada document showed that more than five grams has the potential to increase risks to the cardiovascular, pulmonary and immune systems, as well as psychomotor performance. It has a chance of increasing the risk of drug dependence.

Ferguson’s office could not find any evidence to support this decision to increase the threshold. Veterans Affairs Minister Kent Hehr expressed shock in March that his department lacked an “informed policy” on the use of medical cannabis, even as number of claims by veterans for medical marijuana grew more than tenfold over the past two years.

According to figures provided by Veterans Affairs, 112 veterans were reimbursed for medical marijuana in 2013-14, The following year, it was 628. By March 2016 that number has risen to 1,320.

Mike Blais, president and founder of Canadian Veterans Advocacy, has been abundantly clear about veterans’ consumption of medical marijuana: “I think there should be no cap, and that every case should be judged on individual merit and that the doctor’s prescription is paramount.”

At the same time, Canadian Forces have taken an alternative stand. In 2014, H.C. MacKay who was then the deputy surgeon general of the Canadian Forces, made clear that “with respect to marijuana use for medical purposes, we have identified what appears to be a very significant policy divergence between Veterans Affairs Canada and Canadian Armed Forces.”

In short, even though Veterans Affairs was funding medical marijuana, the military’s health service did not recognize it for medical use. With respect to PTSD, the Canadian Forces have also suggested there is insufficient evidence to authorize marijuana use and could even be detrimental to veterans’ health.

Marijuana remains a highly contested medicine for various scientific, political and social reasons. That is obvious. However, the auditor general report reaffirms how it and the policies surrounding the medical treatments for Canadian veterans require significant clarification.

Lucas Richert teaches the history of pharmaceutical and recreational drugs at the University of Saskatchewan.

Below the CBC covers the story.